Chronic mild generalized periodontitis
Chronic mild generalized periodontitis develops as a complication of untreated chronic catarrhal gingivitis and is characterized by progressive destruction of periodontal tissues and bone of the alveolar processes of the jaws.
Diagnosis and symptoms of mild chronic generalized periodontitis
The clinical picture of mild chronic generalized periodontitis is characterized by an almost complete absence of unpleasant subjective sensations in the patient, hence the low demand for medical care at this stage of the development of the disease. Patients, as a rule, note itching in the gums and their bleeding during mechanical irritation (when brushing teeth, eating harsh food). The general condition in chronic generalized mild periodontitis is not disturbed, although a detailed examination of the patient reveals changes in the immune system, deviations from other organs and systems associated with periodontal pathology. From the patient's anamnesis, it is possible to find out that the disease with mild chronic generalized periodontitis began gradually, and was almost asymptomatic for a long time.
An objective examination of a patient with mild chronic generalized periodontitis reveals chronic mild inflammation of the gums (edema, bleeding, hyperemia). Supra- and subgingival dental deposits (mineralized and non-mineralized) are revealed. In this case, the teeth are motionless and not displaced.
The diagnostic criteria for mild chronic generalized periodontitis are:
- the presence of periodontal pockets up to 3.5 mm deep, mainly in the area of interdental spaces
- the initial degree of destruction of the bone tissue of the alveolar process (X-ray picture - the absence of a compact plate at the tops of the interalveolar septa, foci of osteoporosis, expansion of the periodontal gap in the cervical region)
To diagnose mild chronic generalized periodontitis, it is enough to question the patient, examine the oral cavity, probing clinical pockets, assess the mobility of the teeth, conduct the Schiller-Pisarev test, as well as indicate and quantify the "dental" plaque. To clarify the diagnosis of mild chronic generalized periodontitis, X-ray examination and orthopantomography are performed. It is advisable to do a clinical blood test (CBC), and for patients over 40 years of age, also a blood test for glucose.
Treatment of mild chronic generalized periodontitis
Treatment for mild periodontitis is carried out in 3-4 visits. First, after antiseptic treatment of the gums, the dental deposits are thoroughly removed. It is advisable to apply antimicrobial and anti-inflammatory drugs to the gums. Of the antimicrobial agents in the case of mild chronic generalized periodontitis, 0.06% chlorhexidine solution, metronidazole (trichopolum) are most effective.
Among anti-inflammatory drugs, preference is given to non-steroidal anti-inflammatory drugs (NSAIDs) - acetylsalicylic acid, indomethacin, ortofen, etc.
A patient with mild chronic generalized periodontitis is taught the rules of oral hygiene, helps to choose a toothbrush and toothpaste, and gives recommendations on the use of floss. At this stage of mild chronic generalized periodontitis, toothpaste with anti-inflammatory and antimicrobial effects should be recommended, as well as oral baths with antiseptic solutions, decoctions of chamomile, sage, calendula.
Good results in mild chronic generalized periodontitis are given by physiotherapy:
- UV on the gum area (antibacterial effect)
- electrophoresis of medicinal substances (calcium chloride, vitamin B1)
- UHF in an oligothermic dose
- local hypothermia
- helium-neon laser radiation argon plasma flow (anti-inflammatory effect)
Periodontitis, as a rule, is accompanied by the functional overload of the teeth, therefore, the patient should be referred for a consultation with an orthopedic doctor for selective grinding and other types of orthopedic treatment.
On the second, third, and fourth visits (with an interval of 1-2 days), the level of oral hygiene is checked, the removal of dental deposits continues, the application of pastes based on metronidazole and NSAIDs. After the relief of inflammation in chronic generalized periodontitis of mild degree, curettage of granulations is performed. This procedure can significantly improve the long-term results of treatment.
After carrying out the described course of medical manipulations, chronic mild generalized periodontitis goes into remission. A control examination of the patient is prescribed in 4-6 months.