Pathological gum pocket. Causes of formation and treatment of gum pockets. Symptoms, development and progression of the disease

Good day, dear readers!

In today's article, we will consider with you such a disease of the teeth as - periodontitis, as well as its symptoms, causes, types, degrees, diagnosis, prevention and treatment, both traditional and folk remedies at home. So…

What is periodontitis?

Periodontitis- an inflammatory disease of the periodontium, which is characterized by inflammation and bleeding of the gums, tooth loss and damage to the alveolar process of the jaw, on which the teeth are actually located.

The periodontium is a collection of tissues surrounding the tooth - gums, periodontium, cementum and the alveolar process (part of the jaw), which hold the tooth in the alveolus (dental pocket).

The main reason for the development of periodontitis is a bacterial infection, in particular streptococci, which, by their vital activity in the oral cavity, produce a certain acid, which in turn destroys not only the tooth itself, but also the tissues surrounding the tooth.

Development of periodontitis

The development of periodontitis begins with a lack of oral hygiene, when plaque is constantly present on the teeth. Plaque consists of food debris, which begins to rot over time, and infections, mainly of a bacterial nature. Remains of food, a humid and warm microclimate in the mouth, is a favorable environment for the accelerated reproduction of infection. Then everything goes on the rolled path. Bacteria, such as streptococci, produce acid with their vital activity, which literally “corrodes” the tooth, destroying it, and together with the processes of food decay, they contribute to inflammation of the gums. Thus, gingivitis develops - an inflammatory disease of the gums. The patient begins to worry about bleeding gums.

If the process is not stopped, gingivitis contributes to the appearance of gaps between the teeth and gums (periodontal pockets), which opens the way for infection not only to the upper part of the tooth (crown), but also under the crown, to the roots of the tooth. Of course, at this stage, even with the help of daily brushing, it is already quite difficult to clean the space under the gums, especially on your own. Therefore, this stage of periodontitis is characterized by the development of periodontitis. In addition to bleeding, it is accompanied by sensitivity of the teeth to cold and hot.

Further, the process accelerates, and when the infection affects the root of the tooth, and the root space, i.e., when the inflammatory process has engulfed the entire periodontium, the doctor makes a diagnosis - periodontitis. This is where the looseness of the teeth comes into play.

The end result of periodontitis is tooth loosening and loss.

A complication of periodontitis is - periodontal disease - damage to the alveolar process, which is part of the jaw, on which, in turn, the teeth are held.

periodontitis statistics

Periodontitis is one of the most common dental diseases, only slightly falling short of dental caries in the number of cases. If we talk about the scale of the disease, then the World Health Organization (WHO) notes 93-95% of the world's population!

Periodontitis - ICD

ICD-10: K05.2, K05.3.

Symptoms of periodontitis

Symptoms of periodontitis largely depend on the form, location and extent of the disease.

The first signs of periodontitis are the following symptoms:

• Bleeding gums;
• Staining of the teeth, especially at the bottom of the crown, with a yellowish-brownish tint, which is plaque;

The main symptoms of periodontitis

• plaque on the teeth;
• Unpleasant odor from the mouth;
• Bleeding gums;
• Changing the color of the gums;
• Formation of periodontal pockets;
• Shaky teeth;
• Increased sensitivity of teeth to cold or hot (air, food);
• Discomfort when chewing;
• Deformation of the interdental septa;
• Increasing the distance between the teeth;
• Interdental papillae and marginal gingiva are cyanotic.
• Loss of teeth.

Additional symptoms of periodontitis

• Viscous saliva;
• Abscesses and fistulas on the gums;
• Pulsation in the gums;
• Increase in size and soreness of the submandibular lymph nodes;
• Headache.

Complication of periodontitis

• Sharp pains in the teeth and gums;
• General malaise, feeling of weakness;
• Increased body temperature;
• Purulent discharge from the alveoli (tooth-gingival pockets);
• Destructive changes in the alveolar processes.

If we talk about the causes of periodontitis, then the main one is pathogenic microorganisms (infection), which, with inadequate care for the teeth and oral cavity, actively multiply and begin to rapidly affect the teeth and gums. The most popular pathological microorganisms are streptococci (Streptococcus mutans), staphylococci (Staphylococcus aureus), Actinobacillus actinomycetemcomitans, Klebsiella pneumoniae, Porphyromonas gingivalis, Prevotella intermedia, Pseudomonas aeruginosa, Treponema denticola.

Other reasons include:

• Various diseases, especially gingivitis, diabetes mellitus, HIV infection;
• Violation of the bite and position of the teeth;
• Hypertonicity of chewing muscles;
• Injury to periodontal tissues with filling materials, braces;
• Injury to the tissues of the tooth and gums with toxic substances - formaldehyde, arsenic;
• Physical trauma to the teeth during impacts, falls;
• High attachment of strands and frenulums of the oral mucosa.

Additional factors that contribute to the development of periodontitis can be:

• Tartar;
• Smoking;
• Chronic kidney disease;
• Alzheimer's disease;
• stress;
• Hormonal disorders.

Types of periodontitis

The classification of periodontitis includes the following types of disease:

With the flow:

Acute periodontitis. It is characterized by rapid periodontal disease, acute pain, bleeding gums. May have exacerbations in the form of abscesses of gingival origin - with a fistula and without a fistula.

Chronic periodontitis. It is characterized by a slow but persistent periodontal lesion, at the beginning without any special signs. If adequate measures are not taken at the beginning of the disease, the pathological process reaches the lower parts of the periodontium, after which the treatment becomes very laborious and lengthy. It is very important to prevent damage to the alveolar processes, which are part of the jaw, on which the teeth are actually located. The chronic form of periodontitis is sometimes accompanied by exacerbations, which are usually caused by a weakening of the immune system against the background of stress or the appearance of secondary infectious diseases (ARVI, acute respiratory infections, influenza, pneumonia, and others).

Chronic periodontitis is divided into the following types:

• Localized;
• Generalized;
• Chronic pericoronitis;
• Thickened follicle (papilla hypertrophy).

By localization:

Localized (focal) periodontitis. It usually develops against the background of local causes - trauma. With the removal of the cause of the disease and adequate treatment, the prognosis for recovery is favorable.

Generalized periodontitis. The development of the disease occurs against the background of 2 adverse factors - the presence of infection or trauma to the periodontium, as well as the lack of an adequate response of the human immune system to the first factor, for example, the body does not produce the necessary antibodies or their number to counter infection.

By severity (degree of periodontitis):

Easy degree. It is characterized by structural changes in the epithelium and blood vessels (dilation of the veins and narrowing of their lumen, sclerosis, hyalinosis) of the gums. The size of periodontal pockets is up to 3.5 mm. Resorption (actually destruction, by resorption) of the bone tissue of the interradicular septum of the tooth - up to 1/3 of the length of the roots.

Average degree. The process of pathological changes in the structure of the periodontium continues, pronounced stromal sclerosis appears, and granulation tissues appear. The size of periodontal pockets is 3.5-6 mm. Bone resorption of the interradicular septum of the tooth is from 1/3 to ½ of the length of the roots. Mobility of teeth of 1-2 degrees is manifested, their displacement is possible. There are edema, hyperemia and profuse bleeding of the gums, as well as foci of osteoporosis.

Severe degree. There is a sharp and rapid deformation of the interdental septa, their disintegration into separate parts, as well as the disintegration of collagen fibers. The size of periodontal pockets is more than 6 mm. Resorption of the bone tissue of the interradicular septum of the tooth is more than ½ of the length of the roots, where there are processes of abundant infiltration (significant deposits in the periodontal pockets), sometimes with the release of pus. There is tooth mobility of 2-3 degrees.

Important! The consequences of moderate and severe degrees of periodontitis, even after their treatment and recovery, may remain an altered level (recession) of the gums.

Diagnosis of periodontitis

Diagnosis of periodontitis includes the following examination methods:

• Anamnesis;
• Visual examination of teeth and gums;
• Bleeding index;
• Rheoparodontography;
• Radiography (X-ray);
• General blood analysis;
• General urine analysis;
• A periodontal index is applied.

How to treat periodontitis? Treatment of periodontitis is carried out by a dentist or orthodontist, and only on the basis of a diagnosis of the disease. Methods of therapy mainly depend on the form and severity of periodontal lesions, but they are all divided into local and general methods of treatment.

