Periodontitis – what to do against periodontosis?

Periodontitis - what to do against periodontosis

Periodontitis is an inflammation of the periodontium. The first symptoms, such as sensitive teeth and bleeding gums, are often underestimated. However, once the inflammation has spread, tooth loss and other serious consequences are at risk. In the following, we explain how to prevent periodontitis and treat it.

Definition: What is periodontitis?

Periodontitis, colloquially also incorrectly referred to as periodontal disease, is an inflammation in the mouth caused by bacteria – more precisely, it is an inflammation of the periodontium.

The first stage of periodontitis is inflammation of the gums (gingivitis). If treated in time, the infection can usually heal entirely without complications. However, delayed gingivitis spreads until the entire periodontium is affected.

As a result, the gums recede, and the bone is attacked. Aggressive periodontitis or lack of treatment can lead to tooth loss.

A distinction is made between marginal periodontitis, which begins at the gum line, and apical periodontitis, which begins at the tip of the root. For apical periodontitis to develop, the pathogens must reach the root tip through a damaged tooth, for example, as a result of caries.

Even though the term periodontal disease is often equated with periodontitis in everyday language, there is a difference. Strictly speaking, periodontal disease is another much rarer disease: the progressive, non-inflammatory decline of the periodontium.


How do you know if you have periodontitis?

The insidious thing about periodontitis is that it often only becomes noticeable in an advanced stage.

The gingivitis that precedes it may not be recognized by the person affected because it is hardly associated with pain. Their symptoms are often mild, and they are not taken seriously if they are noticed.

Signs of gingivitis are:

Anyone who observes such symptoms should see a dentist immediately. Early detection and prompt treatment can prevent periodontitis from developing.

How does periodontitis develop?

The prerequisite for developing periodontitis is the so-called plaques, the precursor of tartar. This is a biofilm on which bacteria can accumulate over time, which is the actual cause of periodontitis. These pathogens excrete toxins that attack teeth and gums.

The body defends itself against this attack by triggering an inflammatory response. If no therapy is initiated, the gums will swell due to the inflammation, making it difficult to clean the affected areas.

After some time, the infection spreads to the tissue. Now, the gums are receding. Pockets form between the tooth and the gums in which the bacteria settle. If periodontitis is not treated, tissue destruction will continue and eventually affect the bone as well.


A chronic and aggressive course

In response to the inflammation, the body activates what are known as osteoclasts. These bone-degrading cells attack the jawbone to remove the invading bacteria and the affected bone parts.

Usually, these cells work in concert with the bone-building cells (osteoblasts) to regularly renew our bones. However, the activity of the osteoblasts is inhibited by the processes in the body, resulting in a breakdown of the jawbone.

If this process occurs slowly, one speaks of chronic periodontitis; if it progresses quickly, it is called aggressive periodontitis.

How is periodontitis treated?

A visit to the dentist is an absolute must if you suspect periodontitis or periodontal disease. Self-treatment is strongly discouraged because of the threatening consequences of inadequate therapy. Homeopathy and home remedies should, therefore, only be used as supplements.

The first step in treating periodontitis is cleaning the tooth surfaces. At the latest, the affected person must also start meticulous dental hygiene at home. In the case of periodontitis, a soft toothbrush and toothpaste with a low abrasion value should be used.

The next step in treatment depends on how far the disease has progressed. It is often sufficient for the dentist to clean the periodontal pockets under local anaesthesia and smooth all accessible surfaces. Bacteria can no longer settle so quickly, and gums and teeth can reconnect.

It may be necessary to take an antibiotic as well.

What is done during periodontosis treatment?

With advanced periodontitis or failure of the first treatment, surgical intervention is performed.

Also, under local anaesthetic, the dentist opens the gum pockets during periodontosis treatment (more correctly: periodontitis treatment) to gain better and deeper access to the infected areas. In this way, these areas can also be thoroughly cleaned.

Now, there is also the possibility of applying an antibiotic locally. However, the latter treatment causes costs not covered by statutory health insurance.

In particularly severe cases of periodontitis, when much tissue and bone has been destroyed, it is necessary to carry out regenerative treatment to support the periodontium to grow back. Reconstruction can also be helpful – for example, connective tissue from the palate is transplanted to cover the gaps in the gums. In addition to the visual improvement, this treatment method reduces the risk of tooth decay in the exposed areas, for example.


Can periodontitis be cured?

There is no definitive cure for aggressive periodontitis. Prompt treatment can alleviate the symptoms. However, the body’s processes for breaking down bone can not be stopped completely.

Thorough oral hygiene that is maintained over the long term is essential. It increases the chances of success of periodontitis therapy.

Proper prevention: What helps against periodontitis?

