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TYPE
Original Research
PAGE NO.
26-32
DOI
OPEN ACCESS
SUBMITED
25 October 2024
ACCEPTED
27 December 2024
PUBLISHED
17 January 2025
VOLUME
Vol.05 Issue01 2025
COPYRIGHT
© 2025 Original content from this work may be used under the terms
of the creative commons attributes 4.0 License.
Prevention of periodontal
diseases
Abdurashidov Oybekjon Abdurashid Ugli
Assistant, Samarkand State Medical University, Samarkand, Uzbekistan
Abstract:
Periodontal is a complex of tissues that
surround the tooth and ensure its fixation in the
jawbones. This complex includes the gum, the
periodontal ligament connecting the tooth root to the
bone socket, the alveolar processes of the jawbones and
the cement of the tooth root. In certain diseases, both
individual periodontal tissues and their entire complex
can be affected.
Keywords:
Jawbones, alveolar processes, diseases.
Introduction:
Periodontal is a complex of tissues that
surround the tooth and ensure its fixation in the
jawbones. This complex includes the gum, the
periodontal ligament connecting the tooth root to the
bone socket, the alveolar processes of the jawbones and
the cement of the tooth root. In certain diseases, both
individual periodontal tissues and their entire complex
can be affected.
Periodontal diseases include gum disease
(gingivitis), periodontitis, and periodontal disease.
Gingivitis (inflammation of the gums) and periodontitis
(inflammation of the entire periodontium) are two
interrelated forms of the disease, since the
inflammatory process occurs first in the gum tissues,
and gradually the rest of the periodontal structures are
involved in it.
Periodontal disease is a dystrophic process in
periodontal tissues, the cause of which is currently
unknown. The disease develops slowly and is
manifested, first of all, by exposing the roots of the
teeth.
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In gingivitis, the inflammatory process is localized only
in the soft tissues of the gums and is not accompanied
by changes in the bone tissue of the jaws. Gingivitis
most often develops in young people. It is
characterized by redness and swelling of the gingival
papillae and gingival margin, its thinning or,
conversely, the proliferation of interdental papillae.
Patients complain of bleeding and sore gums when
brushing their teeth and while eating. If left untreated,
this form can develop into a more severe form of
gingivitis: areas of ulceration of the oral mucosa
appear, covered with a gray necrotic plaque, and bad
breath appears.
Periodontitis is a chronic, long
—
term inflammatory
process in the periodontium (lasts for years).
In periodontitis, the entire complex of periodontal
tissues is affected by the pathological process, and
gingivitis is one of the symptoms of this disease. In
periodontitis, unlike gingivitis, the X-ray shows the
destruction of the bone tissue of the jaws.
Periodontitis begins, as a rule, imperceptibly: bleeding
gums appear when brushing teeth, short-term
("volatile") pain in the gums, sometimes a feeling of
itching and burning in them. If treatment is not started
during this period, the disease progresses:
inflammatory phenomena in the soft tissues increase,
the process of resorption of the bone tissue of the jaws
increases, pathological gingival pockets appear
—
slit-
like spaces between the teeth and the jaw bone,
usually filled with pus. Gum bleeding increases: blood
flows not only when brushing teeth, but also during
meals, and also for no apparent reason. Bad breath
appears; due to the progressive loosening of the teeth,
the process of chewing food becomes difficult, and
tooth mobility leads to tooth loss.
Against the background of a long-term inflammatory
process, an extensive focus of chronic infection forms in
the periodontium with a weakening of the div's
defenses. As a result, the general well-being of patients
suffers: they become irritable, get tired quickly,
complain of poor sleep and appetite. Against the
background of a decrease in the reactivity of the div,
various diseases of internal organs and systems develop.
Causes of periodontal diseases.
The most common cause is poor oral hygiene, plaque
buildup, and tartar deposition. The vast majority of
periodontal diseases are inflammatory in nature.Gum
inflammation occurs under the influence of plaque
microorganisms. If plaque is not removed by brushing
for a long time, then the soft plaque under the action of
minerals in saliva turns into tartar, which is removed
only with the help of professional oral hygiene. Tartar
has a porous structure and contributes to the
accumulation of even more soft plaque, in addition,
tartar mechanically injures the gums, bedsores appear.
Consequently, areas of the dentition that are difficult to
clean can be predisposing factors for the development
of periodontal diseases: crowding of teeth, overhanging
edges of fillings, improperly made crowns and dentures,
malocclusion; also, the presence of bad habits: smoking,
habits associated with frequent injury to the gums,
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namely improper and inappropriate use of toothpicks
or matches; other injuries: sharp edges of carious
cavities, injuries associated with wearing poorly made
dentures, overload of certain groups of teeth due to
the absence of a large number of teeth. The course of
the disease is aggravated due to the presence of
common somatic diseases (diseases of the
cardiovascular
system,
gastrointestinal
tract,
hormonal disorders, etc.).