Periodontitis treatment usually includes the following therapies:

1. Local treatment:
1.1. Local drug treatment;
1.2. Surgery;
1.3. Orthopedic treatment;
1.4. Physiotherapy.
2. General treatment.

1. Local treatment of periodontitis

Local treatment of periodontitis begins with:

- rehabilitation of the oral cavity;
– professional teeth cleaning;
- removal of tartar, deposits;
- elimination of the cause contributing to periodontal injury.

After carrying out the above procedures, medical treatment of periodontitis is carried out.

1.1. Local drug treatment of periodontitis

The use of drugs is aimed at eliminating inflammatory processes. To do this, use the following tools:

Antiseptics. For the sanitation of the oral cavity - to remove pathogens (infections) that contribute to the further development of the disease, antiseptics are used.

Among the antiseptics, one can distinguish: chlorhexidine bigluconate ("Drill", "Korsodil", "Lyzoplak", "Parodium", "Sebidin"), "Miramistin", "Mundizal" (gel), solutions of furacilin (1: 5000), iodinol 0 .5-1%, iodine 0.1% or hydrogen peroxide (3%),

Mouthwashes. They serve as additional measures to sanitize the mouth and reduce inflammation: "Phytodent", "Elam".

Hypertension agents. Hypertonic agents are used to relieve the inflammatory process and edema: solutions (urea (30%), calcium chloride (10%), salvin (0.2%), glucose (10%), hexomethylenetetramine), ointments (butadiene, heparin, indomethacin) , films ("Diplen-Dent"), "Polyminerol".

Adsorbents. To adsorb pathogenic microflora and products of its vital activity, to stop intoxication of the body, adsorbents are used: AUVM "Dnepr", biological medicinal cryogel "BLK", applications based on "Gelevin", "Polifepan".

Adsorbents are introduced into the periodontal pocket or used as applications. In addition to stopping the infection, it also contributes to the removal of inflammatory processes in the periodontium.

Enzymes. For the splitting of necrotic tissues and the normalization of redox processes, enzymes are used: "Ribonuclease", "Trypsin", "Chimopsin", "Sodium Chloride".

The enzymes are mixed until completely dissolved with an isotonic solution, after which the agent is injected into the periodontal pockets with the help of thin swabs (turunda), for 10-20 minutes, for 7-10 days.

Immunostimulants. To normalize and strengthen local immunity, immunostimulating and immunocorrective drugs are used: Imudon, Cycloferon.

1.2. Surgical treatment of periodontitis

Surgical treatment of periodontitis is used for severely loosened teeth, i.e. in advanced cases, and is aimed at eliminating the mobility of such a tooth and restoring the periodontium.

To do this, under local anesthesia, the following manipulations are performed: patchwork operations, splinting of teeth and open curettage.

1.3. Orthopedic treatment of periodontitis

Orthopedic treatment of periodontitis is carried out by an orthodontist. This type of treatment is used in the absence of a tooth, and is based on the installation of dentures. This is necessary to prevent malocclusion and the continuation of the development of this disease.

1.4. Physiotherapy

In combination with medical and surgical treatment of periodontitis, the use of physiotherapeutic methods of therapy is shown, which are aimed at normalizing blood and lymph circulation, metabolism, reducing inflammation, strengthening and restoring periodontal tissues.

Among the physiotherapeutic methods of treatment, one can note: ultrasound, electrophoresis, aerosol therapy, darsonvalization, diathermocoagulation, UHF therapy, massage, balneo- and peloid therapy, phototherapy and others.

2. General treatment of periodontitis

Antibiotics. Antibiotics for periodontitis are used mainly during exacerbation of the disease, for example, with abscesses. Usually these are broad-spectrum drugs: Lincomycin, Rulid, Sumamed, Erythromycin.

Anti-inflammatory drugs. They are used to suppress the synthesis of mediators of inflammatory processes: Butadion, Ibuprofen, Indomethacin.

Hyposensitizing drugs. They are used to stop allergic reactions, and, accordingly, relieve additional symptoms that worsen the course of the disease: Calcium Gluconate, Diazolin, Diphenhydramine, Pipolfen, Tavegil, Calcium Chloride.

Immunostimulants. They are used for general strengthening and correction of the immune system: Insadol, Sodium nucleinate, Timalin, Timogen.

To restore blood microcirculation, capillary walls, periodontal tissues and normalize metabolism, apply: vitamins C (ascorbic acid), E (tocopherol), K, PP, B vitamins (B5, B6, B12 and others), Trental, as well as hyperbaric oxygen therapy.

Vitamin complexes can be distinguished: Aevit, Askorutin, Undevit and other multivitamin complexes.

Sedative drugs. Appointed to normalize the nervous system, relieve tension, anxiety, irritability: tinctures of valerian, motherwort.

Important! Before using folk remedies at home, be sure to consult your doctor!

Sea buckthorn and fir oils. Mix sea buckthorn and fir oils in equal parts, then wrap a small piece of gauze around your finger, and, moistening it in the mixture, massage the inflamed gums with your finger for 10 minutes, 2 times a day.

Linden and calendula. Mix in equal proportions linden and calendula flowers, after which 1 tbsp. pour a spoonful of the mixture with a glass of boiling water, let the product brew for 25 minutes, then strain and use as a mouthwash, 3-4 times a day.

Oak. Grind the oak bark as finely as possible, then pour 1 teaspoon of powder into 250 ml of water and put on fire. Bring the remedy to a boil, then set aside for infusion, for 30 minutes, strain the remedy and use as a mouthwash, during the day, every 2 hours.

Comfrey. Chopped, dry roots of comfrey, in the amount of 1 tbsp. spoons pour a glass of water, put on fire, bring to a boil, set aside to infuse, for 30 minutes, then strain and use as a rinse, 2 times a day, periodically holding the agent in the inflamed area for 30 seconds.

Prevention of periodontitis

Prevention of periodontitis includes the following recommendations:

• Observe the rules of personal hygiene and proper brushing of teeth;
• Choose your toothbrush carefully;
• Do not leave to chance diseases of the teeth and gums;
• Strengthen the immune system;
• Avoid stress;
• Try to eat foods fortified with vitamins and minerals;
• If the child's bite is deviated, visit the dentist, it may be necessary to correct the bite;
• In the absence of teeth, install dentures for yourself;
• Visit the dentist for a scheduled examination, which will help to identify possible deviations in the health of teeth and gums in time;
• Try to move more, temper.

Which doctor should I contact with periodontitis?

• Dentist.

Video about periodontitis

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How to treat gum periodontitis with medication

After examining the patient and confirming the diagnosis, the dentist determines the prognosis for all teeth. Further, the patient is offered a large number of options on how to cure the disease and an action plan is agreed with the corresponding prices. Treatment of gums with periodontitis can be conservative and surgical. In the first case, the use of special medications is implied. Gum treatment is divided into:

1. Local. Includes preparations for the treatment of gums for external use: gels, means for rinsing and washing periodontal pockets. This also includes physiotherapy, massage, the use of special toothpastes and brushes.
2. General. This type of treatment consists of taking oral antibiotics, which are prescribed taking into account the stage of periodontitis, as well as associated diseases.

Local therapy

In most cases, periodontitis is the result of poor dental care. Because of this, plaque accumulates on them, and deposits appear under and above the gums. They cause an inflammatory process, without the elimination of which no treatment will bring a positive result. For this reason, before prescribing therapy, the doctor removes stones and plaque. Further, he also gives recommendations on proper oral care. The next step is gum treatment. It is aimed at eliminating the inflammatory process and includes the following activities:

1. The use of non-steroidal anti-inflammatory drugs: ointments and gels. This includes funds such as Metrogil Denta, Asepta and Holisal.
2. Washing periodontal pockets, rinsing the mouth with antiseptic solutions. Applications with antimicrobial gels. The last 2 treatments can be done at home. If the stage of the disease is severe, then the doctor will prescribe at least once a day to come to the dental clinic to wash the periodontal pockets with a syringe.
3. Physiotherapy. This method of gum treatment is considered additional along with medication and allows you to quickly eliminate the symptoms of the inflammatory process. This includes procedures such as electrophoresis and laser treatment.
4. The use of special toothpastes. Another additional method in the treatment of gums from periodontitis. Toothpastes should dissolve plaque and contain enzymes with antiseptics. Among these stand out Parodontax, LACALUT fitoformula, PresiDENT exclusive, Parodontol Active. Their price is higher than that of ordinary pastes.

