PERIODONTITIS

Periodontitis is an advanced chronic inflammation of the gums. It is one of the most common diseases overall. The presence of bacteria in dental plaque leads to the development of inflammation that affects the supporting structures of the teeth located around the tooth root and can also involve the surrounding bone. If left untreated, it can result in visible gum recession, teeth becoming loose, or even complete tooth loss. This ongoing inflammation can also impact the entire body, contributing to conditions like heart and circulatory diseases and diabetes. Therefore, special diagnostics and targeted treatment are very important.

The cause of gum inflammation is plaque located at the gum line. Certain bacteria in the plaque release toxins, which trigger an inflammatory response from the body. This, combined with existing aggressive bacteria, leads to the breakdown of gum tissue. Gingival pockets form, one sign of which is bleeding gums when brushing teeth. The gums can become red and swollen. Often, however, there are no symptoms or only a few, so the disease progresses largely unnoticed. Plaque continues to form in the pockets. If this cause is not removed, it leads to a vicious cycle of inflammation. The pockets become deeper until the supporting structures of the teeth are damaged, leading to the breakdown of surrounding bone. The periodontium consists of special fibers that anchor the teeth but also allow movement to prevent overloading the tissues and bone during heavy use (like chewing). Loss of the tooth’s supporting structures is an irreversible process; even with successful treatment of periodontitis, new tissue that the body can rebuild cannot fully regain its original function. Therefore, timely treatment is essential whenever possible.

The risk of heart and vascular diseases like stroke, as well as the risk of rheumatism and premature birth with low birth weight, is significantly increased if chronic periodontitis is present. 

Factors affecting the course of the disease:

• Smoking
• General diseases like diabetes
• Hereditary factors
• Overweight
• Inadequate nutrition
• Hormonal changes, for example, during pregnancy and menopause
• Increased stress

The course of periodontitis can vary greatly among individuals. It often appears in middle to older age and is characterized by a slow, chronic progression with occasional flare-ups. However, the course can be very aggressive and progress rapidly, sometimes appearing in adolescents and young adults. In these cases, it is usually due to hereditary factors and infection with particularly aggressive bacteria.

Symptoms/consequences of periodontitis:

• Accumulation of dental plaque
• Gum inflammation (gums are enlarged, red, swollen)
• Feeling of a foreign body between the teeth
• Bleeding gums
• Exposure of the tooth neck and roots (gum recession)
• Bone resorption (breakdown)
• Gingival pockets
• Bad breath
• Tooth migration
• Tooth mobility
• Tooth loss

Only the early stages of periodontitis (gum enlargement, swelling, inflammation, bleeding) are reversible. If treated adequately during this period (removing dental plaque, maintaining oral hygiene, rinsing with oral solutions), it is possible to restore the condition before the inflammation.

If bone, gum, and the tooth’s supporting structures (collagen fibers) have broken down, the damage is permanent, and treatment cannot restore the previous state before the disease began. What can be done is to prevent further progression of the disease with appropriate therapy and regular oral hygiene. Treatment methods include removing dental plaque, removing tartar, pocket curettage and deep pocket curettage, applying medication to the periodontal pocket, rinsing pockets, and surgical (periodontal) operations.