In the presence of supragingival and subgingival tartar,
the gingival margin is constantly injured, which leads
to the development of a chronic inflammatory process
in it, as a result of which pathological gingival pockets
are formed. Therefore, tartar must be removed
periodically (1-2 times a year).
Complaints of patients with periodontal diseases.
The first sign of periodontal disease is bleeding gums
when brushing teeth or when eating.
- bad breath
- pain when cleaning or eating
- tooth mobility
- itching, burning, and flying gum pain
- pain from cold or hot. The main alarm signal is an
increased reaction that occurs when chemical and
thermal stimuli affect the area of the necks of the
teeth, which is important when eating
- unpleasant sensations when chewing
Prevention and treatment of periodontal tissue
diseases.
Prevention: maintaining a high level of personal oral
hygiene, eating harsh, plant-based foods, uniform
participation of all teeth in chewing, regular visits to
the dentist for timely removal of dental deposits and
dental fillings. Dietary disorders play a role in the
development of periodontal disease. It is known that
one of the conditions for the normal course of
metabolic processes is a balanced diet: a diet
containing the right amount of proteins, fats,
carbohydrates, vitamins and trace elements.
In the presence of the above complaints, it is necessary
to consult a dentist for professional oral hygiene, as
well as to identify the severity of periodontal diseases
and prescribe the necessary treatment.
Treatment is individual and comprehensive, and the
choice of methods depends on the stage of the
disease, the nature of the complication, and the
general condition of the div.
In most cases, the elimination of traumatic factors,
proper oral care, and smoking cessation lead to the
disappearance of gingivitis (in the absence of dental
calculi, hygiene is necessary), and local remedies may be
prescribed by a dentist.: antiseptics, anti-inflammatory
drugs, enzymes, essential oils.
Conservative treatment of periodontitis is aimed at
strengthening the gums. Unfortunately, it is almost
impossible to restore the destroyed bone tissue to its
previous position.
Prevention of periodontal diseases should be carried
out in the following areas:
• rational nutrition;
• the use of fluoride preparations;
• elimination of malocclusion and abnormal structure
and location of some soft tissues and organs of the oral
cavity, elimination of supracontact and functional
selective grinding (traumatic factor);
• elimination of defects in filling, prosthetics and
orthodontic treatment;
• elimination of violations of the architectonics of
attachment of soft tissues of the vestibule of the oral
cavity;
• timely dental treatment;
• compliance with oral hygiene
;
• treatment of concomitant diseases.
Prevention of periodontal diseases should begin from
the first years of a child's life, ensuring proper sucking
and swallowing functions at the first stages. From the
age of 4, it is possible to carry out oral cavity sanitation
(restoration of the normal shape of tooth crowns by
filling and normal bite). It is necessary to monitor the
elimination of harmful habits in children (nail biting, lip
licking) and proper chewing of food (including the
mandatory consumption of hard food). It is necessary to
observe oral hygiene from childhood.
Since periodontal diseases are highly dependent on the
general immune status of the div and the state of the
vascular system, it is necessary to monitor their support,
which is largely determined by the normalization of
nutrition and healthy lifestyle. Food (both in childhood
and in adults) should contain sufficient amounts of
protein, ascorbic acid, vitamin E, and mineral salts.
People who have the initial signs of periodontal disease
need a diet with limited intake of carbohydrates and
fats. Food products should contain choline, lecithin,
methionine (cottage cheese, legumes, cabbage,
oatmeal, fish), which prevents the deposition of
cholesterol in blood vessels. Lactic acid products,
vegetables and fruits that promote the elimination of
cholesterol from the div are mandatory. It is
extremely important to monitor the condition of the
gastrointestinal tract, to detect and treat dysbiosis in
time.
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In the general complex of preventive measures, it is
necessary to give place to gum massage, which trains
the vessels of the maxillofacial region. This includes
finger massage of the gums, and hydro massage.
In
the
prevention
of
periodontal
diseases,
circumstances that can lead to an overload of certain
groups of teeth (orthodontic treatment at an early age,
rational prosthetics in adults) should be eliminated.
Since periodontal diseases are closely related to many
somatic diseases, both the prevention of the latter and
the complete elimination of the consequences of past
illnesses (in particular, acute infectious diseases of
various etiologies) are extremely important. It is
necessary to eliminate any overloads of the div,
including nervous (stressful conditions).
