Periodontitis

Periodontitis and periodontosis describe the same condition: the inflammatory disease of the tooth-supporting structures (periodontium, tooth bed).

The medically accurate term is periodontitis and should ideally be used. The term periodontosis, on the other hand, is outdated and colloquial but has become widely accepted in popular language.

The diagnosis of periodontosis in a dental practice includes a clinical examination with a magnifying glass and probe, and possibly the taking of X-rays. There are also innovative diagnostic methods for periodontitis, such as the determination of the enzyme ammp8 produced by granulocytes, a type of immune cells.

Periodontosis can be classified into stages or severity levels, each with different symptoms.

Mild periodontitis is characterized by a mild inflammation of the tooth-supporting structures. The gums are red and may bleed easily upon touch or brushing. At this stage, there is no bone loss around the affected teeth.

The inflammation of the tooth bed continues, gum pockets and bone pockets around the teeth form, and teeth often show slight loosening. Patients may observe increased gum recession and seek dental attention.

Advanced periodontitis, also known as severe periodontitis, exhibits severe signs of inflammation. This stage leads to significant gum recession, tooth loosening, and bone loss with pockets around the teeth. Often, this stage culminates in tooth loss. Complete healing of advanced periodontosis is not possible.

The core cause of periodontitis is an unhealthy oral flora with a high concentration of periodontitis bacteria. These bacteria are highly aggressive, penetrating gum pockets and breaking down the tissue anchoring the teeth (periodontium or tooth bed). The immune system responds with local inflammation to defend against the invaders, resulting in an inflammatory process.

These pathological microbes can enter the bone and bloodstream from the gum pockets, causing systemic symptoms and significantly compromising health.

A high concentration of periodontitis bacteria in the oral flora predisposes individuals to periodontitis. These bacteria break down the collagen fibers anchoring the teeth in the jawbone. These bacteria are anaerobic and perish when exposed to higher concentrations of oxygen. Since deep gum pockets have a lower oxygen level and higher CO2 concentration, it is understandable why problematic bacteria thrive there. Building a healthy oral flora is crucial to eliminate these bacteria.

In cases of poor oral hygiene where dental plaques are not removed, harmful bacteria multiply rapidly, leading to a significant increase in periodontosis. Bacterial plaques provide ideal conditions for the progression of periodontosis.

Bacteria that penetrate gum pockets also accumulate on the teeth, forming dental plaques. Over time, these plaques harden, creating a rough surface that irritates the tooth-supporting structure and worsens periodontosis. This hardened dental plaque is known as calculus or tartar and should be gently removed by a dentist, ensuring minimal tissue damage.

Smoking increases CO2 concentration in the mouth and decreases oxygen levels, providing ideal living conditions for causal bacteria. It is an additional factor that impacts the core cause (oral flora).

Malnutrition disrupts the balance of the immune system, leading to either excessive reactions or weakening. This imbalance can facilitate rapid progression of periodontitis. Additionally, malnutrition affects the optimal structure of the tooth-supporting structure, leading to swift destruction, as seen in vitamin C deficiency (scurvy).

Various general conditions such as diabetes mellitus, different chemicals and medications, or stress can also negatively influence periodontosis. However, with proper attention to a stable oral flora, these influences can be effectively compensated.

The symptoms of periodontitis can be divided into local symptoms, directly in the area of the teeth, and generalized symptoms, which can become noticeable throughout the entire body. The local symptoms are usually noticed first by the patient.

The local symptoms and signs of periodontitis can manifest themselves in bleeding gums, receding gums, pain in the teeth, loosening of the teeth and ultimately tooth loss.

The systemic symptoms of periodontitis can be very varied. Links have been established with arteriosclerosis, diabetes mellitus, arthritis, rheumatism and osteoporosis. However, non-specific symptoms such as tiredness and fatigue can also be observed in most cases.

Local symptoms are limited to the tooth-supporting structures (periodontium), the tissue anchoring the tooth in the jawbone. Patients often complain of varying degrees of pain, ranging from acute (painful) to chronic (persistent and less painful), depending on the condition.

Gingivitis, inflammation of the gums, almost always precedes periodontitis. The gums appear swollen and bluish-red. They quickly bleed upon touch or brushing and can be painful.

Gum bleeding is a classic local symptom that almost always occurs in periodontitis. A healthy gum should not bleed during gentle probing. Patients often notice gum bleeding during brushing, which is an early sign of existing periodontitis. Bacterial plaques, often unremoved by patients, are commonly found in highly inflamed and bleeding areas.

Especially in acute phases of periodontitis, tooth pain may occur. However, periodontitis is often chronic, and pain is less frequent. In some patients, periodontitis progresses rapidly, leading to tooth loss without accompanying pain.

Periodontitis results in the breakdown of the entire tooth-supporting structure, evident through bone loss and gum recession. The dentist can detect bone loss through clinical examination and X-rays. Gum recession is observed when more of the tooth is visible, and exposed tooth roots become apparent.

Bad breath is not exclusive to patients with periodontosis but is more pronounced and frequent in them. Therefore, bad breath is included in the list of local symptoms.

Periodontitis has systemic effects on the entire body, causing physical symptoms and significantly impacting health. Thus, periodontitis should be treated not only to preserve teeth but also to maintain overall health.

The systemic burden has two main reasons:

In blood vessels, the immune system attempts to combat invading bacteria by depositing them in fat and calcium, rendering them harmless. This process increases the formation of plaques in vessels, narrowing them. Atherosclerosis can ultimately result in stroke and heart attack later in life.

Studies show clear links between periodontitis and diabetes mellitus. The impact on the pancreas is particularly significant in patients with advanced or severe and prolonged periodontitis.

Arthritis and rheumatism, inflammatory joint diseases, result from inflammatory cascades and bacterial invasion. As long as stabilization of periodontitis is not achieved, symptoms often persist, leading to ongoing degradation.

Prolonged inflammation leads to body acidification. In response, the body starts breaking down bone tissue to buffer acids, releasing mineral ions. These minerals have a good buffering property, neutralizing acids. This process weakens the bone structure, leading to the development of osteoporosis.

For more information on holistic and systemic influences from the mouth and jaw, please read articles on holistic dentistry and environmental dentistry.

Periodontitis treatment, also known as periodontal treatment, should address the root cause of the disease by eliminating harmful periodontitis bacteria. Therefore, the foundation of successful and lasting periodontosis treatment is building a healthy oral flora.

To eliminate harmful bacteria, it is optimal to use oxygen compounds such as ozone.

Additionally, calculus and tartar should be removed, and the patient should maintain good oral hygiene.

Quitting smoking and adopting a healthy diet are self-evident steps.
If a correctly conducted periodontitis treatment is initiated promptly, the condition is curable and highly treatable. However, if treatment is delayed until the advanced stage, permanent damage to the teeth may occur.

There are some home remedies that can provide supportive relief for periodontosis. However, they are not a specific treatment for the root cause.

Since home remedies only offer symptomatic relief, a comprehensive and cause-specific treatment plan should be developed in consultation with a dentist.

To prevent periodontosis, it is essential to maintain a healthy oral flora, not neglect daily oral hygiene, and follow a balanced diet.

Toothpaste and mouthwashes claiming to combat periodontosis often provide insufficient protection and may contain harmful ingredients.

Optimizing oral flora through oxygen and ozone, where harmful bacteria perish in high oxygen concentrations, is an ideal approach. We are happy to work with you to create an effective treatment plan.

Many people suffer from periodontosis without understanding the connections of this disease. We aim to inform you as comprehensively as possible.

The information listed contains relevant topics for a better understanding.