Anti-inflammatory drugs

With periodontitis, anti-inflammatory drugs are used in the form of solutions, gels, ointments or even pastes. Along with the above non-steroidal anti-inflammatory drugs, the following drugs are recommended for the patient:

1. Maraslavin. Promotes the regeneration of the periodontal tissue, relieves pain and swelling in periodontitis.
2. Heparin ointment. Improves blood microcirculation in periodontal tissues, makes capillaries more resistant and relieves swelling.
3. Elgifluor, Elugel. The main substance of these gels is chlorhexidine. They promote tissue regeneration, have an anti-inflammatory effect.
4. Polyphepan. The drug is injected into periodontal pockets. It eliminates inflammation due to the absorption by the gel of toxins formed as a result of the activity of microbes.

Antibiotics

With periodontitis, antibiotics are inevitable, because therapy is based on the antimicrobial method. Among these drugs, broad-spectrum drugs are more often prescribed. They can kill the maximum number of pathogenic bacteria. Before prescribing drugs, a special analysis is carried out. It determines how sensitive bacteria are to a particular antibiotic. Among the commonly used drugs in this group are:

1. Erythromycin. It is used for the second degree of severity of periodontitis, when serous fluid begins to stand out.
2. Sumamed. It is prescribed immediately before surgical treatment to relieve inflammation.
3. Polyminerol. Effectively stops the reproduction and growth of bacteria, prevents their reappearance.

Vitamins for gums

Since beriberi can be the cause of periodontitis, vitamins are additionally prescribed for treatment. They are necessary for the overall strengthening of the gums. The patient is prescribed the following drugs:

1. Vitamin C. It is indicated for all forms of periodontal disease, especially in spring and against the background of problems with the gastrointestinal tract. It is prescribed in powders, injections or iontophoresis.
2. Vitamin P. It has a positive effect in combination with vitamin C, therefore it is indicated in the same cases.
3. Vitamins of group B. Saturate periodontal tissues with oxygen, enhance protein synthesis.
4. Vitamin E. Eliminates swelling, is indicated for periodontal disease against the background of hypertension.
5. Vitamin A. It is recommended in the initial stages of periodontitis to normalize the function of the epithelium and oral mucosa.

Laser treatment

This method is absolutely bloodless, because the enamel is simply polished with a laser. The result of the procedure is a tighter fit of the gums to the teeth. The advantage of the method is the absence of contraindications, so they can cure periodontitis in pregnant women, allergy sufferers and children. In addition to polishing the enamel, periodontal pockets are cleaned with a laser, which are more difficult to treat with a simple rinse. Judging by the reviews, relief comes after the first procedure.

Splinting of teeth

With periodontal disease, not only inflammation of the gums is observed, but also loosening of the teeth. To stop this process, splinting is carried out. The procedure is carried out in several ways:

1. Fiberglass. Under local anesthesia, small dimples are made on the teeth. Then a fiberglass thread is laid there, which is fixed with a composite material. So the teeth with periodontitis are pulled together and become stiffer.
2. Cable-stayed with aramid fiber. Similar to the previous method, but here an aramid thread is used, which is more compatible with enamel.
3. Removable prosthesis. It is a temporary measure during the main treatment.
4. Bugel prosthetics. The teeth are fixed with a metal arc that prevents them from falling out.

How to treat periodontitis at home

Bleeding and inflammation of the gums can be reduced at home. For this, a course of treatment of 15-20 procedures is carried out. Mandatory are rinsing with decoctions and tinctures. The following recipe is effective against gum disease:

1. Mix equal parts of oak bark, violet, lingonberry leaves and calendula.
2. Pour 1 liter of boiled water into this mixture.
3. Infuse the remedy for one and a half hours.
4. Rinse with warm decoction 2-3 times daily.

Treatment with folk remedies

After rinsing the mouth, applications can be made. To do this, you will need gauze napkins, a bandage, or just cotton pads. Use them for applications like this:

1. Mix honey and sea salt in a 4:1 ratio.
2. Apply them to the disk, which must be wrapped around the finger and rubbed with smooth movements into the gum tissue.
3. Another option is to soak a gauze or bandage with the prepared product and apply it to the sore spot for half an hour.

Surgical treatments

In the absence of positive results from conservative treatment of periodontitis, the only way out is surgical intervention. It is carried out in several ways:

1. Curettage. The operation of curettage of periodontal pockets of pathological tissue and subsequent bone grafting. May be closed or open.
2. Flap operation. In addition to removing all pathological deposits, the gum itself is restored. It is pushed back, treated with an antiseptic, and then returned back and sutured.

Price of treatment

The method of therapy against periodontitis affects the price of the entire treatment. The specific method is determined taking into account the stage of the disease. Ultrasonic teeth cleaning has a price of 7 to 11 thousand rubles. Open or closed curettage will cost 1-1.5 thousand rubles. A patchwork operation has a higher price. It costs about 6 thousand rubles. The most expensive is splinting. Depending on the method, its price is:

• fiberglass - 10 thousand rubles;
• crowns made of metal-free ceramics - 19 thousand rubles. for 1 piece;
• clasp prosthesis - 25 thousand rubles.

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The structure of the periodontal pocket

The periodontal pocket is the space freed as a result of the destruction of the periodontium. The inflammatory process violates the integrity of the periodontal joints, atrophy (resorption) of the alveolar bone begins. There is an area where there is no attachment of the gum to the surface of the tooth root.

Let us explain that the periodontium includes the periodontal tissues:

• circular ligament of the tooth;
• cement covering the root;
• alveolar processes (the part that bears the teeth).

The bottom of the pocket is usually filled with granulation (connective) tissue, plaque and pus. There is a large number of destroyed leukocytes, which indicates a protracted inflammatory process. Particles of food constantly fall into the hole.

The defect is clearly visible on the x-ray, it appears as a dark area between the teeth. For diagnostics, the probing method with hand instruments is also used.

Reasons for education

The main reason for the formation of periodontal pockets is poor oral hygiene, the accumulation of bacterial plaque and hard tartar.

Factors accelerating the formation of a defect:

• the use of exclusively soft food - it is known that hard vegetables and fruits (carrots, apples, cabbage) help to clean teeth from plaque;
• improper installation of a dental filling - the sharp edges of the filling can injure the gums;
• malocclusion - leads to increased stress in certain areas of the periodontium;
• some chronic diseases, such as diabetes;
• hormonal imbalance;
• immunodeficiency states.

Symptoms of inflammation

• Putrid odor from the mouth that does not go away even after brushing your teeth;
• bleeding gums, which increases with any mechanical impact;
• pain and itching during meals, especially hard ones;
• reaction to cold and hot;
• release of purulent exudate;
• visual lengthening of the tooth crown by lowering the gums;
• at a later stage - loosening and displacement of the teeth.

Depth measurement of periodontal pockets

Normally, the space between the neck of the tooth and the gingival margin should not exceed 1-2 mm. With a mild degree of periodontitis, a gingival pocket with a depth of 3.5 mm is formed.

The average severity of the inflammatory process is characterized by pockets with a depth of 4 mm. At the same time, a bone defect and destruction of the interdental septa already appear on the x-ray. At a late stage, the depth of the fossa exceeds 5 mm.

Treatment of periodontal pockets and periodontal disease

Periodontitis (inflammation) and periodontal disease (destructive process) should be treated in a complex manner. The first stage is ultrasonic cleaning of periodontal pockets, then medical treatment is carried out. In the most advanced cases, surgical intervention is prescribed.

Ultrasonic cleaning

It is carried out by the apparatus "Vector". A special scaler nozzle generates ultrasonic vibrations that destroy hard dental plaques, including deep pockets. All pathogenic microflora is destroyed due to the antibacterial effect of ultrasound.

curettage

Open and closed curettage is the mechanical cleaning of pockets using hand instruments (scalers and curettes). Applicable when the pocket depth exceeds 3 mm.

