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 Neglected gingivitis,
originated by bacterial plaque badly removed, is usually the main cause of
serious forms of pyorrhea. It could take years, but sooner or later, if oral
hygiene is neglected and the necessary cures not undergone, dental plaque
prevails.
Pyorrhea is a disease which in
the most advanced stages brings to teeth loss as it destroys the bones that
support them. Genetic proneness plays an important role, but it wouldn’t bring
to the disease without the decisive action of dental plaque.
Prevention should start by
addressing the dental plaque which settles along the neck of our teeth, passing
zone between the crown and the root, protected and “sealed” by our gums.
Dental plaque produces toxins
which corrode this seal (called connecting epithelium by scientific terms) and
penetrate deeply to the bottom of the gums. If not taken care of by toothbrushes
and dental floss, the toxins exert all their harmful potential on the
surrounding tissues.
When gums break away from
teeth roots and bacterial plaque lurks deeply, it is no longer possible to
eliminate it, even with the help of constant and daily brushing. At this point
the damage is self-evident and well visible to the patient, and can’t be cured
without the dentist intervention anymore. It is now techniquely impossible to
clean up the pouches where the plaque becomes tartar and invades the radicular
surfaces. Here, very aggressive germs called anaerobes (the name indicates
their capacity to survive without oxygen) live and reproduce in big quantities,
attacking the surrounding tissues.
However, even if entering this
phase, the patient should not lose his hopes of winning the battle against the
fatal outcome of the disease: teeth loss. Progresses made in the diagnosis and
cure of the chronic paradontitis (scientific name for pyorrhea) enable success
even in the most compromised cases. A periodontist, i.e. a dentist specialized
in the treatment of all those tissues which surround and support our teeth, is
the right person to address in order to cure the disease. He will probably
consider it necessary to take a sample of bacterial plaque and carry out
specific tests in order to find out which bacteriums need to be fought.
Afterwards, he will ask the patient to undergo a couple of therapy sessions and,
if necessary, a few small surgical operations associated to antibiotic therapy,
in order to get rid of unwanted periodontal
pouches. With the cooperation of the patient, educated on how to carry
out a correct domestic oral hygiene, the periodontist will manage to reduce the
pouches’ depth, rebuild a normal gum groove andstop the disease from spreading.
Pyorrhea is therefore a curable disease, even in the most advanced cases, provided that we intervene
before it becomes expulsive, taking away our smile forever.
Gingivitis is a term used to
indicate gums inflammation, which begins around the tooth neck and causes
hemorrhages, an affection which if not cured can provoke permanent damages to
our teeth, followed by their fall.
Acute gingivitis symptoms are a strong sensitiveness, gums bleeding, pain during mastication, but the most
widespread sign is gums edges reddening. Such symptoms point out the formation
of periodontal pouches, which are those areas in which the bacteriums
responsibe for the disease assemble.They find an ideal habitat in the deepest
areas of our gums, where food leftovers and oxygen shortage allow them to
survive and reproduce in big quantities.
If treatments are not started at the right time, some pus can grow within the gum pouches,
and that will make gingivitis develop into chronic periodontitis. At this stage,
teeth definitively lose their support and start moving by themselves.
Gingivitis therapy consists in the elimination of
bacterium plaque, by gums decontamination and decongestion. This will restore normal circulation conditions, together
with a physiological colour and consistency. Accurate hygiene, both domestic
and professional, will make sure gums stop bleeding and that they don’t appear
swollen, red anymore.
A balanced diet, with less sugary food and more vitamins, is good for helping gums to recover from
diseases.
It is important to highlight that gingivitis can be cured with a relatively simple therapy; in a short time,
swelling, bleeding and reddening can regress. When the disease evolves to a
chronic periodontitis instead, treatments become more complex, and the patient
is required to be more attentive and
cooperative. If neglected, gums and deep periodontium inflammation can develop
with time and then compromise teeth stability.
Bacterial plaque has only
recently been identified as a relevant factor in the destructive process of the
tissues which support our teeth, with consequent preventive and curative
measures carried out in developed countries. Before that, a serious dental
disease called pyorrhoea or “expulsive gingivitis” was affecting a large part
of the population.
The disease used to reveal itself with swelling, pain, gums reddening and, in the most serious cases, pus
leaks (the name pyorrhoea comes from the Greek and means “pus drainage”). Signs
of the disease used to predict a very dramatic outcome, such as teeth loss;
together with them, as the disease used to address young people, seduction
capacities were lost too. A deep and irreparable wound for those who were
affected by it.
The disease’s natural course was the progressive replacement of natural teeth with either removable metallic
prosthesis or, for the poorest, resin ones. Dental mobility, pain during mastication, periodontic abscesses etc.
would then bring to teeth loss. Those who were affected by the disease used to
request false teeth as a final solution, as it would put an end to all the
physical and economical suffering. Many dentists in the past years have
listened to the following and desperate request, coming from their patient suffering from pyorrhoea: “please
remove all my natural teeth and replace them with a denture”.
This used to happen when teeth loss was a socially accepted disease, as it was common through the elderly,
even though not in a very advanced age, to carry mobile prosthesis and
dentures. Progresses made by dentistry permit nowadays expulsive gingivitis
prevention and recovery; current social precepts have therefore changed and do
not accept dentures bearers anymore. It has been understood that the main cause
of expulsive gingivitis is dental plaque settled between teeth and gums, and
that this factor can be removed with an accurate oral hygiene or specific
professional operations. Whoever carries false teeth is therefore seen as
somebody who neglects his personal hygiene, or as somebody who is at least not
at all informed about how to prevent it.
The disease is today called chronic periodontitis, which emphasizes the condition of inflamed
tissues, which brings to their destruction, loosening and fall. If taken care of in time, it
regresses and can be totally cured. Teeth expulsion can be avoided even if the
cures start in the most advanced stages of the disease. If not taken care of
though, this is a chronic and progressive disease, which can quickly lead to
loosing teeth, even shortly after the first signs of the sickness.
The specific branch of dentistry which studies causes, prevention and remedies of chronic
periodontitis is called periodontology. The dentist who takes care of its
diagnosis and therapy is called periodontist. The scientific term used to
indicate the tissues affected by this serious disease is periodontal: an
important organ, made up of gums, alveolar bones, joints etc, whose function is
to support our teeth and act as a shock-absorber of the pressures acted on
them.
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