The most important tool to prevent periodontitis disease is also careful dental hygiene. Teeth should be brushed at least twice a day. In particular, the spaces between the teeth must be cleaned with specially designed brushes or dental floss.

The dentist can recommend the correct toothbrushing technique and other suitable aids.

A mouthwash can also be used. However, this should also be discussed with the dentist, as some products may only be used for a limited time.

Statutory health insurance companies pay for one tartar removal per year. Professional teeth cleaning is even better. Some cash registers subsidize these. Regular preventive appointments at the dentist also serve as a preventive measure.

What to do for early detection?

The so-called periodontal screening index (PSI) is used for the early detection of periodontitis. During this examination, the dentist places a probe around the teeth. This probe examines various factors, such as the depth of the periodontal pockets or the tendency of the gums to bleed.

After the examination, the results, summarized in six areas on the upper and lower jaw, are evaluated:

  • The classification 0 means that everything is fine.
  • Scores 1 and 2 indicate gingivitis.
  • A value of 3 indicates periodontitis.
  • Bei Wert 4 liegt bereits eine schwere Parodontitis vor.


Welche Risikofaktoren begünstigen die Entstehung von Parodontitis?

Nikotinkonsum erhöht das Parodontitisrisiko signifikant – Raucher sollten also besonderen Wert auf eine gründliche Mundhygiene legen.

Auch Diabetiker können schneller an Parodontitis erkranken als gesunde Menschen. Ist eine Diabeteserkrankung nicht gut eingestellt, kommt es zu erhöhten Blutzuckerwerten. Dies schwächt die Abwehrkräfte, sodass Entzündungen leichteres Spiel haben. Umgekehrt schwächen entzündliche Prozesse im Körper die Wirkung des Insulins und können so den Blutzuckerspiegel noch weiter erhöhen. So begünstigen sich Diabetes und Parodontitis gegenseitig.

Grundsätzlich ist ein gut funktionierendes Immunsystem neben der Mundhygiene ein wichtiger Pfeiler bei der Parodontitisprophylaxe. Alles, was das Immunsystem schwächt, erhöht somit das Erkrankungsrisiko – nicht nur in Bezug auf Parodontitis. So schwächen beispielsweise Stress und ungesunde Ernährung die Abwehrkräfte.

Zu guter Letzt erhöhen auch Immunschwächen und bestimmte Medikamente wie Blutdrucksenker das Risiko für die Entstehung von Parodontitis.

Ursachen von Parodontitis

Genau wie beispielsweise im Darm und in der Scheide befindet sich auch im Mund eine Bakterienflora. Deren Zusammensetzung ist bei jedem Menschen individuell. Bei diesen Bakterien handelt es sich nicht zwingend um Krankheitserreger. Es können sich aber auch Parodontitiserreger darunter befinden.

Nicht jeder Mensch, der diese Erreger im Mund hat, erkrankt selbst an Parodontitis. Ob man erkrankt, hängt neben den genannten Risikofaktoren von zahlreichen anderen Aspekten wie dem Lebensstil und der Mundhygiene ab. So begünstigt beispielsweise Zahnstein die Entstehung einer Parodontitis, weil seine raue Oberfläche den Bakterien ideale Wachstumsbedingungen bietet.

Auch die genetische Veranlagung scheint eine Rolle zu spielen. Damit wäre zumindest die Neigung sowohl zu Parodontose als auch zu Parodontitis vererbbar.

Ist Parodontose ansteckend?

The bacteria from the oral flora can be transmitted from person to person, for example, when kissing or sharing cutlery. It is important to remember that even people who do not suffer from periodontitis themselves can have the pathogen in their mouth and transmit it.

This transmission can also lead to juvenile periodontitis – probably in conjunction with the corresponding genetic predisposition – which occurs in children and adolescents and often takes a particularly aggressive course.

Chronic periodontitis, which progresses more slowly, usually occurs later and has other causes, such as lifestyle and poor oral hygiene.

In non-inflammatory periodontal disease, however, the destruction of the periodontium tends to occur due to ageing, presumably due to a hereditary predisposition. So, there is no need to fear infection.


Secondary diseases caused by periodontitis

As already mentioned, there is a close connection between periodontitis and diabetes. But that’s not all: the risk of cardiovascular diseases such as stroke and heart attack also increases due to periodontitis because it accelerates the hardening of the arteries.

The bacteria that cause periodontitis can also infect other body parts, such as the heart or artificial joints. The latter has a surface to which the pathogens can adhere particularly easily.

In addition, the toxins released by the pathogens that cause periodontitis could trigger premature birth in pregnant women – regular check-ups at the dentist are, therefore, remarkably advisable during pregnancy.


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