What's wrong with the gums - periodontal disease, periodontitis or occlusal injury?

Soldatova Lyudmila Nikolaevna

Candidate of Medical Sciences, Professor of the Department of Clinical Dentistry of the St. Petersburg Medical and Social Institute, Chief Physician of the Alfa-Dent Dental Clinic, St. Petersburg

Periodontal disease is one of the most dangerous and insidious dental diseases, which can lead to the complete loss of not only single teeth, but also entire dentitions. Periodontal disease practically does not affect the teeth themselves, however, under its influence, periodontal tissue is destroyed - that part of the gum and jaw that is in direct contact with the root of the tooth and ensures its fixation. Not only the soft tissue of the gums weakens and collapses, but also the bone tissue, as a result of which the teeth become loose and there is a threat of their complete loss.

Degenerative processes in gum tissue that occur during periodontal disease develop under the influence of a number of factors, none of which researchers single out as the main and only one. Patients suffering from periodontal disease almost always exhibit certain trophic and circulatory disorders in the gum tissue, in particular of an atherosclerotic nature. However, such disorders can arise as a consequence of a wide variety of pathologies. Among the reasons that can provoke the occurrence of periodontal disease, experts name various dysfunctions of the endocrine and digestive systems, vascular diseases, neurological diseases and occlusion pathologies, single or regularly recurring injuries. Bad habits (alcohol and tobacco consumption), poor nutrition, which causes a lack of vitamins and minerals, and a persistent decrease in immunity, leading to increased activity of pathogenic and opportunistic microorganisms in the oral cavity, play a role in this process.

Unfortunately, today there is not a single drug that could completely restore destroyed tissue and reverse the process of development of periodontal disease. However, the use of a complex of physiotherapy and medications makes it possible to stop the progression of the disease, stabilize the patient’s condition and help the body regenerate damaged periodontal tissue. The leading role in achieving this result belongs to medications. You will learn about how to treat periodontal disease with medication from our material.

Introduction

The information world is very huge. Each of us is haunted by a million points of view

for any problem in any field of knowledge, you just need to ask a search query. The same thing happens in medical circles on the Internet - discussions of health problems are widely represented by both patients and doctors and often reach the point of absurdity:

For example, in questions:

• loosening of the tooth,
• exposure of the neck of the tooth,
• why are my gums and teeth exposed?

that is, in situations where the gums on a tooth have receded, patients are always confused: they have periodontal disease

, then suddenly it changed to
periodontitis
, then periodontal disease returned again. And the search for an answer to the question becomes endless.

The problem of “how to treat periodontal disease” is picked up by doctors who only add fuel to the fire by recommending medications and even folk remedies for periodontal disease, without having sufficient competence to do so.

Let's consider these points of view professionally, and try to convey one simple truth, which for the vast majority of patients (and even some doctors) will be a revelation: the diagnosis of periodontal disease of the gums

» —
does not exist
.

An expert point of view is expressed by the famous periodontist, Doctor of Medical Sciences Laura Mikhailovna Tebloeva:

As a rule, for patients who come to me and say: “I have periodontal disease,” I always clarify - did you make this diagnosis yourself or did you see a doctor? Often patients answer that they have this information from their doctor. It turns out that the patient did not read somewhere and determine the diagnosis of “periodontal disease” for himself, but, unfortunately, such a diagnosis was made by a doctor.

Symptoms

Periodontal disease is an extremely rare disease. It is most often encountered by older people. The disease develops unnoticed: patients may not even be aware of it. Usually the pathology is discovered by a dentist during a routine examination.

Symptoms of periodontal disease are similar to those of other diseases:

• unpleasant odor;
• swelling of soft tissues;
• bleeding and pain of gums;
• reaction to sour, hot, cold;
• discharge of pus;
• taste of blood;
• tooth mobility.

Always treat gum problems

When a patient comes to the doctor, he complains about something. What symptoms does he see a doctor with before receiving a diagnosis of periodontal disease? What worries him?

Literally, patients tell the doctor this: my gums have sagged, my gums have become exposed, my lower gums have receded. And for some reason the symptom of gum subsidence automatically means that the patient has the so-called. periodontal disease.

More experienced patients, who have already heard a lot of professional terms, who delve into the professional colloquial language of doctors, say this: “The necks of the teeth have become exposed a little, the teeth have become a little higher.” But, according to statistics, most patients complain about sagging gums.

And so, when patients come to the doctor with complaints about the problem of exposed tooth necks, the doctor diagnoses them with periodontal disease. Of course, he begins to treat them. And to treat it specifically for periodontal disease.

But time passes, money also goes away, and the question of why the gums recede and the necks of the teeth become exposed, why the gums recede, has not been resolved. And the patient still has periodontal disease.

