Periodontitis. What it is?

When they talk about inflammation of the tooth root, they mean periodontitis (an inflammatory process in the tissues located in the area of ​​the root apex). This is a serious medical condition that often causes a person severe pain. However, the severity of periodontitis is assessed not only by the degree of pain, but also by the danger of the consequences, in particular, the spread of infection throughout the body and the development of pathologies in various organs (heart, joints), odontogenic sepsis, inflammation of the maxillary sinuses, osteomyelitis (purulent lesion and destruction of the jaw bone).

Modern dentistry has all the tools to quickly and painlessly diagnose and cure periodontitis at any stage. However, the specialists of the Amel Dental clinic urge patients not to wait until the pain becomes unbearable and the situation becomes irreparable. At the first signs of an inflammatory process, make an appointment with a doctor. Timely treatment will preserve and prolong the life of your teeth.

Why are the roots of teeth inflamed?

Inflammation of the roots of the teeth (periodontitis) develops for various reasons, but the main ones are:

• Launched, not cured caries in time, pulpitis. In this situation, bacteria that infect the tooth tissues reach the periodontal tissues, where the infection begins to develop rapidly and can lead to damage to the periodontal tissues.
• Injury. Damage can be provoked not only by a strong direct blow to the jaw area with a heavy object, but also by systematic microtrauma, for example, when biting through hard objects (nuts, bones).
• Errors in endodontic treatment. The root of a tooth can become inflamed as a result of a chemical burn (when processing root canals), due to an allergic reaction of tissues to drugs, or due to incomplete elimination of the focus of infection.

Other causes of periodontitis

The development of the disease can also be associated with factors such as:

• damage to the walls of the root canal;
• obstruction of the root canals;
• the formation of granulomas, cysts at the apex of the root;
• damage to the root when removing the post, the tab that forms the stump under the crown.

Types of periodontitis

Periodontitis can occur:

• in an acute form;
• in a chronic form.

In addition, in a patient with chronic periodontitis, the inflammatory process may worsen.

Types of chronic periodontitis

Classification of chronic periodontitis:

• Fibrous.

The first stage, which is characterized by almost complete absence of symptoms, slight pain.

• Granulating.

At this stage, the gums swell, pus is released from the gums when pressed.

• Granulomatous.

At the site of inflammation, granulomas are formed, cysts are capsules filled with purulent exudate.

The diagnosis of chronic periodontitis is complicated by the fact that the disease has mild symptoms, which may be similar to the symptoms of other pathological processes (for example, complicated pulpitis). To identify pathology in dentistry, an X-ray examination is carried out, thanks to which the doctor can see what the tooth root looks like, whether there are signs of inflammation. At the initial stage, periodontitis on the picture is diagnosed by the presence of a periodontal gap.

Causal factors of periodontitis

Causal factors are another criterion for the classification of periodontitis. Depending on the method of infection, tooth root inflammation is:

• Infectious – when inflammation is provoked by disease-causing organisms. Infection can get into the periodontal tissue both from the crown of the tooth (advanced caries) and retrograde – due to gum inflammation.
• Traumatic – caused by mechanical damage to the walls, tooth tissues, soft periodontal tissues. The cause of damage can be a blow to the jaw, hitting a tooth when biting a hard object, damage during the treatment of caries (the result of improper installation of the filling).
• Toxic or allergic – caused by the effect of medicinal filling materials on the tissues.

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Periodontitis symptoms

Symptoms of dental root inflammation depend on the nature and stage of the pathological process.

Acute periodontitis has 2 stages of development:

• Intoxication phase.

In this phase of the disease, the patient experiences constant aching pain that does not subside, as well as a feeling of heaviness around the causative tooth. It is especially painful to press on the tooth (when pressing, the patient experiences bouts of sharp pain).

• Exudative phase.

The pain becomes unbearable and diminishes only after taking painkillers. Exacerbation of pain occurs at the slightest touch of the tooth. At this stage of the disease, patients notice a feeling of protrusion, protrusion of the tooth. The tissues in the area of inflammation swell, the lymph nodes become enlarged and painful. The appearance of pulsating pain indicates the onset of a purulent inflammatory process.

The acute stage of the disease can last from several days to 2 weeks.

Signs of chronic periodontitis

Over time, the acute symptoms of periodontitis subside, and patients think that the disease has receded. But this is far from the case. It’s just that periodontitis has passed into a chronic stage. At this stage, inflammation develops slowly, often with little or no symptoms, but leads to very serious consequences. Treatment of chronic periodontitis is much more difficult than acute, requires complex measures.