It is performed under local anesthesia and includes the following steps:

1. Antiseptic treatment of the entire oral cavity (rinsing with a solution of chlorhexidine or miramistin).
2. Scraping of softened tissues and purulent exudate at the bottom of the pocket, removal of bacterial deposits on the entire surface of the tooth, including on the roots.
3. Washing the cleaned cavity with an antiseptic solution.
4. The imposition of a protective bandage on the gum.

The recovery period lasts 2-3 weeks. During this time, a new scar-connective tissue is formed.

Flap operation

The doctor makes 2 vertical incisions with a scalpel and peels off the mucoperiosteal flap. Then the standard mechanical cleaning of the pocket and polishing of the tooth surface is carried out.

At the end of the procedure, an osteogenic medicine is applied to the affected area (restores bone tissue), and the gum is sutured. The operation lasts about 40 minutes and, of course, includes local anesthesia.

For drug therapy, healing solutions and gels for external use are prescribed (drug cryogel, Furacilin, etc.). It is also recommended to use ointments that stimulate the epithelization of the gums (Actovegin, Solcoseryl). The doctor may prescribe a course of antibiotics.

The consequences of the formation of pockets in the gum

With the formation of periodontal pockets, the ligaments that hold the tooth in the alveolus (hole) are destroyed, the tooth roots are exposed, and the crown loses its natural support. As a result of such a pathological process, the mobility of healthy teeth occurs, the bite is disturbed.

In this state, it is difficult for a person to chew even soft food. Ultimately, the interdental spaces increase more and more, and the loose teeth begin to fall out one by one.

Therefore, if you notice that the gum has moved away from the tooth, do not postpone a visit to the periodontist. It is not difficult to find such a specialist. Just use the search bar on our website.

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Periodontitis is an inflammatory disease accompanied by the destruction of all periodontal tissues without exception: periodontium, bone tissue of the alveoli and gums. The causes of this disease can be both general and local. First, they lead to the development of gingivitis, and then to a general inflammation of the gums, which spreads to all underlying tissues. The main etiological factor that causes periodontitis is pathogenic microflora that penetrates into the dental plaque, and then into the periodontal sulcus. The source of infection is plaque, in which gram-negative bacteria, spirochetes and fusobacteria begin to multiply, called "associations of potentially aggressive microflora."

According to recent data, there are several groups of risk factors that can provoke the activity of pathogenic microflora. This is primarily a group of factors that create conditions for an increased periodontal load. These include malocclusion, traumatic knots, certain bad habits such as clenching, and defects in fillings or dental prosthetics.
Another group are factors that cause malnutrition and ischemia of periodontal tissues: shortening of the frenulum of the lips and tongue, violations of the attachment of cords and frenulums of the lips and tongue, a small vestibule of the mouth.
The third group includes factors that create favorable conditions for the development and delay of pathogenic microflora: insufficient hygiene of the teeth and the entire oral cavity, the presence of carious cavities near the gums, crowding of teeth or other violations of interdental contacts.
In addition, the development of periodontitis is favored by congenital defects in the structure of the periodontium. e.g. thin gums, thin alveolar bones, bulge
roots, usually combined with the bulge of the contour of the dental arch, general diseases, some bad habits, etc. These factors, interfering with the protective system of the periodontium, can create prerequisites for the development of pathogenic microflora on its tissues, primarily at the place where the teeth are attached to the gum, which, in fact, , and is the beginning of periodontitis.
What's happening?
During periodontitis, the periodontal joints are destroyed and a so-called periodontal pocket is formed. In addition, periodontal and alveolar bone tissues undergo rough destruction. The main pathogenic mechanism of the acute form of the disease is the active effect of enzymes that negatively affect the intercellular connections of the epithelium and lead to its increased permeability.
In addition, by acting on the organic substance of epithelial attachments, enzymes can change its colloidal state, which leads to disruption of the epithelium's bonds with the surface of the teeth. Toxins formed by bacteria damage cells, the ground substance and connective tissue formations, simultaneously causing cellular and humoral immune responses.
They also contribute to the inflammatory process in the soft tissues of the gums, followed by the destruction of the bone tissues of the alveoli, and the serotonin and histamine formed during inflammation affect the membranes of vascular cells.
The formation of a periodontal pocket is associated with the destruction of the epithelium and its growth into the underlying connective tissues. With the further development of the disease, the connective tissue in the circular ligament of the tooth is destroyed. As a result, granulations are formed, and the bone tissue of the alveoli is destroyed. Thus, a periodontal pocket is formed, and the supporting apparatus of the tooth is completely destroyed, which leads to a gradual loss of teeth.
Symptoms of periodontitis are very diverse and largely depend on the severity, nature of the course, the duration of the pathological process and many other factors.
The main manifestations of this disease are the depth of the periodontal pocket and the degree of destruction of the bones of the alveolar process. These signs are considered the main ones, since they cause other symptoms - such as the degree of loosening of the teeth, the appearance of abscesses, suppuration of the gum tissue, etc.
Types and forms of the disease
Localized acute periodontitis develops in case of periodontal rupture during orthopedic dental treatment. In such cases, chronic periodontitis is usually detected, which has developed as a result of advanced gingivitis. According to the severity, mild, moderate and strong forms are distinguished, but all of them can occur in one person. Just this kind of division of the disease according to the degree of intensity gives doctors the opportunity to more accurately determine the treatment measures.
Chronic periodontitis begins imperceptibly, without causing pain or other unpleasant sensations in a person, only bleeding gums and bad breath are noted. In some cases, tartar and loosening of individual teeth become noticeable.
If treatment is not started, the disease progresses: gaps appear between the teeth, the teeth move, become mobile, and then fall out. As symptoms increase, pain, abscesses, and some other signs of the disease are noted. When viewed on the teeth, dental deposits, hyperemia of the gums and the presence of periodontal pockets are visible.
With a mild degree of periodontitis, the depth of the pockets does not exceed 3.5 mm, the bone tissues are destructured in the initial degree, and the foci of osteoporosis are almost invisible due to the small loss of bone tissue. The teeth are not displaced, practically immobile, the outflow of pus is not observed.
The average severity of chronic periodontitis is characterized by a pocket depth of about 4-5 mm, the teeth are somewhat mobile, the destruction of the bone tissues of the interdental septum is visible on the x-ray. The expiration of pus is rare.
In severe chronic periodontitis, all symptoms are more pronounced: the depth of periodontal pockets is more than 5 mm, the teeth are very loose and displaced.
If treatment is not carried out, individual teeth fall out. The x-ray shows severe bone destruction. The expiration of pus and abscesses at this stage of the disease is a fairly common phenomenon. In addition, patients experience psycho-emotional stress associated with poor oral health. Diction is impaired, an unpleasant odor emanates from the mouth, etc.
Severe generalized periodontitis is the final stage of dystrophic inflammation in the periodontium. It is characterized by bleeding gums, displacement and mobility of teeth, putrid breath, difficulty chewing food and general malaise. On examination, chronic inflammation of the gums with the expiration of pus from periodontal pockets is seen. There are abundant deposits on the teeth, which are mobile and displaced. The depth of periodontal pockets exceeds 5 mm. The x-ray clearly shows the destruction of the bone tissue of the gums up to its complete absence.
Exacerbations of chronic periodontitis usually occur due to a deterioration in general well-being and condition due to infectious
or colds, diabetes, cardiovascular diseases, etc. In addition, periodontitis can worsen with functional overload of a particular group of teeth. This is characterized by severe pain, food intake and hygiene procedures are difficult, the general condition worsens, weakness, headaches, fever, etc. appear. The gum becomes inflamed, pus is released from it, loosening of the teeth is more pronounced.
Diagnosis of periodontitis
The diagnosis of "periodontitis" is made on the basis of the patient's complaints and periodontal examination data, including the study of the contents of periodontal pockets.
Traditional Treatments
To eliminate periodontitis, you need to undergo a course of therapeutic measures, which include the removal of tartar, dental prosthetics, treatment of gum inflammation and related general diseases. Usually, the doctor removes the most mobile teeth and treats periodontal pockets with healing solutions (solcoseryl, furatsilin, etc.). If the teeth are stable and their extraction is not necessary, the doctor dissects the periodontal pockets, removes tartar and
overgrown connective tissue. Then the cavity is filled with bone sawdust: this event stimulates the recovery processes in the bone tissue of the alveolar processes.
At home, the course of treatment is carried out by taking 5-7 periodontal granules 2-3 times a day for 5-6 days, after which a 1-2-day break is taken. To prevent this disease, you need to regularly eat vitamins and solid foods, as well as treat and prosthetic teeth in a timely manner. You should massage your gums daily and rinse your mouth with toothpaste or fresh chamomile infusion.