What tactics are used to treat periodontal disease?

I want to start with the fact that patients who come with a diagnosis of periodontal disease, they need, every single one, treatment... not from the periodontist to whom they initially turned.

If we talk about the tactics of managing patients with the so-called. periodontal disease, which then come to me again, it’s a shame to voice this, but the treatment of periodontal disease was carried out right up to injections of Lincomycin into the exposed gum.

According to statistics, almost always the treatment of periodontal disease in adults with medications is burdened with a course of some antibiotics and physical therapy.

And most importantly, the task of all these manipulations is completely unclear: what do doctors want to achieve in this way, to destroy some kind of flora or to stop some destructive processes in the gums? It is very difficult for me to say what happens to the competence of a doctor who injects antibiotics for the so-called. periodontal disease, but this is absolute blasphemy. Is it possible to cure periodontal disease by destroying the flora? As a result, the gums will never recover.

Treatment of gum periodontal disease reaches the point of absurdity

I would like to note the widest range of drugs and folk remedies that patients use to attempt self-treatment of periodontal disease at home. Among the folk remedies, one can note the treatment of periodontal disease with hydrogen peroxide, and even treatment with soda:

What about the use of various toothpastes for periodontal disease? What goals do patients have? The purpose of toothpaste is preventative, not curative. And no toothpaste will eliminate inflammation, because there is no such inflammation in periodontal disease.

It is not difficult to guess that in these combinations of procedures the question of how to cure periodontal disease remains open.

Clinical researches

The effectiveness of ASEPTA products has been repeatedly proven clinically. For example, clinical trials of ASEPTA gum gel have proven that using ASEPTA gum gel with propolis for a week can reduce gum inflammation by 31%.

Repeated clinical studies have also proven that the two-component mouth rinse ASEPTA ACTIVE more effectively combats the causes of inflammation and bleeding compared to single-component rinses - it reduces inflammation by 41% and reduces bleeding gums by 43%.

Sources:

1. The use of drugs from the Asepta line in the complex treatment of inflammatory periodontal diseases (N.V. Berezina E.N. Silantyeva S.M. Krivonos, Kazan State Medical Academy. Kazan.) N.V. BEREZINA, E.N. SILANTIEVA, S.M. KRIVONOS Kazan State Medical Academy
2. The use of adhesive balm "Asepta®" in the treatment of inflammatory periodontal diseases L.Yu. OREKHOVA*, Dr. med. Sciences, Professor, Head of Department V.V. CHPP**, Dr. med. Sciences, Professor, Head of Department S.B. ULITOVSKY*, Dr. med. Sciences, Professor A.A. LEONTIEV*, dentist A.A. DOMORAD**, O.M. YAKOVLEV** SPbSMU named after. acad. I.P. Pavlova, St. Petersburg - *Department of Therapeutic Dentistry, **Department of Microbiology
3. Study of the clinical effectiveness of treatment and prophylactic agents of the Asepta line in the treatment of inflammatory periodontal diseases (A.I. Grudyanov, I.Yu. Aleksandrovskaya, V.Yu. Korzunina) A.I. GRUDYANOV, Doctor of Medical Sciences, Prof., Head of Department I.Yu. ALEXANDROVSKAYA, Ph.D. V.Yu. KORZUNINA, asp. Department of Periodontology, Central Research Institute of Dentistry and Maxillofacial Surgery, Rosmedtekhnologii, Moscow
4. The effectiveness of the use of Asept “adhesive balm” and Asept “gel with propolis” in the treatment of chronic generalized periodontitis and gingivitis in the acute stage (Municipal Dental Clinic No. 4, Bryansk, Kaminskaya T. M. Head of the therapeutic department Kaminskaya Tatyana Mikhailovna MUZ City Dental Clinic No. 4, Bryansk

There is no inflammation with periodontal disease

When does the so-called periodontal disease, there is no inflammatory process in the gums. The clinical picture of “periodontal disease” differs sharply from periodontitis; it is with periodontitis of the tooth that inflammation occurs.

And injections into the gums, endless restorations of the necks of the gums - this is running in circles. Over time, again all the restoration fillings are chipped, and again these patients come to have these fillings restored again. And this happens endlessly

:

And the diagnosis of “periodontal disease” does not go away. As Desna ran away, she continues to leave. The fillings increase, that is, the teeth increase in size, because the gums sag more and more, and nothing useful happens.

When such a patient gets an appointment with me, unwinding his entire tangle of ordeals during the consultation, it becomes clear that all previously performed gum treatment consists of 3
factors:

• Lost time,
• lost money
• shattered hopes.

The diagnosis was incorrect and the treatment was appropriate for the incorrect diagnosis. What went wrong?

