What is periodontitis?

Written by Li Bao Hua
Dentistry
Updated on September 05, 2024
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Periodontitis is an inflammation of the periodontal supporting tissues, including the gums, periodontal membrane, alveolar bone, and cementum. The early stages of periodontitis are mainly caused by irritants such as tartar, plaque, and soft deposits around the teeth, leading to swollen, pus-leaking gums, or bleeding during eating and brushing. If not treated promptly, tartar will adhere above and below the gums, forming supragingival and subgingival calculus. For calculus above the gums, ultrasonic cleaning, also known as dental scaling, is required. For calculus below the gums, it can be removed through curettage. If the mobility of the teeth improves after removal, the periodontitis can then enter the maintenance phase for the teeth.

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Written by Li Bao Hua
Dentistry
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Is periodontitis serious?

Periodontitis is a development of gingivitis. To determine the severity of periodontitis, an X-ray of the teeth is required to check for pathological bone resorption in the alveolar bone. If the symptoms are limited to the gingival tissue, such as simple gingival bleeding, brushing bleeding, gingival swelling, or pus discharge, it can be managed by dental cleaning or ultrasonic scaling, followed by medicated irrigation around the gums to improve the inflammation. If subgingival calculus is present, it might also be addressed with scaling or root planing to remove the calculus. If there is significant alveolar bone resorption due to severe periodontitis, the condition is serious and may require guided bone regeneration surgery. In severe cases, tooth extraction may be necessary.

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Can periodontitis be cured?

Periodontitis is divided into early and late stages. Early periodontitis can be cured, while late periodontitis is difficult to treat and may require tooth extraction if severe. Periodontitis is an inflammatory, destructive resorption that occurs in the periodontal supporting tissues. There are usually significant amounts of dental calculus and plaque around the teeth. The initial treatment involves removing these through teeth cleaning. After cleaning, applying medication through rinsing around the gums can be helpful, and in many cases, this can lead to a cure. Generally, early periodontitis does not involve noticeable absorption of the alveolar bone. However, in advanced stages, the formation of periodontal pockets and absorption of the alveolar or jaw bone represent severe manifestations of periodontitis. If it is difficult to maintain or restore oral health through basic treatment in such cases, tooth extraction may be necessary.

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What are the symptoms of periodontitis?

Periodontitis stems from the further development of gingivitis, sharing many symptoms, including gum redness, congestion, and pain when eating. Additionally, periodontitis can cause teeth to become loose, and in severe cases, lead to tooth loss. There is also the presence of a periodontal ligament condition. Generally, gingivitis corresponds to a pseudo periodontal ligament while periodontitis involves the actual periodontal ligament due to the resorption of the alveolar bone—this distinction is crucial in differentiating gingivitis from periodontitis. Periodontitis features true periodontal ligament formation concurrent with the resorption of the jawbone. Dietary precautions for periodontitis include avoiding hard foods and not chewing hard objects to prevent resorption of the alveolar bone in the root apex area.

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Can teeth be extracted with periodontitis?

Teeth should not be extracted during a periodontitis flare-up, as it may involve symptoms like swollen gums, pus discharge, or the presence of inflammatory processes in the periodontium. Extracting teeth during such a flare-up could lead to the systemic spread of the inflammation, potentially causing severe conditions such as bacteremia or sepsis, and even life-threatening situations. Periodontitis involves the resorption of the supporting periodontal tissues. If periodontitis can be managed by cleaning the teeth to remove local irritants, or through guided bone regeneration, and if the teeth can be preserved, it is generally best to avoid extractions. Teeth that can be preserved should be retained. However, if the periodontitis has caused severe lesions and the teeth cannot be preserved, showing signs of looseness or are even on the verge of falling out, extraction should only be considered after the inflammation is under control.

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Is periodontitis stage two serious?

Periodontitis stage two indicates that the resorption of the patient's alveolar bone has reached a certain degree, necessitating systemic periodontal treatment at an established hospital's dental department. In severe cases, periodontal surgery may also be required. Periodontitis is a chronic inflammatory disease caused by microorganisms accumulating around the teeth, eroding the ligaments, alveolar bone, and dentin around the teeth. Stage two periodontitis indicates a certain degree of alveolar bone resorption, resulting in the loss of attached gingiva and alveolar absorption. The patient's teeth may exhibit some mobility and potential shifting. Systemic periodontal treatment at an established hospital's dental department is required, including supragingival cleaning, subgingival scaling, root planing, and, in severe cases, periodontal surgery. Therefore, it is important to maintain oral hygiene, brush your teeth morning and evening, rinse after meals, use the internationally recognized Bass method of brushing, avoid spicy and stimulating foods, and eat fresh vegetables and fruits regularly.