Swollen, flushed gums, yellowed teeth that are almost falling out, an obvious bite deformity, and foul-smelling breath. These are all signs of periodontal disease. If left untreated, the disease can progress to a severe purulent stage, when nothing more can help a person than to have the teeth extracted.

What is Periodontitis

Periodontitis is a very painful oral condition that affects both your teeth and gums. It is in the gums that the disease originates. Germs entering the pocket between the tooth and gum cause inflammation. The result is atrophy of the bone tissue, and tooth mobility. Almost always periodontitis is accompanied by bleeding and swelling of the gums, itching and pain, and sometimes pus.


The cause of this serious disease, as is often the case, is banal: poor oral hygiene or its complete absence. In other words: he who brushes teeth badly, he gets periodontitis.

What to Do if You Have Periodontitis

This problem, unfortunately, does not go away by itself and requires comprehensive treatment. The longer treatment is delayed, the greater the risk of tooth loss. Remember that it’s also a big money investment: it’s always cheaper to fix a problem in its early stages than to deal with the consequences of a more severe problem.

However, before you go to the clinic, find out all about the qualifications of the attending doctor. It should not just be a dentist, but a periodontist with special training. Do not hesitate to ask for a certificate or diploma of appropriate courses. If everything is in order, trust the specialist. Here’s what to expect.

Examination, plan the treatment

The first step in treating periodontal disease is an examination. At the initial stage, a visual examination is usually sufficient. In rare cases, an x-ray is required. You may be offered a local or panoramic scan, depending on the extent of the lesion.

Brace yourself that you will not stop at one visit to a periodontist. If your bite has changed and you have serious dental health problems, you may need to see a dentist and a general dentist. If dentures or cavities need to be removed, the procedure is performed prior to the direct treatment of periodontal disease.

As a result of the examination (or several), the patient receives the following information:

  • A prognosis for action with the affected teeth (treatment, extraction, prosthetics);
  • An overall treatment plan, including an estimate;
  • Treatment strategy for periodontitis itself.

Complete cleaning of dental plaque

Over- and under-gingival deposits are the most common causative agents of periodontal disease. Beginning with soft plaque, gum plaque builds up on the enamel like caustic kitchen grime and builds up in the pockets between the tooth and gum. If they are not removed with a toothbrush in time, they can become inflamed and eventually develop into periodontitis.

Once this condition is advanced, standard dental cleaning, unfortunately, will not help. No matter how hard you try, plaque transformed into tartar, just do not come off. You’ll need a machine cleaning. It is a precursor to further treatment.

Ultrasound is the gentlest method, in terms of the intensity of the action on the tooth and painful sensations. Specialized ultrasound machines are available in clinics in a wide range.

Stop the inflammatory process

It is noted that already after the first cleaning procedure, the patient feels considerable relief. However, there is still a lot of work to be done. The key to the treatment of periodontitis is the elimination of inflammation, removal of swelling in the gums, and stopping purulent discharge. Medications are involved in the fight against infection. They are involved in general and local therapy.

Local therapy of the oral cavity involves a number of activities. They are associated to a greater extent with the local treatment of the disease. As a rule, local therapy lasts about 10 days and includes the following:

  • Rinsing the oral cavity with antiseptic solutions;
  • Flushing periodontal pockets with a syringe;
  • application of antimicrobial gels to the affected areas;
  • physiotherapy: laser treatment or exposure to electrophoresis;
  • application of specialized toothpastes with anti-inflammatory and strengthening effects.

Depending on the complexity of the particular case, the doctor may prescribe treatment at home or plan a schedule of visits to the dental office.

General therapy involves acting on the body as a whole. The most common solution is the prescription of antibiotics. Medications can be administered intramuscularly (more preferred) or taken in pills. The average duration of general therapy, as in the case of local treatment, is 10 days.

Preparation for dentures

Preparation for dentures is often carried out along with taking medication. This is the usual treatment of teeth affected by decay, as well as the removal of hopeless specimens.

If the doctor has previously prescribed the placement of bridges, it may be necessary to depulpate the teeth. In addition, it is recommended to depulpate teeth with periodontal pocket size greater than 2/3 of the root, as well as teeth with affected bone tissue in the root (about half the length).

Dissection is almost always necessary for advanced periodontitis. Firstly, this procedure eliminates the development of pulpitis with deep penetration of the infection. Secondly, pulping significantly reduces the mobility of the tooth.

Teeth splinting

This is a mechanical strengthening of the periodontal tissues and fixation of the teeth in order to reduce their mobility. Splinting also reduces inflammation and stops bone atrophy. This ultimately extends the life of the teeth.

Treatment of periodontal disease with surgery

This method is not always used due to its radical nature. Meanwhile, surgical treatment of periodontitis is rightly considered the most effective and quickest.

During surgery, the gum is opened and the granulation tissue that causes inflammation is expelled from the cavity. It forms in the place of the destroyed bone and in periodontal pockets. Synthetic tissue is implanted instead of the removed tissue.


Prosthetics, or orthopedic treatment for periodontal disease, like surgery, is not performed in all cases. Prosthetics are placed in the place of the missing teeth, to restore chewing ability of the jaw and reduce the pressure on the remaining teeth. If surgical treatment is necessary, dentures are placed first.

Can Periodontitis Be Treated With Home Remedies?

All of the above suggests a reasonable conclusion that the proper treatment of periodontitis is a long, time-consuming and very expensive story. Not surprisingly, many people look for cheaper and quicker solutions. The most common one is gargling. Anything: soda, chamomile, sage, calendula, and all kinds of tinctures.

Can they help? Certainly, the deterioration of these means will not be worse. Chamomile and sage, as well as soda, have a disinfecting effect. But they have a superficial effect and practically do not help in neglected cases. In other words, you can observe some improvement in appearance, reduction of pain, but deep in the periodontal canal the inflammation does not go anywhere. What’s more, it progresses, causing bone decay inside the gum. In this sense, delaying medication and taking herbs is not only not helpful, it’s harmful.

Remember one simple thing: If you care about your teeth and value your health, don’t put off going to the doctor. Yes, comprehensive treatment is often an expensive procedure. But with advanced disease, it costs incomparably more. Take a little more care of yourself.

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Dr. R.Mammadli (Dental Expert Team)

Bachelor in biotechnical medicine. Author of several medical blogs, author of articles on dentistry and oral health.