Folk remedies for the treatment of periodontitis

Recipe 1
Ingredients
Unrefined vegetable oil - 1 tbsp. l. Cooking method
Rinse your mouth with vegetable oil for at least 5 minutes 2 times a day for 6 months.
Recipe 2
Ingredients
Nettle leaves - 1 tbsp. l.
Hypericum perforatum - 1 tbsp. l.
Chamomile flowers - 1 tbsp. l.
Birch leaves - 1 tbsp. l.
Oak bark - 1 tbsp. l.
Water - 600 ml
Cooking method
Pour boiling water over the crushed herbal ingredients and leave covered for 30 minutes, then strain. Take the prepared infusion in 50-70 ml, diluting it with hot water in a ratio of 1: 1.
Recipe 3
Ingredients
Oak bark - 2 tbsp. l.
Water - 200 ml
Cooking method
Pour boiling water over crushed oak bark and insist, wrapped, for 30 minutes, then strain. Ready to rinse your mouth 2 times a day.
Recipe 4
Ingredients
St. John's wort - 2 tbsp. l.
Water - 400 ml
Cooking method
St. John's wort pour cold water, bring to a boil over low heat and cook for 5 minutes. Then carefully strain and use hot for rinsing.
Recipe 5
Ingredients
Calendula flowers - 2 tsp
Water - 400 ml
Cooking method
Pour calendula flowers with boiling water and leave covered for 30 minutes,
then strain. Warm up the infusion and rinse your mouth with it 2 times a day.
Recipe 6
Ingredients
Comfrey root - 1 tbsp. l.
Water - 200 ml
Cooking method
Pour crushed comfrey root with hot water, put on fire and boil for 10 minutes. Strain the finished broth and rinse your mouth with it 2 times a day.
Recipe 7
Ingredients
Alder cones - 3 tbsp. l.
Water - 200 ml
Cooking method
Pour alder cones with boiling water and insist, wrapped, for 40 minutes.
Strain the finished product and use for rinsing the mouth in a warm form.
Recipe 8
Ingredients
Horsetail herb - 3 tbsp. l.
Water - 200 ml
Cooking method
Pour chopped horsetail grass with boiling water and leave for 20 minutes, then strain. Ready infusion is used for rinsing the mouth 2 times a day.
Recipe 9
Ingredients
Sea buckthorn oil - 2 tbsp. l. Cooking method
Soak a small cotton swab with sea buckthorn oil and place it on
periodontal pocket area for 10-15 minutes.
Recipe 10
Ingredients
Green walnuts - 100 g
Water - 500 ml
Cooking method
Cut off the peel from unripe walnuts, chop it, pour hot water over it and boil for 20 minutes.
Strain the prepared broth and use it to rinse your mouth 2 times a day.
Recipe 11
Ingredients
Peel of green walnuts - 2 tbsp. l. Olive oil - 200 ml Cooking method
Grind the peel of unripe walnuts, add oil and infuse for 7-8 days, stirring occasionally.
Strain the finished product and process periodontal pockets with it.
Recipe 12
Ingredients
Grass violet tricolor - 2 tbsp. l. Grass of a series of tripartite - 1 tbsp. l. Water - 200 ml Preparation method
Chop the herbal ingredients, pour boiling water over it and insist for 30 minutes, then strain. The finished product is used for rinsing the mouth 2 times a day.
Recipe 13
Ingredients
Chinese tea - 2 tsp
Water - 200 ml
Cooking method
Brew black tea and use as a mouthwash. The same tool can be used to prevent caries.
Recipe 14
Ingredients
Grass stonecrop - 1 tbsp. l.
Water - 200 ml
Cooking method
Pour boiling water over fresh stonecrop herb and insist, wrapped, for 30 minutes. Strain the finished product, soak a cotton swab with it and apply it to the area of ​​the periodontal pocket 2 times a day.
Recipe 15
Ingredients
Great celandine herb - 0.5 cup 70% medical alcohol - 500 ml Glycerin - 400 ml Method of preparation
Grind dried celandine grass, pour into a glass container, pour alcohol and leave in a dark place for 7 days, then strain and mix with glycerin.
The prepared product is used for rinsing the mouth.
Recipe 16
Ingredients
Fresh plantain leaves - 50 g
Rinse the leaves thoroughly and pass through a meat grinder.
Squeeze juice from the resulting slurry and process periodontal pockets with it after curettage.
Recipe 17
Ingredients
Plantain leaf gruel - 3 tbsp. l. Peach oil - 3 tbsp. l. Vaseline - 3 tbsp. l. Cooking method
Mix these ingredients thoroughly and apply to
treatment of periodontal pockets.

Elena Lvovna Isaeva
Treatment of gum and teeth diseases in traditional and non-traditional ways

www.svoylekar.ru

Treatment

A gum pocket is a reversible condition that can be cured with proper hygiene. In case of a disease, for example, periodontal disease, treatment by a dentist will be required. Especially in the case of inflammation, soreness, swelling of the gums with the release of pus, a surgical operation can be used. Otherwise, it will lead to tooth loss.

With inflammation of the gum pocket, treatment is carried out in different ways. Therapeutic methods are applied if the depth is not more than 4 mm. First of all, it is necessary to carry out cleaning of plaque, calculus, microbes, deposits, so that the neck closes, the attachment of the gums to the teeth is restored.

In case of bleeding, you should consult a doctor. Medical procedures are carried out with the help of:

• hand tools;
• ultrasonic scaler;
• photosensitizer;
• surgery.

The pocket area is cleaned with an ultrasonic sclera, then the surface of the tooth root is processed with polishing. Excess growths are removed from the inflamed tissue. Thus, conditions are provided for the restoration process for the normal attachment of the gums to the teeth.

Photodynamic therapy - a modern method by which an advanced form of the disease is treated without surgical intervention. The principle of the method is that after brushing the teeth, a special substance consisting of concentrated chlorophyll is applied to the surface of the gums.

It is obtained from spirullins - seaweed. In the destroyed, inflamed cells under the action of the drug, photosensitizers develop, and after that, after a certain period of time, the specialist applies a laser beam to the gums. Its light acts on photosensitizers with the release of oxygen. In this case, an active oxidative reaction occurs, as a result of which the pathogenic flora and harmful bacteria die. When the affected tissue areas in the periodontal pocket are removed, it closes completely. With the help of one procedure, you can completely cure the pocket and get rid of inflammation, bleeding. If the treatment is carried out with a laser, then a protective formation is created on the mucous membrane, which prevents microbes from entering the gums, and also helps to restore the normal state of the pocket. After carrying out procedures to remove infected gum tissue, bone tissue should be restored. Successful therapy will be in case of complete restoration of periodontal joints and gum functions.

For this, a patchwork technique is used, in which the gums are peeled off in the area of ​​​​several teeth located nearby. After opening, the pockets are cleaned manually, and then the root of the tooth is processed and the gum is sewn on.

Such an operation is almost always performed with a positive effect, but the only drawback of the procedure may be the complexity in the psychological aspect for the patient himself. You can consider the result of the operation of the tooth pocket, the photo of which is presented above.

Many patients are interested in how to treat a pocket in the gum between the teeth with curettage technology, which is often recommended by specialists. It is considered effective and less painful. Distinguish between open and closed methods. During the procedure, gum pockets are thoroughly cleaned from deposits, tartar, and altered tissues.

The dentist prescribes a cleaning, taking into account the degree of the disease.

• Closed curettage carried out by laser, ultrasound at a small depth of formation, not exceeding 5 mm.
• Open curettage is a surgical operation that is performed with the use of anesthetics. In the process, a gum incision is made in the region of the interdental papillae, then cleaning is carried out and a means for effective healing is applied, after which the wound is sutured.

