Chronic periodontitis is a slowly progressing disease of the tooth support system that leads to its destruction. Chronic periodontitis is the most common form of periodontal disease.
Long phases of standstill and short phases of progress are characteristic. Mostly patients from the age of 45 are affected. Increasing bone loss occurs, which leads to tooth loosening and tooth loss.
One of the most common causes of the development of chronic periodontitis is insufficient oral hygiene and the resulting subgingival plaque, i.e. plaque accumulates on the gumline and the body's first defense reaction causes the gums to loosen up and become inflamed. This situation favors the formation of plaque below the gums.
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Learn more about this at: Causes of periodontal disease
Chronic periodontitis can often only be recognized late or not at all by the patient, as it progresses slowly and causes hardly any pain.
A regular visit to the dentist can provide clarity. The dentist can use the medical history to assess and classify the risk factors.
During a clinical examination, the teeth are examined for gum pockets and bleeding and then classified into different risk profiles. This gives you an overview and can compare the values with each other during the next check.
An X-ray can also be helpful to assess and compare the extent of bone loss.
A characteristic of chronic periodontitis is the slow and intermittent course of the disease.
The periodontal disease begins with gingivitis. There is reddening of the gums and bleeding of the gums.
The progressive inflammation of the gums creates gum pockets. Sometimes the pockets are filled with purulent inflammatory secretions and there is often a bad taste in the mouth and bad breath.
The longer the inflammation lasts, the more tissue falls victim to it, so that the jawbone also breaks down and the formation of recessions, i.e. significant regression of the gums on the affected teeth. The teeth appear longer than normal to the patient.
This is followed by tooth loosening and tooth migration, which ultimately leads to tooth loss.
More on this: Inflammation of the gums
Chronic periodontitis is often painless and therefore often goes unnoticed by the patient. Often only the beginning with the typical symptoms of gingivitis is perceived as painful; after the acute symptoms have subsided, the pain also subsides.
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However, many patients report tooth necks that are sensitive to pain when the gums have receded.
Also read our topic: Exposed tooth neck What to do?
Chronic periodontitis can lead to pocket abscesses, i.e. accumulations of pus in the gum pockets, but the bones can also be affected and inflammation in the area of the tip of the root of the affected tooth occurs.
The pus and inflammatory secretions then drain through a fistula (in this case the passage to the oral cavity). A fistula usually indicates inflammation at the tip of the root of the affected tooth. One then speaks of a paro-endo lesion.
Read on below: Fistula on the gums
The treatment of chronic periodontitis begins with the elimination of the acute inflammation through a thorough removal of the dental plaque and the subgingival plaque. Disinfecting mouth rinses (e.g. Chlorhexidin®) can also have a supportive effect.
Afterwards, the cooperation of the patient at home is very important. Thorough oral hygiene should be observed. Defects should be recognized by the dentist and explained to the patient and a correct toothbrushing technique demonstrated. Mouth rinses and interdental brushes and dental floss are used as support.
There are different degrees and stages to classify chronic periodontitis. Pocket depths are measured for the division, the six-point measurement has proven itself. A periodontal probe, which has a blunt end and a millimeter mark, is used to measure from the gum line to the bottom of the pocket. This is smart with the six-point measurement at six different points on the tooth. The bleeding tendency is also assessed.
In addition, an x-ray can be helpful to assess the extent of bone loss.
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After the classification, a decision is made about the course of therapy. In conventional therapy, bypassing surgical measures, the root surface is processed with manual and mechanical instruments without direct view. The aim of this curettage is a clean, i.e. biologically acceptable root surface on which fewer plaque bacteria can adhere.
Another possibility of treatment is surgical therapy, whereby under sight, i.e. The surface of the roots is smoothed and freed of plaque by making an incision in the oral mucosa. This procedure is mainly used when the disease is widespread and when conventional therapy has not led to improvement.
Maintenance therapy includes regular check-ups by the dentist and regular professional teeth cleaning.
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Unfortunately, chronic periodontitis cannot be cured with homeopathic remedies alone. They can only be used in a supportive manner, but do not lead to improvement on their own.
The periodontitis leads to irreversible damage to the tooth support system, i.e. that the disease can be halted but not cured. A complete healing and regeneration of the tissue so that the previous situation is restored is unfortunately not possible in chronic periodontitis.
As a rule, conventional or surgical periodontal therapy reduces the probing depths and leads to general improvement. Nevertheless, the lost bone or soft tissue does not regenerate.
With regular check-ups and so-called maintenance therapy, the condition can be kept in such a way that no further bone is broken down and tooth loss is counteracted.
The recessions can be covered surgically. Mucosal grafts are used for this.
Also read: Healing of periodontal disease
Chronic periodontitis progresses slowly and in phases. There are long phases of stagnation (standstill) and short phases of progression (progress). The relapses vary from patient to patient.
After the initial therapy, check-ups and professional teeth cleaning should be carried out at least every three months. Later, the time between controls can be extended up to six months.
