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Periodontitis? Here's what it is

Periodontitis is a polymicrobial disease (caused by several bacteria) of the periodontium, that is, of the tooth, gum and bone support apparatus which, if not stopped in time, can lead to tooth loss.

Periodontitis can begin with inflammation of the gums (gingivitis) and then progress to affect the bone within which the tooth is contained.


Periodontitis symptoms

The first visible signs of periodontitis are:

  • Gingival bleeding during brushing

  • Recessions (gums that recede leaving the roots uncovered)                                                               with increased sensitivity to heat and cold

  • Suppuration (presence of pus)

  • Mild dental mobility

Warning: initial periodontitis is extremely subtle! Only the dentist, with a periodontal probe and an x-ray, can diagnose the disease when the patient has not yet realized he has it.

If periodontal disease is not treated, the pathology worsens and the withdrawal of the gums becomes more and more important.

In these cases, other signs and symptoms are added:

  • spontaneous bleeding

  • increased gum shrinkage

  • greater tooth mobility

  • diastemas (spaces between the teeth)

  • apparent "lengthening" of the teeth

  • swollen, red and painful gums

  • repeated abscesses

  • severe bad breath

  • spontaneous tooth loss in more advanced cases ( pyorrhea )

However, remember that to diagnose periodontal disease it is not enough to have these symptoms but one is necessary  visit and medical opinion .

Periodontitis causes

The main causes that determine diffuse periodontal disease are

bacterial plaque (1)

tartar above and below the gums (2)

cigarette smoking (3)

family history and genetic predisposition (4)

and incongruous fillings and / or prostheses (5)


Psychological causes of periodontitis

Some scientific studies have identified stress, anxiety and depression as risk factors for the onset of periodontosis. Stress can in fact generate in the individual a series of negative physiological responses which, in summary, would alter the body's immune defenses.

How long does it take for periodontitis to develop?

Periodontitis generally occurs in mature age and has a slow course over time, but sometimes it can also affect the young adult (aggressive or rapidly progressive form); in this case the course is faster.

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Why do the teeth move?

The teeth that move together with the  receding gums  and gingival bleeding are the symptoms of periodontitis that most alarm patients, making them immediately think of periodontitis. This happens because the bacteria attack and inflame the supporting apparatus of the tooth (periodontal ligament, gum and bone).

The mobile tooth can become stable again if periodontitis is diagnosed and treated in time.

Dental mobility in most cases is attributable to periodontitis but sometimes it can also be due to an endodontic problem (tooth to be devitalized) or excessive grinding of the teeth which is why it is important that the diagnosis is made during the  visit , to a dentist  expert in periodontitis .

Teeth that move remedies. Most of the time the therapy for the moving tooth is the same for the periodontitis treatment; in other cases, however, it depends on the diagnosis that is made. If the origin of the mobility is an endodontic problem then proceed with the  devitalization  and if the tooth that moves is due to excessive grinding the  bruxism .

Periodontitis how to cure it

We have two ways of approaching periodontal therapy: one NON surgical and one surgical. New technologies have allowed us to use the first method more and more frequently .

How to cure periodontitis with NON-surgical therapies

The NON surgical approach of periodontal therapy involves two steps:

1) Subgingival cleaning

2) LASER therapy

Treatment for periodontitis with deep gum cleaning

Plaque and tartar hide the bacteria responsible for periodontal disease.

There is a superficial tartar, easily removable with ultrasonic instruments, and a deeper tartar (subgingival tartar), which is adhered to the roots of the teeth. The latter cannot always be removed with traditional tools, but in most cases one is required  thorough gingival cleaning .

For deep cleaning, the dentist and / or dental hygienist uses a manual procedure called "Scaling" and "Gingival Currettage".

Both procedures are performed under local anesthesia, thus being completely painless.

Scaling (also called root planing) is a technique that removes the tartar present in depth from the root of the tooth. A manual tool called "Scaler" is used. This procedure is used after first removing all visible tartar with classic ultrasonic instruments.

Dental curettage, in addition to manually eliminating deep tartar, also removes infected soft tissues present in the gingival sulcus or periodontal pockets. In this case, manual instruments called “Curettes” are used.

Gingival curettage cost

The costs of deep gingival cleaning (gingival curettage) are very variable and depend from case to case, which is why it is very important to  first visit  made in the studio. In all ways they can range from 100 to a maximum of 500 euros per arch.

LASER cure for periodontitis

Laser periodontitis. For some time now for the non-surgical treatment of

periodontitis we also have the LASER available. Revolutionary tool

and very effective.

Thanks to its peculiar characteristics, the Laser on the one hand manages to eliminate

the bacteria responsible for the disease, which are otherwise not reachable

from drugs, mouthwashes, ultrasounds and hand tools

(scaling teeth) used for the  subgingival cleaning,  and on the other

at the same time it induces rapid tissue repair thanks

to the biostimulation effect.

