Periodontology - treatment of gum diseases

The most common gum diseases are gingivitis, periodontitis, and periodontosis. A periodontologist treats gum diseases in the clinic. An effective treatment plan for gum diseases can only be developed after establishing an accurate diagnosis, taking into account the presence of concomitant diseases and aggravating factors.

Gingivitis - is an inflammation of the gums that does not affect the tooth ligaments or bone tissue. Gingivitis is characterized by redness, swelling, and bleeding of the gums. Gingivitis can be acute or chronic. Acute gingivitis can be catarrhal, ulcerative, or necrotic. Chronic gingivitis can be catarrhal, ulcerative, necrotic, or desquamative. In terms of the extent of inflammation in the oral cavity, it can affect only the gums around a few teeth, called localized gingivitis, or around all teeth, called generalized gingivitis.

The most common form is acute localized gingivitis, for example, due to mucosal trauma; chronic localized gingivitis occurs in the presence of overhanging margins of fillings or crowns; acute generalized gingivitis is associated with viral infections; and chronic generalized gingivitis is associated with systemic poor oral hygiene.

Patient complaints with gingivitis:

• Swollen, red gums
• Bleeding when mechanically irritated (brushing teeth, eating hard or rough foods)
• Sensitivity to hot, cold, or spicy foods
• Unpleasant breath odor despite thorough oral hygiene
• Appearance of sores and ulcers on the gums with certain types of gingivitis
• Possible overall malaise and fever (with general intoxication of the body) accompanying ulcerative-necrotic gingivitis.

There are many causes and factors that contribute to the development of gingivitis. Gingivitis can be a stand-alone disease or a manifestation of another condition.

External factors:

• Inadequate oral hygiene.
• Presence of dental calculus (tartar).
• Untreated dental caries.
• Poor quality fillings, crowns, and prosthetics.
• Mechanical trauma to the oral mucosa.
• Burns to the mucous membrane.
• Smoking.
• Nasal breathing problems.

Internal factors:

• Lack of vitamins (hypovitaminosis and avitaminosis).
• Anomalies in the development of teeth and jaws.
• Teething, anomalies in tooth position, malocclusion.
• Reduced immunity.
• Gastrointestinal disorders.
• Chronic respiratory diseases.
• Hormonal disorders: diabetes, thyroid disorders, impaired production of sex hormones.
• Hepatitis.
• Acute and chronic infectious diseases.

Periodontitis -  is a gum disease in which inflammation affects the gums, the tooth ligament, and the alveolar bone that surrounds the teeth. It can be localized - affecting a group of teeth - or generalized - involving all teeth and surrounding tissues. If left untreated, periodontitis can quickly progress, leading to the loss of even healthy teeth.

• Painful sensations in the gums
• Bleeding gums
• Swollen and red gums
• Unpleasant odor from the mouth
• Increased tooth sensitivity
• Tooth mobility
• Tilting of individual teeth
• Thick saliva
• Increased formation of dental plaque and tartar
• Tooth loss

Unlike gingivitis, periodontitis involves the destruction of bone tissue. Diagnosis is made based on radiological examination, which will show uneven destruction of bone tissue both vertically and horizontally, as well as periodontal pockets.

In the development of periodontitis, an important role is attributed to the genetic factor, unsatisfactory oral hygiene, chronic diseases, endocrine disorders (diabetes). Patients with blood diseases, immunodeficiency states are at risk. Periodontitis can develop against the background of taking certain medications, chemotherapy, and radiation therapy for cancer. The presence of the following factors leads to the development and progression of periodontitis:

• foci of chronic infection in the oral cavity;
• poor oral hygiene;
• poor-quality restorations and prosthetics;
• absence of teeth without their replacement with prostheses;
• incorrect bite;
• low attachment of tongue or lip frenula.

Periodontosis - is a generalized gum disease that is characterized by the destruction of the alveolar bone tissue without symptoms of inflammation. If left untreated, it can lead to tooth loss.

• Itching and a feeling of soreness in the jaw
• Increased sensitivity to cold, hot, sour, and sweet
• Spaces between teeth
• Tilted individual teeth or groups of teeth
• Defects in the tooth near the gums
• Increased tooth wear
• Tooth mobility
• Exposure of tooth roots
• Increased formation of dental calculus

1. Malocclusion, the position of individual teeth.
2. Poor quality fillings and tooth prosthetics.
3. Hormonal disorders, including during puberty, pregnancy, and menopause.
4. Calcium metabolism disorders.
5. Decreased immunity, autoimmune diseases.
6. Diseases of the gastrointestinal tract.
7. Smoking, alcoholism, and drug use.
8. Vitamin deficiency (avitaminosis and hypovitaminosis).
9. Metabolic disorders.
10. Hereditary factors.
11. Imbalanced nutrition.
12. Prolonged use of medications.
13. Inadequate oral hygiene and other factors.

Gum disease (periodontitis, gingivitis, periodontosis) cannot be contracted, as its cause is not infectious.

Gum treatment should be comprehensive, aimed at eliminating general and local factors contributing to gum disease development, including:

• Professional oral hygiene
• Sanitation of chronic infection foci (treatment of caries, replacement of poor quality fillings and prosthetics)
• Restoration of missing teeth
• Correction of malocclusion and pathology of individual teeth
• Treatment of chronic diseases
• Strengthening immunity
• Replenishment of vitamin and micronutrient deficiencies
• Normalization of hormonal balance, and others

The methods of gum treatment can be conditionally divided into therapeutic and surgical methods.

Broad-spectrum antibiotics, anti-inflammatory drugs, and antihistamines are prescribed to reduce inflammation and treat abscesses. Immune stimulants and immunomodulators are used to boost immunity. Vitamin and mineral complexes are used to treat deficiencies in vitamins. Treatment of concomitant diseases (chronic and endocrine disorders) is carried out by a specialized specialist.

Gingivitis affects only the mucous membrane of the gums, while periodontitis and periodontosis also affect the bone tissue of the alveolar processes.

For gingivitis and periodontitis, there is an inflammatory process that is accompanied by swelling, redness, pronounced bleeding, and pain in the gums. For periodontosis, there is no inflammatory process.

Periodontosis is a generalized process that affects the mucous and bone tissue around all teeth, while periodontitis and gingivitis can be localized or generalized.

Untreated periodontitis and periodontosis can lead to tooth loss, but not in the case of gingivitis.