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Periodontosis is the wrong name for periodontitis

Periodontitis - a widespread disease
Almost every 2nd from 35 suffers from it: Periodontitis, better known as periodontosis. It all starts imperceptibly and painlessly, patients suffer from bleeding gums, sometimes suffer from acute episodes, so-called pocket abscesses. Mostly, however, bone is lost quite imperceptibly, tooth loss is then the consequence. Plaque bacteria are the cause of periodontitis and caries, unfortunately, most people only come to the periodontist when the teeth are loose! A timely periodontal therapy can stop the inflammation of the periodontium.

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Ahead a little definition of terms

If your dentist is talking about Periodontosis, then you are at the wrong doctor! Why do so many doctors today still mistakenly say periodontal disease to periodontitis? In medicine, the ending -itis means inflammation, while -osis stands for a metabolic degenerative disorder. Thus, osteoarthritis means joint degeneration, for example, as a result of joint dysfunction. Arthritis, on the other hand, means joint inflammation, e.g. after infection by bacteria in an accident. The terms periodontosis, periodontopathy and periodontitis are each derived from the word "periodont". This refers to the periodontium, i.e. the anchoring system of the tooth in the bone (paro = around, dont = tooth). The periodontium is composed of gum, bone, periosteum and root cementum. For a long time it was not possible to isolate bacteria from the gum pockets of patients with periodontitis, because the germs were grown under oxygen. However, these bacteria occur in the gingival pockets precisely because they appreciate the low-oxygen conditions that prevail there. The fallacy was: no bacteria, therefore an -osis! Only by molecular biological methods one could prove DNA of bacteria 25 years ago, later succeeded then also the bacteria breed in special brood chambers - incubators - under oxygen-poor conditions.

So it is an -itis after all. This is not just a play on words, an inflammation is treated differently than a degenerative disorder and the correct diagnosis is the beginning of the right therapy! In the periodontitis therapy it depends on two important factors, firstly that the doctor knows the disease and secondly that you understand the connections. Without these two factors, treatment is not promising. In order for you to understand the correlations, good education is required, which usually takes time. In the past, due to ignorance of the disease and the resulting incorrect examination techniques, no bacteria could be detected and therefore spoke of periodontal disease, but for about 25 years we know that it is a bacterial inflammation of the periodontium, i.e. periodontitis. The periodontitis therapy begins with the correct diagnosis, a periodontosis can not be treated! No matter if aggressive - or chronic periodontitis, the treatment has also nothing to do with oral hygiene, because many patients get to hear that too. In periodontal therapy, the dentist makes precise findings at the beginning, then follows an initial therapy. After a break of at least 8 weeks after the last initial therapy, findings are again collected and compared with the initial findings data, only now the exact therapy plan is determined.

Why is the occupation with our tooth holding apparatus so important, does our gum condition reflect our health? Yes and no! This local chronic inflammation can negatively affect the whole system - the body. Deterioration of blood sugar control in diabetics, joint inflammation and premature birth in pregnant women can result. Studies in recent years indicate that untreated periodontitis may be a risk factor for preterm birth and, consequently, should be treated early. When periodontitis is present, various bacterial products are released from the gums. These bacterial products cause our immune system to release increased amounts of defense substances - so-called cytokines. These cytokines have also been detected in amniotic fluid and show an increase in women with preterm labor. Animal studies on the golden hamster have shown that certain cytokines from gram-negative bacteria have a dose-dependent, harmful effect on birth weight and can lead to malformations! It is now known that periodontitis can increase the risk of preterm birth. In addition, studies indicate a link between periodontitis and underweight preterm infants. Initial trends show that non-surgical periodontal therapy can have a favorable impact on the course of pregnancy.

Periodontitis is also discussed as a contributory cause of arteriosclerosis. In patients with a tendency to thrombus formation, there is a risk of bacteria nesting in formed thrombi and thus causing inflammation. Our immune system fights with millions of microorganisms and viruses every day! Mostly successfully, if not, we notice it immediately - we get sick. Our orifices are a welcome entry point for pathogens. That is why we find special "defense stations" of our immune system in the area of the large orifices (mouth, rectum, genitals, ear, nose), e.g. the physician speaks of tonsils in the mouth area, the layman of "tonsils". Let's stay with the small "body orifices" like the nails or teeth. Teeth are normally "fused" with the gums; there is no niche for bacteria in the healthy periodontium. However, this changes when the gums become inflamed. The inflammation destroys the tooth-gum bond, and blood vessels also "swell", all of which causes bacteria from our oral cavity to enter the vascular system more easily. The medical profession speaks of "transient bacteremia", and for patients with heart defects this can end dangerously. The reason is as follows: bacteria are normally killed quickly by the immune system, unless the bacteria manage to hide from the immune cells in time. Bacteria like to do this in so-called "thrombotic vegetations". Thrombotic vegetations are nothing else than "blood crusts" in the vascular system. They consist mainly of blood platelets and always form where there are disturbances in blood flow. These "blood flow disturbances" can be of natural origin, as in congenital heart defects, or acquired, as in artificial heart valves, artificial vessel walls, vascular shunts, etc. If bacteria get into our vascular system, they can "hide" in the blood crusts and are thus protected from the access of immune cells. Passing immune cells "think" nothing of the blood crusts, because they are the body's own. Only foreign structures are attacked. Inside the blood crusts, however, the germs multiply undisturbed until their cell number is so large that they spread. The immune system can then no longer fight the invaders on its own - depending on the location of the germs, the patient falls ill with an organ infection. In the past, antibiotics were given immediately for this reason during many dental treatments. Good scientific studies to this topic are however rare and thus one limits today the antibiotic precaution, only with as can be prove heart ill ones, or with patients with known dangerous diseases.