Therefore the use of the laser, combined with other methods, therefore allows

to cure periodontitis (laser cure periodontitis) in all its phases without

resort to surgery.  The laser generates two fundamental effects:

Bactericidal effect. Eliminates the bacteria responsible for periodontitis

present within dental plaque and gum pockets.

Biostimulating effect. In the irradiated tissues the laser induces a rapid

proliferation of reparative cells accelerating considerably

the healing process.

The efficiency of the laser is mainly based on selective absorption

light energy from some materials contained in the tissues

target such as bacterial cell membranes,

hemoglobin, water, hydroxyapatite and so on.


Gingivitis is a simple, easily treatable gum infection. Symptoms are easy to recognize as the gum bleeds during tooth brushing; in some cases it may be swollen and slightly painful. It is difficult to distinguish gingivitis (gum infection) from early stage periodontitis, so only the dentist can make the differential diagnosis.

Gums retracted and swollen

For  gingival retraction  we mean the process by which the gums "run away" towards the root of the tooth. It is an important sign along with swollen gums (gum disease) that could indicate the onset of periodontitis.  In some cases, however, this symptomatology could be the sign of more easily solved problems ( see here ) such as gingivitis or dental abscess .

How gingivitis is treated

Gingivitis cures. Gingivitis is treated with  teeth cleaning  done in the office together with the use of specific mouthwashes and gels that the dentist or dental hygienist will recommend after the oral hygiene session.


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Correlation between heart attack and periodontitis

Is there a correlation between heart attack and periodontal disease? Unfortunately, the answer is yes.

Studies have highlighted a link between periodontal disease and  cardiovascular disorders which would be expressed through two different mechanisms.

A direct mechanism consisting in the migration of periodontal pathogenic bacteria from oral tissues to other organs, by means of the bloodstream (bacteremia).

The indirect mechanism, on the other hand, refers to the production, by the bacteria that cause periodontal disease, of inflammatory mediators capable of reaching the circulatory system and causing vascular damage even at a distance.

It can therefore be argued that there is a direct association between untreated periodontal disease and the increased risk of myocardial infarction and  ischemic stroke.

Diabetes and periodontitis

Are diabetic patients more prone to periodontitis? The answer is yes.

Diabetic patients, especially those who cannot control their blood sugar, suffer from gingivitis and periodontitis more frequently than non-diabetic patients. Some scholars have defined periodontitis as "the sixth complication of diabetes". Unfortunately, the mechanism underlying this phenomenon has not been fully clarified.

Therefore, people with diabetes must pay particular attention to their gums and undergo periodontal treatment as soon as possible, if this disease is diagnosed.

Complications in pregnancy and postnatal period

Various researches hypothesize a link between periodontal disease in pregnancy and the risk of premature birth, with all the consequences that can derive from it for the newborn.

Furthermore, it must be taken into account that the hormonal changes typical of pregnancy can lead to a worsening of the health of the gums, which becomes difficult to manage if you were to start from a non-optimal state.

Other Correlations

  There are also other important correlations based on the fact that the chronic inflammatory state at the gingival level due to the presence of bacteria can harm the whole organism.

It should be made clear that, although the research has reached a very advanced stage,

an unequivocal cause-effect relationship between periodontal disease and the pathologies presumed to be related to it has not yet been ascertained.

To date, periodontitis is not considered on its own a sufficient cause to develop other pathologies, but it is certainly a factor of increased risk of getting sick.

       Ten rules for preventing acute periodontitis

To prevent periodontal diseases, some rules must be followed; below we summarize the 10 most important:

  1. Carry out  checkups  every six months to the dentist

  2. Check the dental plaque with the  plaque detector pads .

  3. Use the  dental floss

  4. Brush your teeth and gums after every meal

  5. Make the  teeth cleaning  at least twice a year

  6. Have your dentist clean the subgingival calculus

  7. Quit smoking or minimize the number of cigarettes

  8. Don't use the toothpick but the  pipe cleaners

  9. Remove the  old fillings  if they have any problems

  10. System le  old prostheses  which create chronic inflammation of the gums

Periodontitis definitive cure ?

Periodontitis if treated in time regresses until complete recovery. Untreated, on the other hand, it is a chronic disease (chronic periodontitis) and rapidly progressive, which can lead to dental mobility up to the onset of  PIORREA  and therefore to the loss of teeth. It can be defined as "healing" even when periodontal disease is kept under control.

Obviously, to obtain lasting (definitive) successes over time, it is necessary to scrupulously observe the recall sessions of the periodontist dentist and / or hygienist.

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