Periodontitis: What to Know0June 18th, 2010articles
Periodontitis is often the result of a prolonged, untreated periodontal condition similar to gingivitis –only that periodontitis has a more profound effect on the teeth, making them loose, thereby detaching from the socket at a very visible rate. Periodontitis is the inflammation of the periodontium: the tissues, periodontal ligament and alveolar bone that surround the teeth, which leads to the infectious and rather painless (at first) destruction of the periodontium. If left untreated for some time, the severity of the damage may result to medical complications such as: stroke, myocardial infection, atheroscelerosis, renal failure and larger complications for those who are suffering from diabetes or cancer.
There are two types of periodontitis, chronic and aggressive.
Chronic periodontitis is attributed to rapid tooth loss on adults. Poor glycemic control or fluctuating sugar levels often trigger the early and unprecedented onset of periodontitis in adults. In turn, periodontitis worsens the glycemic control of the body, making it harder for a diabetic patient to recover from diabetes or to live a controlled lifestyle. Periodontitis can also be used to detect diabetes and cancer cell formation. A majority of people who have been treated of their periodontal disease are also subjected to clinical tests, making it easier to narrow down the patient’s medical condition.
Chronic Periodontitis is easier to treat and maintain than Aggressive Periodontitis. There are four systematic steps to disinfect and rehabilitate the damaged periodontium, namely:
1. Full mouth disinfection that uses scaling and root planning to an extent that all the accumulated plaque of the teeth and gum line are complete eradicated and the debridement of the periodontal pocket to prevent any spread of bacteria to healthy periodontium.
2. Open flap debridement is a more sophisticated and a more effective approach, whereby surgical intervention gives way to better clean deeper pocket areas where the periodontitis has spread.
3. Guided tissue regeneration (GTR) is much more effective than open flap debridement and is very expensive, but the benefits will outweigh the costs, especially in severe cases of periodontitis. The accelerated regenerative growth of the new bone and gingival tissue on the patient’s mouth will compensate for the severely degenerated gum tissue that has been depleted by the periodontal disease. GTR will also pave the way for the stability of implants when they have been inserted to replace the lost/fallen teeth.
4. Enamel matrix derivative (EMD) is the same as GTR in terms of cost and effectiveness, though the difference lies on EMD’s ability to lessen pocket depth.
Aggressive Periodontitis is similar to Chronic Periodontitis in some ways, but the former is evidenced accelerated bone destruction and tooth attachment. Aggressive periodontitis affects a younger populace and uses the same treatments mentioned above, only with a higher chance of using extensive surgical debridement paired with strong antibiotics.
To sum up, dentists/periodontists initiate the cleaning process by scrape off the plaque and calculus accumulated on the enamel of the teeth and also below the gum line. Several appointments may follow as some severe cases of periodontitis require scaling and debridement to completely eliminate the plaque and tartar that have stuck below the gum line, which is a very sensitive area. By using antibiotics like amoxicillin or metronidazole, the regenerative process becomes easier.
Prevention of recurring periodontitis starts with a well-maintained oral hygiene. Similar to the treatment for gingivitis, the patient is advised to brush his/her teeth every day, and may also require a special toothbrush (Proxi-brush) for easier removal of dirt and debris that cling in-between teeth.