Smoking is one of the predisposing factors of
periodontal disease. Therefore, it is necessary to get
rid of this bad habit. People who are exposed to
occupational hazards are also at risk for periodontal
diseases. Therefore, it is necessary to avoid the
influence of harmful environmental factors (gases,
dust particles, thermal radiation, low temperatures,
etc.) as much as possible.
It is necessary to carefully monitor the condition of
teeth and consult a dentist on time, since untreated
teeth are a constant source of infection.
The main factor preventing the development of
periodontal diseases is proper oral hygiene using an
arsenal of modern remedies. Today, the following
personal oral hygiene products are available:
toothbrushes of various modifications, dental floss for
cleaning interdental spaces, toothpicks, interdental
stimulants, tongue cleansing devices, interdental
brushes, oral irrigators, tooth powders, toothpastes
and gels, mouthwashes, deodorant sprays, chewing
gums, care products for removable orthopedic and
orthodontic structures, dyes for self-detection of
dental deposits, individual dental mirrors.
The effectiveness of therapeutic and prophylactic
toothpastes is determined by their composition, the
components of which affect periodontal tissues and
the oral mucosa. Toothpastes may contain the
following components:
• biologically active additives (sources of micro
- and
macronutrients, vitamins) that enhance protective
processes in tissues;
• enzymes that remove plaque and have a bactericidal
effect;
• antibacterial drugs that af
fect microorganisms in the
oral cavity;
• mineral salts that improve blood circulation, dissolve
mucus, and prevent plaque formation;
• agents that reduce the sensitivity of dental hard
tissues (for example, 10% strontium chloride, potassium
chloride, formaldehyde, aluminum lactate);
• abrasive substances;
• gel
-forming and foaming substances, dyes, fragrances
that improve the taste of the paste;
• agents that prevent the formation of tartar and
effectively remove soft and even partially mineralized
dental deposits (however, regular use of such pastes can
lead to premature abrasion of tooth enamel);
• bleaching ingredients.
• Pastes containing powerful antiseptics (triclosan and
chlorhexidine) can cause tooth enamel pigmentation
and imbalance of the oral microflora.
Toothbrushes are also diverse and are selected strictly
individually, taking into account the characteristics of a
particular person. Many of them have special options
that allow you to massage your gums simultaneously
with brushing your teeth. Modern toothbrushes (which
come in different degrees of hardness) are distinguished
by a very original arrangement, shape and height of the
bristle bundles, which allows them to clean the most
inaccessible places of the oral cavity. Of particular note
are electric toothbrushes, in which, due to the motor,
the head performs both vibratory and rotational
movements, which significantly increases their
efficiency. Ultrasonic toothbrushes are based on the
ultrasonic destructive effect on bacteria, and intensive
foaming additionally helps to eliminate plaque. There
are also acoustic and ion toothbrushes (in the latter,
plaque is actively destroyed due to the electrostatic
interaction of particles with dissimilar charges). A
toothbrush should not be used for more than 2-3
months due to the accumulation of microorganisms in it
and the abrasion of its bristles. After use, the brush
should be thoroughly washed with soap and running
water each time.
Interdental brushes perfectly clean wide interdental
spaces, spaces under non-removable dentures and
orthodontic structures. Dental floss is suitable for
cleaning narrow interdental spaces. There are special
thread guides for conducting a floss under an
orthodontic arch or under a bridge-like prosthesis.
Special dental floss is used for sensitive teeth.
Toothpicks are designed to remove food debris from the
interdental spaces and to remove plaque from the side
surfaces of teeth. However, when using them, care must
be taken to avoid injury to soft tissues and enamel.
Interdental stimulators
–
elastic cones made of rubber
or soft plastic
–
are designed to massage the gingival
papillae.
If orthopedic or orthodontic structures (prostheses,
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braces, bridges, crowns, splints, etc.) are present in the
oral cavity, it is necessary to monitor their cleanliness
especially carefully. Removable structures are washed
and cleaned daily with a toothbrush with soap or
toothpaste. There are also special instant tablets for
cleaning removable dentures.
Currently, there are more complex devices (for
example, oral irrigators) that at home can effectively
clean the interdental spaces, spaces under dentures,
shallow spaces under exfoliated gums with
simultaneous effective hydro massage of the gums.
Irrigators provide a constant or pulsating stream of
water or antiseptic solution with a pressure of 2 to 10
atm flowing from a narrow tip.
In addition, it is necessary to periodically carry out a
complete hygiene complex in a dental clinic
(professional oral hygiene), including, in particular,
effective removal of dental deposits, plaque removal,
teeth whitening, coating teeth with special fluoride-
containing varnishes, polishing teeth.
Oral hygiene in periodontal pathology helps to
consolidate the results of treatment and eliminate
relapses, and in healthy people it helps to prevent
periodontal diseases.
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