The result after curettage is noticeable after two weeks. Puffiness, redness, bleeding of the gums disappear, the depth of the pocket is reduced. To find out how to treat pockets in the gums, which method would be better, you need to seek advice from specialists at the first sign of the onset of the disease.

Preventive actions

In order to prevent re-treatment in the dental pocket, preventive measures should be taken in a timely manner. When the curettage procedure is performed, the doctor prescribes a number of preventive measures that should be performed regularly:

• brushing teeth;
• use cleaning products, pastes with an abrasive effect, where deposits are removed with the help of solid particles and polished teeth;
• use floss (dental floss) to clean between teeth;
• a visit to the dental clinic for prevention at least twice a year;
• compliance with additional recommendations of the doctor will reduce the growth of pockets, prevent complications of a different nature.

Treatment with folk remedies

Patients, when contacting a dentist, often ask if the dental pocket can be treated at home.

In this case, antiseptic solutions, decoctions from medicinal plants with a wound healing effect can effectively help. Several recipes can be found below.

• Walnut. The recipe uses green peel. Grind a tablespoon of peel and pour olive oil in a warm state - 0.25 ml. Pour the product into a jar and close tightly, then refrigerate for a week with occasional shaking. After infusion, the resulting solution is filtered and the gums are lubricated five times during the day.
• Plantain. Boiled water - 0.25 ml pour 20 grams of crushed plantain leaves and insist for at least an hour. They rinse the mouth four times throughout the day. In the summer, plantain juice helps a lot, for which the leaves are crushed in a blender and the juice is squeezed out with gauze. You can see the result of treatment with juice of gum pockets, the photo of which is presented below. A positive effect is achieved on the third day.
• Eucalyptus oil. In 200 ml of boiled water, add 2 teaspoons of oil, stir, then rinse at least three times a day for seven days. The tool is excellent for strengthening the gums.
• Hydrogen peroxide. 1 teaspoon of peroxide is added to 100 ml of water. The mouth must be rinsed twice a day for a week.
• Sugar beet. Grate the beets and wrap the resulting slurry in the amount of one teaspoon in cheesecloth, do not squeeze the juice. The remedy is applied for fifteen minutes to the inflamed areas. The procedure is carried out at least three times a day with a new compress. The expected result can come after two days of regular treatment.
• Highlander kidney. With this tool, treatment is carried out for a week. A spoonful of highlander is poured with 0.25 ml of boiled water, then infused for 25 minutes. It is necessary to moisten a piece of cotton wool in the resulting tincture, apply to the inflamed area, hold for 10 minutes. The agent is applied twice a day. The infusion is applied hot, but not boiled.
• Leaves and stems of golden mustache. The leaves of the plant are applied to the places of inflammation, and rinse the mouth with a tincture of the stems. One spoonful of the plant is brewed with half a liter of boiling water and infused for 30 minutes. Rinse is carried out at least three times a day.
• Lemon peels. Brew chopped lemon peel with a glass of boiling water, leave for half an hour and rinse your mouth three times a day for ten days.
• Air, propolis. The resulting remedy is effective for inflammation, as an anesthetic, wound healing. Preparation is carried out in advance with the addition of vodka. This will require one liter of vodka of the best quality, grind the root in an amount of 250 gr., And propolis - 20 gr. Each component is taken separately, poured with five hundred milliliters of vodka and infused for ten days with daily shaking. After preparation, proceed to treatment. The treatment is carried out over four weeks. To do this, mix calamus tincture with propolis tincture in a teaspoon.
Prevention of periodontal disease at home

Periodontal disease is a very unpleasant and complex disease, accompanied by various complications, such as bleeding gums or loosening of teeth.

The reason for the development of periodontal disease is quite simple, it is an infection. And the source of infection is most often precisely plaque, in which gram-negative bacteria and other microbes begin to multiply. The resulting pathogenic zone on the surface of the tooth penetrates into the dental plaque, and then into the periodontal sulcus.

Causes of the disease

As a result of the formation of these dental deposits, or as they are also called dental stones, an inflammatory process begins in the dental tissues and in the tissues of the gums. In the future, due to these bacteria, the connective tissue of the gums is damaged. As a result, most often periodontal pockets are formed, or as they are also called the periodontal pocket.

If the depth of the periodontal pocket is not very deep, approximately 3 mm, then in the course of daily hygiene it can be cleaned independently. But, if the depth of the periodontal pocket exceeds this depth, then it is unlikely that it will be possible to clean it with a toothbrush. As a result, deposits will accumulate until the inflammatory process begins.

Features of the development of the disease

Next, the epithelial cells are infected, which, plunging into the periodontium, begin to surround the root of the tooth with their pathogenic flora. At the same time, the inflammatory process continues to deepen, which subsequently leads to a decrease in bone tissue and makes the periodontal pocket even larger.

The next stage is the destruction of the connective tissue ligament, which leads to the absorption of the cement itself. Damaged bone tissue is replaced by epithelium Thus, the body tries to fight the pathological process and overgrow the affected area, but the result is only much worse. The epithelial cells are unable to hold the tooth in place. The walls of the gums are already sinking so low that the entire tooth is already exposed. And since the tooth no longer holds, the tissues and gums are broken - the tooth falls out.

The formation of a periodontal pocket is fraught with its pathology, so in the case of generalized periodontitis it is also fraught with complete adentia. This means the absence of teeth in both dentitions. In this case recommended orthopedic treatment when missing teeth are replaced with removable and fixed dentures.

Patients suffering from inflammatory diseases of the oral cavity often there is discomfort when eating, bad breath and all this can be accompanied by tissue suppuration and, as a result, an abscess is formed.

Periodontal pocket treatment methods

In order to cure a periodontal pocket, first you need to determine the degree of the disease, the dentist will help with this. At the very beginning of the disease, when the inflammatory process is not yet very strongly launched, can be managed with conservative therapy, that is, treatment, the process of which is aimed at alleviating the symptoms of the disease. Conservative therapy in this case will include, if it is the treatment of periodontal disease:

In case of a more severe degree of the disease, additional treatment is prescribed, in the form of a course of antibiotics.

After the treatment, in order to avoid the recurrence of the disease, it is necessary to observe oral hygiene very carefully. If, nevertheless, after a while, the symptoms of periodontal disease reappeared, such as blood from the gums, pain that appears during brushing, then it is better to consult a dentist without delay. Cause may be periodontal disease, but a poorly fitted crown, and if it is fitted, then all the symptoms will go away on their own.

curettage

There is also a surgical method for treating periodontal pockets - this is curettage, which is used specifically for the treatment of gums. With it, you can treat not only periodontal disease, but also gingivitis. Gingivitis is also an inflammatory disease of the gums, but in this case, the integrity of the dentition does not occur.

The main indications for curettage are the following symptoms:

• pocket depth exceeds 3 mm;
• strong deposition of tartar on the gums;
• inflammation of the gums, bleeding.

Many people confuse curettage with professional teeth cleaning. As a rule, professional teeth cleaning is recommended to be carried out 2-3 times a year, this will effectively help fight the occurrence of caries in the future. With its help, you can get rid of tartar, from the color that gives tea, coffee and tobacco, restoring a healthy natural color and shine to your teeth. Unlike professional cleaning, curettage not only helps to get rid of tartar and polishes the teeth, but also removes the pathological tissues of the periodontal pocket. Depending on how severe the case of the disease is, the doctor determines how and how many times this procedure should be performed.

When the depth of the periodontal pocket does not exceed 5 mm, the method of closed curettage is performed. A doctor can still clean pockets without surgery. In this case, the procedure is carried out in several stages and is almost painless. Straightaway must be diagnosed, to determine the stage of inflammation. After the diagnosis, an anesthetic medicine is administered, which will help dull the pain during the further procedure.

Direct cleaning of periodontal pockets is carried out with the help of special dental instruments, while trying not to disturb the basic structure of the gums. After the main cleaning, as a rule, the roots are also polished. The method of closed curettage very well helps to remove pathological deposits and significantly reduce the depth of the periodontal pocket.

The method of open curettage is used when the depth of the pockets already significantly exceeds 5 mm, or, for example, if the closed curettage procedure performed was not as effective as expected. It takes place in several stages, as a rule, already with surgical intervention. Before starting the procedure, as in the previous case, it is necessary to conduct a diagnosis of the gums. During open curettage be sure to inject anesthesia to anesthetize the desired area of ​​\u200b\u200bthe gum. An incision is then made with surgical instruments to reach the pathological pocket, and the pocket is cleaned with special dental instruments.