The following symptoms indicate chronic inflammation of the dental root:

• 1
  discomfort when chewing, pressing on the causative tooth;
• 2
  feeling of fullness and heaviness in the area of inflammation;
• 3
  the appearance of bad breath;
• 4
  enlargement and soreness of the lymph nodes (cervical, submandibular);
• 5
  swelling, sensitivity of the inflamed gums;
• 6
  the formation of fistulas on the outer surface of the jaw.

When an exacerbation of chronic periodontitis begins, painful symptoms return, the gum tissue around the diseased tooth swells.

Both acute and chronic inflammation of the tooth root, even if this inflammation of the dead tooth under the crown requires immediate treatment.

Periodontitis treatment in the dental clinic Amel Dental

Subject to timely treatment at the Amel Dental clinic, tooth root inflammation can be successfully treated with conservative methods. We treat inflammation of the roots of teeth in adults and treat periodontitis of primary teeth in young patients. We use international treatment standards, which imply an integrated approach and include digital X-ray diagnostics at the stage of examination and control of results, as part of drug therapy – pain relievers, antibiotics for inflammation of the tooth root, treatment of concomitant diseases (caries, periodontitis), removal of fistulas, etc.

Conservative treatment

Complex professional treatment of tooth periodontitis includes the following actions:

• Examination and X-ray diagnostics.
• Local anesthesia.
• Removal of old restorations, fillings, cleaning of the tooth cavity, cavity formation and access to root canals. If a tooth hurts under the crown, at this stage the doctor dismantles the crown, forms a cavity in the stump that provides free access to the treatment of the tooth roots.
• Pulp removal (in a living tooth), mechanical treatment of the root canals.
• Expansion, grinding of the inner surface of the channels, acidic, antiseptic treatment.
• The insertion of drugs into root canals.
• Temporary filling of a tooth.
• Prescribing anti-inflammatory, analgesic drugs to the patient (according to indications).

This is only the first stage of treatment. At the second stage (after 2-3 months):

• the results of treatment are monitored by X-ray diagnostics;
• the doctor removes the temporary filling;
• carries out repeated disinfecting treatment of root canals;
• if the treatment is effective (no signs of inflammation) at this stage, the doctor conducts a permanent filling of the root canals and restores the crown of the tooth.

Treatment of the chronic fibrous form of the disease is carried out according to the same algorithm, but in the process of endodontic treatment, the canals do not expand.

Treatment of granulating and granulomatous periodontitis (with not large-scale tissue damage) requires more time. The duration of the treatment tab increases (it is set for a period from 3 months to six months). Along with anti-inflammatory therapy, the doctor prescribes to the patient immunomodulating drugs that stimulate tissue regeneration.

Surgical treatment of acute and chronic periodontitis

Modern technologies of conservative treatment are effective in 70-90% of cases. With severe tissue damage, in the absence of the possibility of conservative treatment, as well as in cases where drug therapy has not yielded results, surgical treatment is performed. In modern dentistry, the following methods of surgical treatment of periodontitis are used:

• root apex resection;
• removal of the cyst;
• removal of a tooth.

The latest achievements in the field of equipment for surgical dentistry make any surgical intervention highly effective, safe and painless. The dental microscope allows for minimally invasive operations to remove granulomas, treat inflammation at the root apex, control the quality of treatment and canal filling. Laser technologies help doctors to carry out bloodless surgeries, their use significantly reduces the risk of infection of the wound surface.

When can you not avoid removal in case of root inflammation?

Removal is the most radical measure that is used in dentistry only if the preservation of the tooth is impractical and impossible. For example, it makes no sense to preserve a rotten tooth, it is impossible to preserve a tooth in the stage of exacerbation of a chronic process, in a situation where inflammation from the apex of the root has spread to other tissues.

Recommendations after treatment of periodontitis

The main recommendation is adequate adherence to all doctor’s prescriptions regarding oral cavity care, mandatory monitoring of treatment results at a specified time, adherence to preventive measures – regular examination by the dentist and professional hygiene.

How to prevent the development of root inflammation?

Prevention of periodontitis consists in following the standard rules:

• do not start diseases of the teeth and gums, treat caries, pulpitis in a timely manner;
• regularly undergo a preventive examination by a dentist;
• urgently consult a doctor if signs of inflammation appear – a timely visit to dentistry will avoid the development of the disease, complications, tooth loss;
• follow the rules of hygiene (brush your teeth correctly and regularly, use a suitable toothbrush, high-quality paste);
• for the purpose of prevention, do professional teeth cleaning in dentistry 2 times a year;
• take care of your health, balanced diet.

Responsible attitude to the health of teeth and gums is the most effective way to prevent various dental diseases, including inflammation of the tooth root.