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Nurmatov Ortiq Sattarovich
PhD Assistant of the Department of Dentistry, Faculty of Postgraduate Education, Samarkand
State Medical Education University
Isoxodjayev Sardorbek Faxriddin ugʻli
1st year clinical resident Samarkand State Medical Education University
BASICS OF PREVENTION OF PERIODONTAL DISEASES
Abstract:
Prevention of periodontal diseases is a complex task, the solution of which requires
conditions of both local and general nature, including social issues and problems of modern man
Key words
:periodontium, periodontal diseases, somatic diseases, dental plaque, dental plaque,
biofilm, prevention, oral hygiene
INTRODUCTION
The periodontium is a complex multifunctional complex of tissues surrounding and
supporting the tooth, interconnected morphologically, functionally and genetically, and includes
the gum, periodontium, cementum of the tooth root and the dental socket (alveolus). Periodontal
diseases are one of the current problems in dentistry. This group includes all pathological
processes that occur in the periodontium. They can be of varying severity and develop
independently or against the background of common somatic diseases. Pathological processes in
the periodontium can be inflammatory or dystrophic in nature (a combination of both is often
observed). Periodontal diseases lead to significant disorders of the dental system, the
development of purulent-inflammatory diseases of the maxillofacial area and, in most cases, to
infectious sensitization, chronic intoxication and changes in the immune status of the div.
According to WHO, every adult over 30 years of age suffers from periodontal disease to varying
degrees. In the general structure of providing medical care to patients in dental treatment and
prevention institutions, periodontal diseases account for up to 90% of the total number of visits
and occur in people of all ages. A sharp increase in the prevalence of periodontal diseases, the
loss of a large number of teeth as a result of their progression, which, in turn, causes the
occurrence of secondary deformations of the dentition and pathology of the temporomandibular
joint, disturbances in the act of chewing and speech, and an impact on the general condition of
the div and a decrease in the quality of human life require close attention of specialists to this
pathology not only as a general medical, but also a social problem.
An important role in the effectiveness of the prevention of periodontal diseases is played by
the condition of the whole organism, since this type of dental pathology is directly related to the
general condition of the human div, with its somatic status and depends on it, which can
facilitate or complicate the implementation of preventive measures. Of course, periodontal
diseases are polyetiological in nature. According to the results of microbiological studies of the
microflora of periodontal pockets, more than 350 types of bacteria have been identified.
Destructive forms of periodontal diseases are directly associated with anaerobic gram-negative
microflora - Porphyromonas gingivalis, Actinobacillus actinomycetemcomitans, Bacteroides
forsythus. Studies in recent years have shown that P. gingivalis is a critical pathogen in the
development of severe forms of destructive periodontal diseases. For many years, dentists,
together with general practitioners, have been studying the relationship and interdependence of
general somatic pathology with dental pathology. This is a completely natural process, since the
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human div is a single whole, and no matter how we "break" it into separate areas for ease of
study, it nevertheless remains such, and the processes occurring in one area inevitably affect the
condition of all its other parts.
Periodontium diseases
Are the second most common after dental caries. This fact gives special importance to the
prevention of this group of diseases, especially since recently there has been an aggravation of
their course, an increase in the number of people with chronic generalized periodontitis
A person is a single complex self-regulating system of cells and non-cellular structures,
united by cellular, humoral, nervous regulation mechanisms. This explains the relationship of
dental diseases with the condition of other organs and systems and the div as a whole. Today,
in modern conditions, there is an increase in the number of chronic diseases of a general somatic
profile, which is associated with the deterioration of environmental conditions, especially in
recent decades.
The vital activity of man himself plays a far from insignificant role in this negative process.
Unfavorable environmental conditions, global climate change, the emergence of forms of
microorganisms resistant to antibacterial therapy, unhealthy diet, bad habits, a sedentary lifestyle,
constant stress and many other reasons often lead to the emergence and development of various
chronic diseases and a reduction in life expectancy. It should be remembered that the nature of
the course and severity of any somatic diseases will be aggravated by chronic inflammatory
diseases of the maxillofacial region. In turn, such local pathological factors as inflammatory
periodontal diseases inevitably affect the characteristics of the course of systemic diseases. At
the same time, the more severe the general condition of the patient, the worse the condition of
the periodontal tissues will be.
Currently, there are works related to the increase in the incidence of cardiovascular
pathology against the background of periodontal diseases, but their number is still small.
Extended studies are required to study the possibilities of reducing the risk of developing
coronary pathology against the background of the treatment of inflammatory periodontal
diseases. There is still no consensus on the existence or absence of a relationship between
periodontal diseases and osteoporosis processes.