In order to stimulate the growth of damaged bone tissue, drugs are applied to it that can play the role of a passive matrix for new bone, in other words, osteogenic drugs. The operation is completed, like everything with surgery, by stitching the cut gums.

Flap operation

There is another method of treatment for the removal of pathological pockets - flap surgery, which involves two vertical incisions on the gum. This operation is necessary when the root has already been exposed. Accordingly, the root becomes very sensitive and begins to respond to various external stimuli. To avoid this, many experts recommend tissue transplantation from the sky, to the place where part of the gum was lost. I would like to note that transplantation is not only useful for this, but also because it excludes the reappearance of deep periodontal pockets in this place. With the help of transplantation, the loose tooth can be fixed again in the hole.

Prevention of recurrence

After all the measures taken aimed at the treatment of the periodontal pocket, a visit to the dentist is a must, after a certain time, which the doctor himself will establish based on the neglect of the disease. At this examination, the doctor will determine the success of the procedure and, if necessary, prescribe a second treatment.

In our time, given all the modern technologies, many dentists prefer to do curettage using ultrasound equipment, then this procedure is less painful, more effective and much faster than those described above. And additional polishing of the root will help prevent the formation of tartar in the future. Also, as a preventive measure, a course of treatment using antiseptic drugs can be prescribed.

Proper care and good daily oral hygiene will help to avoid the formation of tartar on the root of the tooth and further treatment of pathological pockets. It would also be useful to have professional teeth cleaning at least a couple of times a year in a dental clinic.

One of the most complex pathologies is the gingival pocket.

It forms between the gum and teeth, grows in size and can cause tooth loss.

Such a disease as a gum pocket, treatment takes a long time, it must be complex, and in advanced cases requires surgical intervention.

Features of the pathology

A gingival pocket is a depression between the gum tissue and the tooth. This space is present in the norm, but its depth is no more than 3 mm. Otherwise, it increases and destroys the deep-lying tissues that fix the tooth.

Causes include:

• inadequate oral hygiene;
• congenital anomalies of connective tissue;
• long-term and other chronic.

As a result, plaque accumulates on the surface of the teeth, which is the result of the vital activity of a microorganism.

It penetrates into the space between the gum and the tooth, food particles and bacteria get there.

Diseases of other organs and systems can also cause gum disease:

• chronic tonsillitis;
• kidney pathology;
• diseases of the gastrointestinal tract;
• inflammatory processes in the upper respiratory tract.

Due to excessive presence of bacteria in the mouth:

• are formed;
• microorganisms, multiplying, secrete proteolytic enzymes that destroy tissues and epithelium;
• the size of the pockets increases, which contributes to the retention of more bacteria and food debris;
• the deepening reaches the roots, that is, periodontal pockets are formed.

Most often, these processes develop in the region of molars and premolars.

Treatment

• it is usually opened;
• carefully remove necrotic tissue;
• scraping walls;
• washed with antiseptic solution.

After that, a rinse is prescribed, in severe cases, antibacterial agents. For the best effect, patients take a complex of vitamins.

One of the modern methods of therapy is photodynamic treatment. It consists in applying a special substance that reacts to light to the affected area. After that, the site is irradiated with a special laser, under the action of which reactive oxygen species are released.

Gingival pocket treatment with apparatus Vector

They are very aggressive, as they easily enter into chemical reactions and have a destructive effect on microorganisms. This procedure is carried out after a radical cleaning of the gum pocket.

Another effective method is sonication of the pocket. High-frequency vibrations destroy the wall of bacteria due to which they die. This method is combined with the removal of affected tissues, cleaning of necrotic masses and stones.

Preventive actions

Since small pieces of food accumulate between the tooth and the gum in this pathology, the main preventive measure should be brushing the teeth.

Teeth cleaning should be done:

• 2 times a day - in the morning and in the evening;
• a toothbrush with soft bristles;
• paste with antiseptic properties with abrasive substances.

Washing the mouth with antiseptic liquids has a good effect.

They slow down the growth of microorganisms, wash away food debris and normalize the acidic environment. It is necessary to select the liquid individually together with the doctor.

Another effective method of prevention is dental flossing. It allows you to qualitatively clean the interdental spaces and remove food particles that contribute to the increase in gum pockets.

Monthly preventive visits to the dentist are also important, since only a specialist can identify early changes, as well as advise the right toothpaste.

What can be done at home?

Before any independent action, it is necessary to consult a specialist. The doctor must determine the size of the periodontal space, as further measures depend on this.

If the depth is more than 3 mm, then the treatment is only surgical - cleaning and scraping the pocket.

Self-treatment at home is contraindicated:

• with multiple and deep gum pockets;
• concomitant and periodontitis;
• systemic disorders in the body, for example, a lack of vitamins.

In the latter case, a complex effect is necessary, since this combination of pathologies is very serious.

Medications

After the gum pocket has been removed, home treatment consists of taking the following drugs:

• Chlorhexidine mouthwash;
• antibiotics in tablets, Metronidazole or penicillin derivatives;
• in severe forms, antibacterial agents of a narrow spectrum of action.

Antibiotics are rarely used when there are concomitant inflammatory processes with purulent complications. For the best effect, they are selected according to the pathogen, after it has been identified with the help of crops.

Antiseptics are used to reduce the growth of pathogenic flora in the oral cavity. Hydrogen peroxide can be used for rinsing.

Such a remedy can be prepared independently by adding 1 tablet of hydroperite to 200 ml of chilled boiled water. You need to rinse 3 times a day. It is important to note that this solution must not be swallowed.

At home, you can combine traditional medicines and folk methods, which will be described below.

Folk remedies

One of the most effective recipes is walnut peel tincture. This plant has antiseptic qualities, contains beta-carotene, active substances that help strengthen and restore gums.

Antiseptic medicine for gums is prepared as follows:

• from a young nut, remove the green peel and finely chop;
• 100 ml of olive oil are added to 2 tablespoons;
• close tightly and leave in a cold place;
• shake periodically;
• the resulting infusion lubricates the gums at least 5 times a day.

Plantain has a restorative effect, leaves are best suited for treatment:

• 20 g pour a glass of boiling water;
• leave for an hour;
• mouth rinse 5 times a day at regular intervals.

You can also use juice. To do this, it is squeezed out of finely chopped leaves and smeared on the affected areas.

A mixture of sage, nettle and chamomile affects the gums very well:

• the above dried herbs are mixed in a ratio of 1: 1;
• a tablespoon of the collection is poured with a glass of hot water and left for half an hour;
• filter and rinse your mouth 2-3 times an hour.

Chamomile and sage have an anti-inflammatory effect, while nettle has antiseptic properties. Therefore, after a day of using the collection, there will already be improvements.

Another useful herb used for gum disease is the golden mustache. You can simply cut the washed leaves and apply them to the affected area for 15 minutes or prepare an infusion, for this:

• finely chop the stem of the plant;
• add a tablespoon of raw materials to half a liter of boiling water;
• insist 30 minutes.

It is necessary to caress in the morning, afternoon and evening.

• honey is added to 500 grams of ripe berries in the same amount;
• pour the resulting mixture with half a liter of 70% alcohol;
• let it brew for 2 weeks.

Drink a tablespoon 4 times a day, preferably before meals. This combination of products is used for any diseases of the oral cavity. The active substances contained in them enhance the regeneration of epithelial cells.

You can also make a paste with honey and garlic. She needs to brush her teeth after eating in the morning and in the evening.

To make garlic paste you need:

• chop a few cloves of garlic;
• mix a teaspoon of gruel and honey;
• add some salt and 8-10 drops of hydrogen peroxide.

Thus, for the treatment of the gum pocket, there are many means by which this disease can be cured at home.

Related videos

Visually about what periodontal pockets are, in the video:

The appearance of periodontal pockets in the gums is a typical sign of periodontitis, that is, chronic inflammation of the gums.

The presence of such "pockets" is accompanied by discomfort while eating, bad breath, suppuration. If the problem is ignored, you can end up losing healthy teeth.

