Periodontal disease is fiercer than a tiger, and the main cause of tooth loss today is periodontal disease, the main reason being that people do not pay attention to periodontal health maintenance. Periodontal disease is a global disease regardless of geography, country, race, gender and age, and is the first cause of tooth loss in adults. The 2005 epidemiological survey in China showed that 68% to 77% of the population suffers from periodontal disease of varying degrees, and 10.5% of the elderly population has missing teeth in their entire mouth. A saying circulating among dentists in Western countries is: “Everyone may suffer from periodontal disease at some point in their lives.” This shows how common periodontal disease is. Do you have periodontal disease? Periodontal disease is a chronic infectious disease that occurs in the tissues surrounding the teeth (gums, alveolar bone, periodontal membrane) and can be roughly divided into two categories: gum disease and periodontal disease. The most common type of gum disease is gingivitis, where the lesion is limited to the gums (flesh of the teeth) and is generally better treated; periodontitis has a more complex cause. Inflammation progresses from the gums to the deeper tissues, destroying the alveolar bone that supports the roots of the teeth, the periodontal membrane, etc. This is manifested by redness and swelling of the gums, formation of periodontal pockets, and gradual loosening of the teeth until they are eventually extracted or lost. Periodontitis is a slowly progressing, insidiously destructive disease with no obvious symptoms such as pain in the early stages, and patients are often unaware of it. Here are the common symptoms and manifestations of periodontal disease, you can conduct a self-examination, if you find yourself with one or several of them, you should go to a regular dental clinic. 1. Redness and swelling of the gums (gingivitis/periodontitis, normal gums should be pink, dense and close to the tooth surface). 2, Gums bleed when brushing or biting food (gingivitis/periodontitis, healthy gums do not bleed when touched). 3.The teeth gradually loosen and chewing is weak (periodontitis, the alveolar bone that surrounds and supports the roots of the teeth resorbs, causing the teeth to lose support). 4.The front teeth appear to have enlarged gaps (periodontitis, which shifts the teeth due to inflammation and bone resorption). 5, Gum recession, root exposure, tooth sensitivity to hot and cold (periodontitis) 6, bad breath (gingivitis/periodontitis. (Gum inflammation produces sulfide). 7. Acute swelling and pain in the gums (advanced periodontitis with deep periodontal pockets that can cause acute swelling). Why do you get periodontal disease? Since ancient times, people have recognized the importance of removing plaque build-up on the tooth surface to maintain dental health, and the 1965 experiment on artificial gingivitis reported by Norwegian scholar Loe et al. eloquently demonstrated that microorganisms in plaque build-up on the tooth surface are the “culprits” of gingivitis. All subjects without exception developed gingivitis within 10 to 21 days, with redness and bleeding of the gums, as plaque on the teeth gradually increased. After a week of resuming brushing, the inflammation subsided and the gums returned to full health. A large number of clinical facts also show that some factors in the mouth that can contribute to plaque accumulation, such as misaligned teeth, fillings that do not fit well with the teeth, and anatomical areas that are not easily cleaned by toothbrushes, can cause gingivitis. Plaque cannot be removed by rinsing or flushing and must be removed with a toothbrush or other instrument. If plaque is not removed in time, it may calcify and form tartar, which cannot be removed by brushing alone and must be removed by ultrasonic scaling. Can periodontal disease be cured? Some people think that there is no good way to cure periodontal disease and that the only way is to wait for the affected teeth to gradually fall out before setting them. In fact, periodontal disease can be treated with some success. Periodontal disease is an infectious disease, and the principle of treatment is to remove the cause of the infection first, and the inflammation can be controlled. Gingivitis, due to its relatively simple cause and limited scope of lesions, can be cured after regular treatment and removal of plaque and tartar, the inflammation will soon subside and the gums can return to normal. Periodontitis, on the other hand, is caused by the gums detaching from the roots of the teeth and forming deeper periodontal pockets, and there is resorption of the alveolar bone. After removal of plaque and tartar, the inflammation can be controlled, the periodontal pocket can become shallow, and bone resorption can stop, but the tissue that has been destroyed cannot be easily regenerated and reattached to the roots. In this sense, periodontitis can be controlled, the disease can stop progressing, and the gum tissue can become “healthy” (no more redness, swelling, bleeding, or pus). However, it is not possible to say that the disease is “cured” but only that it returns to a “healthy” state. More importantly, because of the continuous formation of plaque, if the treatment is not followed by careful maintenance (self-maintenance and regular check-ups), both gingivitis and periodontitis may recur, making all previous work lost. Why is periodontal disease treatment not “once and for all”? Why do I need regular follow-ups? Basic periodontal treatment is effective for most patients with periodontitis. One to two weeks after treatment, the gum inflammation subsides significantly, bleeding is reduced or stopped, the patient feels comfortable and fresh in the mouth, and chewing function is improved. At this point, many patients will think that the treatment is complete and there is no need to go to the hospital. In fact, this is only the foundation for the rehabilitation of periodontal tissues, the follow-up review and treatment must follow in order to obtain the best results and maintain the long-term effect. The reasons are as follows: 1. Plaque is constantly formed, and after thorough cleaning, new bacteria will adhere to the tooth surface within a few hours and continue to thicken, in which the virulence of bacteria is also enhanced. Although the plaque tartar in the periodontal pocket is removed as much as possible, the residual microorganisms will also multiply and breed, and if no intervention is made, the bacteria can rebound to the pre-treatment level in about 6 to 8 weeks, leading to a recurrence of inflammation and aggravation of the lesion. Therefore, it is extremely important to continue to control the plaque carefully after the basic treatment. And the control of plaque can’t just rely on the doctor, should be the patient’s daily “homework”, daily removal of plaque to prevent its accumulation, is the key to prevent recurrence. 2.Basic treatment can get good effect for most people. However, for some teeth with more severe disease, further complicated treatment may be needed. It needs to be reviewed 2 to 3 months after the basic treatment to develop the appropriate treatment plan. Periodontitis is a chronic disease with a long course. It has a resting phase and an active progressive phase, just like other chronic diseases in the body (e.g. hypertension, diabetes, etc.). Periodontal disease can fluctuate as local and systemic conditions change. With regular review, even if the disease worsens, it can be detected and treated in time to stabilize the disease and keep the teeth for a long time. Therefore, the treatment of periodontal disease is not permanent, but depends on the patient’s self-maintenance on the one hand, and regular review and maintenance at the hospital on the other hand, in order to ensure long-term effectiveness.