Periodontosis is a chronic non-infectious disease characterized by damage to the periodontium—the tissues surrounding the tooth. These include the gums, bone tissue, and tooth cementum. One of the most important functions of the periodontium is to keep the teeth firmly fixed in the correct position during chewing.
In periodontosis, this function becomes impaired, and if a patient does not seek timely treatment, tooth loss may occur.
What Causes Periodontosis?
Periodontosis develops as a result of impaired nutrition of the periodontal tissues.
The causes of periodontosis may include:
- Hormonal imbalance. Hormonal changes may occur both as a result of various diseases and physiological changes in the body, such as menopause, pregnancy, breastfeeding, aging, and puberty.
- Poor nutrition. Deficiency of proteins, fats, carbohydrates, and especially vitamins and minerals can contribute to the development of periodontosis. The disease may also develop when nutrients are consumed in sufficient amounts but are not properly absorbed by the body.
- Metabolic disorders. Periodontosis may occur in people with diabetes mellitus, atherosclerosis, and thyroid diseases.
- Gastrointestinal diseases, including pancreatitis, chronic gastritis, gastric ulcers, and duodenal ulcers.
- Weakened immunity resulting from previous illnesses, injuries, surgery, or chemotherapy.
- Harmful habits such as smoking and excessive alcohol consumption.
- Associated dental conditions, including malocclusion, bruxism, and abnormal tooth positioning.
Periodontosis may also develop due to poor oral hygiene. In some cases, the disease can be hereditary.
The more of these risk factors are present, the greater the likelihood of developing the disease. Periodontosis most commonly occurs in adults but may also affect children. In children, possible causes include genetic abnormalities of the dentofacial system, vitamin deficiencies, and reduced immunity.
Types and Stages of Periodontosis
In localized periodontosis, the lesions affect a specific area of the jaw. In generalized periodontosis, the pathological process involves an entire jaw or even both jaws.
Several stages (degrees) of the disease are also distinguished:
- A mild degree is characterized by slight exposure of the tooth neck and a minor reduction in the height of the interdental septa. The gums appear normal, although they may be slightly pale. No pathological tooth mobility is present.
- In moderate periodontosis, the changes become more pronounced. The tooth necks become more exposed, and the height of the interdental septa decreases further. The gums become dense and pale. Gaps may appear between the teeth, and slight tooth mobility may develop.
- Advanced severe periodontosis is characterized by significant changes in both the gums and teeth. The tooth roots become almost completely exposed, and marked tooth mobility develops. As a result, the bite becomes disrupted, and the patient may be unable to chew hard foods.
If a secondary infection develops, inflammation may occur. In such cases, the condition is referred to as purulent periodontosis and requires urgent medical attention.
Symptoms of Periodontosis
The disease is characterized by a gradual increase in symptoms.
At the mild stage, symptoms may be completely absent. The only noticeable sign may be exposure of the tooth necks.
As the disease progresses, the clinical manifestations become more evident. Discomfort and pain while eating may occur, tooth sensitivity to hot and cold increases, and itching of the gums may develop.
With further progression, spaces between the teeth enlarge, the teeth appear longer due to gum recession and exposure of the tooth necks, and wedge-shaped defects may form. The final stage is characterized by the development of V-shaped depressions in the gum area. Without treatment, tooth mobility continues to increase, eventually leading to tooth loss.
Diagnosis of Periodontosis
Diagnosis begins with taking a detailed medical history. The dentist asks about the patient’s complaints, when the symptoms first appeared, and possible contributing factors.
After the consultation, an oral examination is performed. The dentist evaluates the condition of the gums and tooth enamel, assesses the bite, measures the depth of periodontal pockets (the space between the gums and tooth roots created by the disease), and checks for wedge-shaped defects.
Additional diagnostic tests may include:
- Periapical dental X-rays;
- Panoramic dental radiographs;
- Echo-osteometry (ultrasound examination of bone tissue);
- Computed tomography (CT).
Treatment of Periodontosis
Complete treatment of periodontosis can be challenging, especially when patients seek medical care at an advanced stage.
A variety of treatment methods may be used to restore normal dental anatomy, ranging from conservative therapy to surgical intervention.
Medication therapy may include drugs that improve blood circulation and reduce hypoxia, a pathological condition in which tissues do not receive enough oxygen.
The dentist may also perform selective grinding of the teeth. The purpose of this procedure is to establish proper contact between the upper and lower teeth (occlusion). In periodontosis, excessive calcium accumulation in tooth enamel may slow the natural wear of teeth. This can contribute to traumatic occlusion and fan-shaped tooth migration.
To prevent this, enamel is selectively ground on certain teeth to achieve optimal contact between the upper and lower jaws. The treated teeth are then coated with a special protective paste to reduce the risk of caries and rapid destruction.
Another treatment method is splinting of mobile teeth. The goal of splinting is reliable tooth stabilization, which is why it is typically used in advanced stages of periodontosis. A special dental splint is placed on the inner side of the teeth, connecting them into a single unit and preventing further mobility.
The dentist may also recommend physiotherapy, gum massage, laser therapy, and other supportive treatments.
In addition, patients with periodontosis should follow these recommendations:
- Maintain thorough oral hygiene;
- Follow a balanced diet containing all essential vitamins, minerals, proteins, fats, and carbohydrates;
- Eliminate harmful habits;
- Treat all accompanying dental diseases, including caries, gingivitis, pulpitis, and others.
What Is the Difference Between Periodontosis and Periodontitis?
Periodontitis and periodontosis are often confused, but they are different diseases.
The similarity is that both affect the tissues surrounding the teeth. However, periodontitis is characterized by inflammation of the gums, whereas periodontosis is characterized by jaw bone atrophy.
In periodontosis, obvious symptoms are usually absent in the early stages, whereas periodontitis presents with pronounced inflammatory signs. Early periodontosis is commonly associated with gum itching, while periodontitis often begins with tooth sensitivity.
Bleeding gums are generally absent in periodontosis but are a hallmark symptom of periodontitis.
Another difference is that periodontitis often causes throbbing sensations in the gums, while periodontosis causes the gums to become pale.
Unlike periodontitis, periodontosis is not an inflammatory disease. It is manifested by atrophy of the alveolar processes (tooth sockets). Periodontitis, on the other hand, is an inflammatory disease of the periodontal tissues.
However, in both conditions, patients should improve oral hygiene, follow their dentist’s recommendations, and avoid self-treatment.
Why Is It Important to Treat Periodontosis?
Without timely treatment, the following conditions may develop:
- Periodontal abscess;
- Dental phlegmon;
- Osteomyelitis of the jaw;
- Malignant neoplasms.
Because of tooth mobility, pain, and increased sensitivity to hot and cold foods, patients may be unable to eat properly. This can contribute to gastrointestinal disorders, metabolic disturbances, endocrine diseases, and other health problems.
In addition, psychological difficulties and a reduced quality of life should not be overlooked.
All of these complications can be avoided by seeking qualified dental care in a timely manner.
This article does not replace a medical consultation. For complete and personalized information, please consult your dentist.