The structure of the periodontal pocket

The periodontal pocket is the space freed as a result of the destruction of the periodontium. The inflammatory process violates the integrity of the periodontal joints, atrophy (resorption) of the alveolar bone begins. There is an area where there is no attachment of the gum to the surface of the tooth root.

Let us explain that the periodontium includes the periodontal tissues:

• circular ligament of the tooth;
• cement covering the root;
• alveolar processes (the part that bears the teeth).

The bottom of the pocket is usually filled with granulation (connective) tissue, plaque and pus. There is a large number of destroyed leukocytes, which indicates a protracted inflammatory process. Particles of food constantly fall into the hole.

Bacterial deposits literally stick to the surface of the enamel and in the area of ​​the gingival margin. Microorganisms contained in plaque (Prevotella melanogenica, Fusobacterium nucleatum) produce toxins that trigger the inflammatory process.

Factors accelerating the formation of a defect:

• the use of exclusively soft food - it is known that hard vegetables and fruits (carrots, apples, cabbage) help to clean teeth from plaque;
• improper installation of a dental filling - the sharp edges of the filling can injure the gums;
• malocclusion - leads to increased stress in certain areas of the periodontium;
• some chronic diseases, such as diabetes;
• hormonal imbalance;
• immunodeficiency states.

Symptoms of inflammation

• Putrid odor from the mouth that does not go away even after brushing your teeth;
• bleeding gums, which increases with any mechanical impact;
• pain and itching during meals, especially hard ones;
• reaction to cold and hot;
• release of purulent exudate;
• visual lengthening of the tooth crown by lowering the gums;
• at a later stage - loosening and displacement of the teeth.

Normally, the space between the neck of the tooth and the gingival margin should not exceed 1-2 mm. With a mild degree of periodontitis, a gingival pocket with a depth of 3.5 mm is formed.

The average severity of the inflammatory process is characterized by pockets with a depth of 4 mm. At the same time, a bone defect and destruction of the interdental septa already appear on the x-ray. At a late stage, the depth of the fossa exceeds 5 mm.

Treatment of periodontal pockets and periodontal disease

Periodontitis (inflammation) and periodontal disease (destructive process) should be treated in a complex manner. The first stage is ultrasonic cleaning of periodontal pockets, then medical treatment is carried out. In the most advanced cases, surgical intervention is prescribed.

Ultrasonic cleaning

It is carried out by the apparatus "Vector". A special scaler nozzle generates ultrasonic vibrations that destroy hard dental plaques, including deep pockets. All pathogenic microflora is destroyed due to the antibacterial effect of ultrasound.

Cleaning of all dental pockets takes about an hour. The procedure is painless, but with some discomfort.

Open and closed curettage is the mechanical cleaning of pockets using hand instruments (scalers and curettes). Applicable when the pocket depth exceeds 3 mm.

It is performed under local anesthesia and includes the following steps:

1. Antiseptic treatment of the entire oral cavity (rinsing with a solution of chlorhexidine or miramistin).
2. Scraping of softened tissues and purulent exudate at the bottom of the pocket, removal of bacterial deposits on the entire surface of the tooth, including on the roots.
3. Washing the cleaned cavity with an antiseptic solution.
4. The imposition of a protective bandage on the gum.

Curettage of periodontal pockets

The recovery period lasts 2-3 weeks. During this time, a new scar-connective tissue is formed.

The doctor makes 2 vertical incisions with a scalpel and peels off the mucoperiosteal flap. Then the standard mechanical cleaning of the pocket and polishing of the tooth surface is carried out.

At the end of the procedure, an osteogenic medicine is applied to the affected area (restores bone tissue), and the gum is sutured. The operation lasts about 40 minutes and, of course, includes local anesthesia.

For drug therapy, healing solutions and gels for external use are prescribed (drug cryogel, Furacilin, etc.). It is also recommended to use ointments that stimulate the epithelization of the gums (Actovegin, Solcoseryl). The doctor may prescribe a course of antibiotics.

The consequences of the formation of pockets in the gum

With the formation of periodontal pockets, the ligaments that hold the tooth in the alveolus (hole) are destroyed, the tooth roots are exposed, and the crown loses its natural support. As a result of such a pathological process, the mobility of healthy teeth occurs, the bite is disturbed.

In this state, it is difficult for a person to chew even soft food. Ultimately, the interdental spaces increase more and more, and the loose teeth begin to fall out one by one.

Therefore, if you notice that the gum has moved away from the tooth, do not postpone a visit to the periodontist. It is not difficult to find such a specialist. Just use the search bar on our website.

Gingival pockets are one of the symptoms of many periodontal tissue diseases. Between the gum and the cervical part of the tooth, a space is formed in which plaque, food debris and bacteria accumulate. Gradually, inflammation develops, the teeth become mobile, and if left untreated, the risk of their loss increases.

What is a periodontal pocket and how is it formed?

The teeth are connected to the jaw bone with the help of periodontal - a special ligament. Periodontium acts as a shock absorber, thanks to which the teeth are held in place and the load during chewing is distributed evenly. In a healthy person, the tissues of the oral cavity are reliably protected from the penetration of pathogenic microflora.

When periodontal depressurization occurs, plaque accumulates in the cervical region of the tooth, which eventually turns into stone, since it is located in a hard-to-reach area and it is impossible to clean it from there on your own.

Symptoms

Patients rarely go to the dentist at the initial stage of the disease. Often people come to a specialist with an already advanced stage of pathology with pronounced symptoms. characteristic signs the presence of periodontal pockets:

• bad taste and odor in the mouth
• change in the shape and color of the gum mucosa,
• bleeding and sore gums
• tooth mobility,
• discomfort while eating
• gingival prolapse, exposure of the root part of the tooth,
• excretion of pus.

The main diagnostic methods are probing and radiography. Shaded areas in the image are areas where the gum is moving away from the tooth. The stages of pathology are determined depending on the depth of the gum pocket:

Accelerate the formation of space between the gum and the tooth can be the following unfavorable factors:

• the predominance in the diet of soft foods that do not require chewing,
• systematic trauma to the gums with sharp edges of fillings, prostheses, braces,
• often causes an uneven distribution of chewing load on different parts of the periodontium,
• diabetes mellitus increases the risk of developing pathology,
• hormonal disorders,
• imbalance of the immune system.

Smokers are more prone to the formation of periodontal pockets. Nicotine resins settle on the enamel and in the subgingival area, creating a persistent plaque. Smokers must be regularly carried out for the prevention of periodontal tissue diseases.

How is the treatment carried out?

Periodontal gum pockets are not an independent disease, but only a manifestation, a symptom of periodontal tissue pathologies. To get rid of them, it is necessary to cure gingivitis, periodontitis, or any other condition that caused the formation of gum pockets. Treatment is prescribed after evaluating the results of the diagnosis and begins with professional cleaning from plaque and stone.

If the pathology is at an early stage, professional cleaning can be limited. If the periodontal pockets are deep, the symptoms are pronounced, a deep cleaning is carried out - curettage. This is followed by treatment of the underlying and concomitant diseases (periodontal pockets are often formed in people with diabetes, for example).

For what reasons does it appear and how to get rid of it?

How is periodontal pocket curettage performed?

Curettage is a procedure for deep cleaning of periodontal pockets from plaque, granulation, pus, and dead cells. There are several options for the operation:

1. - the main types of procedures.
2. Vacuum.
3. Laser.
4. Cryo curettage.
5. Chemical.

Closed curettage is carried out at the initial stage of periodontitis, while the depth of periodontal pockets should not exceed 4 mm. Open is used for advanced forms of periodontitis, pocket depth of 4 mm or more, detachment of the gums from the tooth and extensive accumulation of plaque.

Stages closed procedure:

• the oral cavity is treated with an antiseptic,
• the drug is injected
• the contents of periodontal pockets (plaque, granulation, pus) are removed,
• tooth surface is polished
• repeated antiseptic treatment,
• a drug is placed in the pockets to restore damaged tissues.

Open curettage is performed with an incision in the gingival mucosa, which allows the doctor to perform the deepest possible cleaning with a detailed overview of the treated area. The doctor makes a vertical incision in the gums, after which he cleans. At the end of the operation, the incisions are sutured.

: indications, benefits and cost of the procedure