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Periodontitis is a dental disorder that results from progression
of gingivitis, involving inflammation and infection of the ligaments
and bones that support the teeth. |
Causes, incidence, and risk factors
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Periodontitis
occurs when inflammation or infection of the gums (gingivitis) is
untreated or treatment is delayed. Infection and inflammation spreads
from the gums (gingiva) to the ligaments and bone that support the
teeth. Loss of support causes the teeth to become loose and eventually
fall out. Periodontitis is the primary cause of tooth loss in adults.
This disorder is uncommon in childhood but increases during adolescence.
Plaque and tartar accumulate at the base of the teeth. Inflammation causes a pocket to develop between the gums and the teeth, which fills with plaque and tartar. Soft tissue swelling traps the plaque in the pocket. Continued inflammation eventually causes destruction of the tissues and bone surrounding the tooth. Because plaque contains bacteria, infection is likely and a tooth abscess may also develop, which increases the rate of bone destruction. |
* Swollen gums
* Gums that appear bright red or red-purple
* Gums that appear shiny
* Gums that bleed easily (blood on toothbrush even with gentle brushing
of the teeth)
* Gums that are tender when touched but are painless otherwise
* Breath odor
* Loose teeth . |
| Examination
of the mouth and teeth by the dentist shows soft, swollen, red-purple
gingiva. Deposits of plaque and calculus may be visible at the base
of the teeth, with enlarged pockets in the gums. The gums are usually
painless or mildly tender, unless a tooth abscess is also present.
Teeth may be loose and gums may be receded. |
The
goal of treatment is to reduce inflammation, eliminate pockets if
present, and address any underlying causes. Dental irritants, such
as rough surfaces of teeth or dental appliances, should be repaired.
General illness or other conditions should be treated.
It is important to have the teeth cleaned thoroughly. This may involve use of various instruments or devices to loosen and remove deposits from the teeth (scaling). Meticulous home oral hygiene is necessary after professional tooth cleaning to limit further destruction. The dentist or hygienist will demonstrate brushing and flossing techniques. With periodontitis, professional tooth cleaning is often recommended more frequently than the standard twice a year.
Surgical treatment may be necessary. Deep pockets may need to be opened and cleaned. Loose teeth may need to be supported. Extraction (removal) of a tooth may be necessary for advanced periodontitis so destruction doesn't spread to adjacent teeth.
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Recurrence of periodontitis
* Tooth abscess
* Infection or abscess of the soft tissue (facial cellulitis)
* Infection of the jaw bones (osteomyelitis)
* Trench mouth
* Mobile or lost teeth
* Tooth flaring or shifting . |
| Good
oral hygiene is the best means of prevention. This includes thorough
tooth brushing and flossing, and regular professional dental cleaning.
The prevention and treatment of gingivitis reduces the risk of development
of periodontitis. |
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