Patients should always go for a consultation with such a diagnosis... to an orthodontist

.
Because periodontal disease is an occlusal injury
.

What I see in these patients with signs of periodontal disease is a completely different diagnosis. This is an occlusal injury that can only be corrected by an orthodontist.

Treatment with antibiotics, dental ointments and gels

Drug therapy is possible after professional teeth cleaning as prescribed by a doctor. Antibiotics should be taken in recommended doses in the absence of inflammatory processes in the oral cavity.

In some cases, during treatment, injections are prescribed simultaneously with the drugs Traumeel and Lincomycin.

To relieve symptoms, the dentist prescribes gels and ointments:

• "Metrogil Denta" is an anti-inflammatory, analgesic agent;
• "Cholisal" - a gel to combat gum inflammation;
• "Kamistad" - for the prevention of gingivitis, relieving swelling, eliminating pain;
• “Gengigel” is a gel that increases blood circulation and promotes the regeneration of soft tissues;
• "Stomatofit" - to relieve severe pain;
• "Asepta" - to stimulate tissue regeneration processes;
• "Solcoseryl" is an antiseptic with a healing effect.

What is occlusal injury

Occlusal trauma is when a tooth experiences excessive stress due to:

• the tooth is not in the dentition,
• the tooth is not in the correct position,
• the tooth has not grown physiologically,
• the tooth is tilted, at the wrong angle.

The occlusion of the teeth is impaired. That is, when chewing in a patient with impaired occlusion, a destructive force of chewing pressure is created, and the bone tissue in the area of ​​these above teeth begins to decrease.

What is chewing from a physiological point of view?

It's teeth hitting teeth. The strongest blow, since the masticatory muscles are the strongest in the body.

In simple words, in a patient, from such a hyper-impact, hyper-contraction of the masticatory muscles, which develops during chewing, from this beating of teeth against each other, the bone begins to contract. Bone tissue shrinks. And after the bone, the gum also contracts, because the bone and gum are tightly connected. The gum descends, following the bone. And here we answered the main question - why gums recede.

Let's now begin to form an understanding of the answer to the next question: what to do if your gums have receded.

What consequences can untreated periodontitis lead to?

Loss of teeth

The advanced stage of the disease destroys the soft and hard tissues around the teeth, which leads to their loss.

Deterioration of conditions for implantation

As mentioned earlier, with severe periodontitis, the volume of the jaw bone is significantly reduced, which makes it difficult to install implants, requiring preliminary bone growth, and in extremely severe cases makes implantation impossible.

The occurrence of other diseases

Periodontitis contributes to diseases of the gastrointestinal tract, diseases of the lungs, heart and even the formation of blood clots.

Orthodontics comes to the fore

Today, a huge mistake is happening both in the search for the causes of periodontal disease and in making a diagnosis, as well as in the method of effective treatment. Instead of putting the tooth into occlusion, removing it from a traumatic bite, patients are offered all these manipulations that I have previously voiced, which are not at all aimed at getting rid of these complaints, but only at the fact that patients are wasting time, the processes are getting worse.

In the treatment of the so-called periodontal disease is a big problem in the loss of time for inadequate treatment, and the loss of time for the patient is a complication of the pathology of dental occlusion, and the transition of the stage of the disease to a more advanced form.

If a patient, for example, three years ago had a loss of bone tissue of two millimeters, then due to the “treatment of periodontal disease” he has already lost five millimeters, that is, we have lost time.

And if he came to the orthodontist with a loss of bone tissue of two millimeters, then it would be easier to stop the loss of gums, it would be easier to eliminate the development of gum pathology after orthodontic treatment, when the teeth become aligned with the dentition.

We can already talk about the fact that we close all exposed necks of gum recession, thereby treating the neck of the tooth. But when patients waste time on treatments that are inadequate for the disease, sometimes closing the recession is no longer possible. Because there are also strict indications and contraindications for the treatment of gum recession.

Question answer

Is periodontal disease inherited?

Yes, this is a chronic disease that can be inherited and be asymptomatic, destroying tissue, but without causing discomfort to the patient.

Is periodontal disease transmitted through kissing?

No, this is not a contagious disease that cannot be contracted through airborne droplets, through shared utensils, kissing, etc. This is a systemic disease that causes disruption of internal organs and is not transmitted from person to person.

Should teeth be removed if there is periodontal disease?

When the disease reaches an advanced stage, the dentist prescribes treatment in the form of strengthening the gums, building tissue, stimulating regeneration and blood circulation. Removal is carried out in the absence of alternative treatment methods.

Is there bad breath?

Yes, when interdental spaces appear, food particles get into them, which serve as a breeding ground for the development of bacteria that cause an unpleasant odor.