Clinical manifestations
Early symptoms are not obvious, and patients often have only secondary gingival bleeding or bad breath, similar to the symptoms of gingivitis. On examination, swelling and softness of the gingival margin, gingival papillae and attached gingiva are visible, dark red or dark red, and bleed easily on probing. With the further spread of inflammation, the following symptoms appear.
1, periodontal pocket formation
Due to the expansion of inflammation, the periodontal membrane is destroyed, the alveolar bone is gradually resorbed, the gums are separated from the roots, and the gingival sulcus is deepened to form periodontal pockets. The depth of the periodontal pocket can be measured with a probe.
2, periodontal pus overflow
Periodontal pocket wall ulcers and inflammatory granulation tissue formation, pus secretions remain in the pocket, so lightly press the gums, visible pus overflow. And often have bad breath.
3.Loose teeth
Due to the destruction of periodontal tissues, especially when the resorption of alveolar bone is aggravated, the power to support the teeth is insufficient, and the teeth become loose and displaced. At this time, patients often feel weakness and dull pain in biting, and gum bleeding and bad breath are aggravated.
When the resistance of the body is reduced and the drainage of the periodontal pocket is poor, a periodontal abscess can be formed, which is a common symptom accompanying the development of periodontitis to an advanced stage and the appearance of deep periodontal pockets. At this time, the gums are oval in shape, red and swollen, with a shiny surface; the tooth looseness increases and there is percussion pain; the patient is accompanied by local intense throbbing pain. At the same time, the patient may have symptoms such as elevated body temperature, general discomfort, enlarged submandibular lymph nodes and pressure pain.
Treatment
I. Local treatment
1.For local irritation factors
Supragingival scaling or subgingival scraping can be performed, and if necessary, the occlusion can be adjusted, food embedding can be eliminated and bad restorations can be corrected.
2.Treatment of periodontal pockets
When the periodontal pocket overflowing pus, available 1%-3% hydrogen peroxide solution rinse, pocket built-in 10% iodine compound or spiramycin, methotrexate and other drug film. After removing local factors, shallow periodontal pockets can be cauterized with iodophenol solution; deeper periodontal pockets require periodontal surgery to eliminate periodontitis. When the periodontal pocket is deep to the root tip and the tooth is loose, extraction can be considered.
3.Loose teeth fixed
If the teeth are still loose, temporary or permanent periodontal splints can be made to fix the loose teeth.
4.Treatment of periodontal abscess
When the abscess is limited, it can be incised and drained. Periodontal pockets should also be rinsed, coated with medicinal film or iodine glycerin at the same time.
Systemic treatment
Enhance the body’s resistance and actively treat the systemic diseases related to periodontitis. When periodontal abscess occurs, patients with heavy systemic reaction should take relevant antibacterial drugs orally.
In conclusion, the treatment of periodontitis includes a series of comprehensive therapeutic measures. In order to consolidate the therapeutic effect and prevent recurrence, oral hygiene promotion and regular review should be carried out.