Periodontium diseases are second in prevalence after dental caries. This fact makes the
prevention of this group of diseases especially important, especially since recently their
progression has become more severe, with an increase in the number of people with chronic
generalized periodontitis of moderate and severe degrees, with abundant supra- and subgingival
hard dental deposits (tartar).
Primary prevention of periodontal diseases involves the following measures:
■ rational and correct feeding of the child and his subsequent nutrition;
■ training of the masticatory apparatus for the purpose of normal formation of the periodontium
(compensation for insufficient chewing load);
■ timely orthodontic treatment using multifunctional therapy (according to indications);
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■ training in the basic rules and methods of individual oral hygiene;
■ elimination of anomalies in the attachment of the ligaments and frenulum of the lips, tongue,
correction of the shallow vestibule of the oral cavity;
■ maintaining the oral cavity in a sanitized state;
■ selective grinding of teeth to eliminate traumatic occlusion;
■ timely and comprehensive orthopedic treatment.
Secondary prevention of periodontal diseases
consists of treating early signs of developing periodontal tissue pathology in order to prevent
their progression and development of more severe conditions, namely:
■ eliminating local traumatic factors (tartar, overhanging edges of fillings, poor-quality dentures,
bite anomalies, etc.);
■ improving methods of individual oral hygiene, monitoring the quality of its implementation
during repeated visits to the doctor by determining the digital indicators of hygiene indices;
■ eliminating precursors of diseases and treating their initial forms.
Tertiary prevention of periodontal diseases
Consists of complex treatment (conservative, surgical and orthopedic) aimed at stopping
pathological conditions in periodontal tissues, preventing complications and restoring the
physiological function of the periodontium and periodontium to the extent possible, which helps
prevent their further destruction, the formation of periodontal pockets, resorption of the alveolar
process and converts the acute condition into a chronic stabilized process.
The main measures for the prevention of periodontal diseases include:
■ elimination of pathogenic and opportunistic microflora;
■ control of plaque formation processes;
■ elimination of dysbacteriosis of the oral cavity;
■ thorough and regular individual oral hygiene;
■ oral cavity sanitation;
■ gastrointestinal tract sanitation;
■ elimination of factors that interfere with the normal functioning of the salivary glands and the
performance of saliva functions, if necessary - the use of saliva substitutes;
■ combating bad habits: smoking, excessive alcohol consumption, etc.;
■ restoration of mineral balance and salt metabolism in general;
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■ elimination of local traumatic factors;
■ elimination of anomalies of attachment of cords and frenulums by surgical intervention;
■ strengthening and maintaining general immunity by hardening the div, a healthy lifestyle;
■ restoration of local immunity of the oral cavity by eliminating the causes causing a violation of
its function;
■ replenishment of deficiencies of vitamins, micro and macroelements due to their additional
introduction into the div;
■ the correct combination of food products, leading to their correct absorption and replenishment
of the lack of nutritional components;
■ completely eliminating sugars from snacks and reducing their quantity during main meals.
Individual oral hygiene as a method of preventing periodontal diseases should be given
special attention. It is known that the main etiopathogenetic factor of inflammatory periodontal
diseases are pathogenic and opportunistic microorganisms of dental plaque capable of forming
biofilms. They can also support and provoke further development of many chronic general
somatic diseases, and the risk of occurrence, development and further progression of both
inflammatory processes in the oral cavity and general somatic diseases directly correlates with
the degree of microbial contamination of the oral cavity. That is why dentists attach great
importance to the quality of hygienic procedures performed by the patient and the individual
selection of personal oral hygiene products, their effectiveness and safety. Modern therapeutic
and prophylactic oral hygiene products (toothpastes, rinses, balms, gum gels) with proper
selection and complex use are capable of providing a pronounced anti-plaque, antiseptic, anti-
inflammatory effect, reducing gum bleeding due to the active components included in their
composition.
In severe periodontal diseases, hygienic measures alone are no longer enough; they must be
combined with complex treatment: conservative, surgical and orthopedic. However, without
high-quality oral hygiene, any therapeutic measures and manipulations will be ineffective.
Conclusions
We draw attention to an important aspect: in order to succeed in the prevention of periodontal
diseases, dentists must learn to talk with their patients, otherwise all medical measures and
manipulations will be useless as long as we only treat, fill, and operate. The process of
preventing any disease primarily consists of a person's awareness of its necessity, and until
doctors learn to work on a mental level, all preventive measures will be reduced to columns of
numbers in reports of medical and social institutions and departments, insurance companies.
In this regard, the goal of any prevention program should be an individual, i.e. a person with
his illnesses, everyday and professional problems, character and characteristics of nutrition and
other factors that influence the features of developing a personalized program. But all these
measures will be effective only if each of us realizes that his life, health and longevity depend on
how he treats himself and the world around him. To do this, a person must love himself, value
his div and take care of it.
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