Introduction
- Mucosal inflammation which has progressed past the level of gingival tissues → periodontitis
. - Gingival margins lose natural congruence - sequelae: periodontal pocket formation, alveolar bone destruction, loosening of teeth, periodontal abscesses.
- Signs : strong halitosis, inflamed gingivae bleed easily, ulceration/abscesses.
- Diagnosis : signs.
- Treatment : scaling/polishing.
Diagnosis
Clinical signs
- Inflamed gingivae/bleed easily .
- Strong halitosis.
- Moderate amount of dental plaque/calculus
.
Advanced periodontitis
- Periodontal pockets .
- Periodontal abscesses.
- Mobility of teeth .
- Spontaneous exfoliation of teeth.
- Attachment loss.
Sequelae
Prognosis
- Unless microbial irritants are removed and mouth is maintained in a clean state permanently, the destruction will progress deeper.
- Periodontal pockets are permanent, abscesses may form in them.
- Alveolar bone destruction is permanent - will not regenerate even in the absence of infection.
- Toxins will constantly be liberated into bloodstream by chronic bacteremia - can contribute to endocarditis , nephritis , hepatitis , amyloidosis .
Reasons for treatment failure
- Professional treatment and home care and maintenance are inter-related: failure in any one area will lead to failure as a whole.