A gum inflammation know most, it hurts and bleeds easily. The main causes of gingivitis are:

  • Tooth plaque (plaque)
  • Tooth plaque (plaque) modified by protruding fillings / crown margins
  • Tooth plaque (plaque) associated with hormonal influences
  • Tooth gingivitis during menstruation
  • Gum disease during pregnancy
  • Gum disease in diabetics
  • Gum inflammation associated with blood count disorders

Once the cause, that is, plaque is removed regularly, gum inflammation usually heals on its own. However, recurring gum inflammation can lead to bone loss, this is called periodontitis, this disease leads to tooth loss over years if left untreated. Fortunately, all these factors are treatable / changeable, for example, optimize your brushing technique by cleaning your teeth first at the back in the hard-to-reach places - more about this in the video tooth cleaning. Also use a mouthwash and plaque tablets. Correct the misalignment of your teeth with braces, for example, and find a conscientious dentist. Who makes beautiful dense crown margins!

So to list the most common causes of periodontitis is quite simple - plaque. Plaque is composed of food debris and bacteria. Bacteria in our mouth build and form the plaque and then use it as a habitat. It takes about 24 hours for a mature, or harmful, plaque to form. If we thoroughly remove the plaque from our teeth every 24 hours, we will not develop tooth decay and/or periodontitis. So the pile of bacteria on our teeth is responsible for bleeding gums. Unfortunately, many people stop brushing their teeth when they see blood. This removes even less plaque and inflames the gums even more! So what to do about bleeding gums? Keep brushing thoroughly (the most important thing is to clean your teeth well), even if there is bleeding, buy an oral irrigator, because it removes plaque even below the gums - in the area called the sulcus. If your gum bleeding does not stop, then visit a periodontist, who will determine whether you have only gingivitis, or already a periodontitis.

If you suffer from increased bleeding gums during pregnancy, then you do not have to worry. Pregnancy is a biological phase in the life of a woman, during which there are significant hormonal changes. Due to the increase in female sex hormones, estrogens and progesterone, among other things, the periodontium is also affected. The gums have estrogen and progesterone sensitive receptors. As a result, already existing gum inflammations (bleeding gums) can be intensified and more easily triggered during pregnancy. This is therefore related to the hormonal changes. This leads to recurring inflammations. Again, brush, brush, brush, even if it bleeds.

. Again and again one reads about scientific and non-scientific reports of vitamin deficiency and the associated consequences. Many then resort to homeopathic remedies - usually a mistake! Even physicians do not shrink from it Parodontitispatienten base powder, Coenzyme and other Humbug to prescribe - packed this is as "holistic dentistry". Gum illnesses in the industrialized countries are to be led back almost exclusively as above pointed out on Plaque and not on a lack of Vitaminen, also is the administration of any preparations for the purpose of regulation of the acid base balance in the sense of the inflammation restraint complete nonsense!

. The oral irrigator is still discussed very controversially, is now an oral irrigator good for periodontitis? YES! An oral irrigator is a sensible purchase, some dentists argue, you could rinse bacteria deeper into the pockets. This is a nonsense, because bacteria can move firstly thanks to protrusions and secondly, the bacteria are harmless by themselves. Only organized in the mature plaque bacteria cause periodontitis and/or caries. With the toothbrush you remove the plaque only above the gum, with the oral irrigator you remove not yet too old plaque also in the sulcus. In the first few days, the gums may bleed easily and hurt - do not stop but continue! This is a sign that the gums are inflamed, the mouthwash will remove the inflammation and thus the bleeding! Do not be alarmed if the teeth then seem "longer", this is because the gums were swollen by the inflammation, after the inflammation subsides, the swelling goes back - the teeth seem longer.

. In contrast to the oral irrigator, a saliva test at the beginning of periodontitis therapy is not useful as well as laser treatments. Again and again it happens that patients with periodontitis are subjected to a saliva test at the beginning of therapy. Congratulations, you now know that you have bacteria in your mouth! If you didn't have them, you wouldn't have periodontitis - so you can see for yourself the benefit of this usually expensive diagnostic procedure. A saliva test is only useful after unsuccessful conservative periodontal therapy. Only after you have undergone periodontal therapy and this therapy has been unsuccessful, is the search for failed germs by means of a saliva test useful under certain circumstances. Respectable periodontists point out these connections to you!

Unfortunately, periodontitis is still treated today, including with lasers, although it has long been proven that this treatment has no benefit. Laser applications have something futuristic in itself, probably this is the reason why patients spend money more easily for such a treatment. Dishonest doctors take advantage of this fact, and of course there are also ignorant doctors. Either way, the laser application is not useful for you, it can even harm you. The laser light usually only roughens the tooth root and thus facilitates the accumulation of calculus. Although a few bacteria are killed, they quickly form again - removal then becomes even more difficult due to creation of a rough root surface.

If the gums recede and bleed easily when brushing the teeth does not always have to be periodontitis, often leaking crown margins are to blame for this happening. There are several ways to grind a tooth for a dental crown. The easiest and fastest way is the so-called tangential grinding. The problem with this type of grinding is that the crown margins would be very thin. However, this would lead to fracture of the ceramic. To prevent this, the dental technician leaves more space at the crown margin, resulting in unsightly bulging margins. To prevent the patient from seeing the bulging edges, the tooth is prepared so that the edges are simply below the gums. The result is bleeding gums and easily inflamed gums, and sometimes a gingival pocket and fistula develops. This is because food debris collects on the overhanging crown margin, which is a good breeding ground for bacteria, which in turn cause the inflammation of the gums. The result is receding gums. Gesundes Zahnfleisch blutet nicht!

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