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Periodontitis: causes, symptoms, types and photos

the exact symptoms of periodontitis

Periodontitis is not a rare problem, so you should talk about it more carefully. In particular, about the symptoms and the causes of the disease. What is periodontitis?

The name comes from the word periodontal – a set of specific tissues that surround the tooth and allows it to be attached to the bone and hold tight in the hole, not dropping and not moving. This tissue is located on the perimeter of the root and starts from the very gum.

Periodontitis has several forms, but each of them means that the inflammatory process has begun in the periodontal connective tissue. The disease can occur for various reasons quite independently of age.

That is why it is necessary to know the main symptoms of various forms of such inflammations, in order to timely consult a specialist and to take the necessary measures.

Differences from pulpitis

Do not confuse it with the pulpitis. They have a significant difference in the localization, despite the often similar symptoms.

The fact that the pulpitis is also an inflammatory disease, however, all processes take place exclusively in the tooth pulp. The pulp is a soft tissue, which is located in the teeth.

In any form of pulpitis, no changes are observed in the surrounding tissues, and the tooth is firmly in the gum. Periodontitis may occur as a complication of pulpitis when the infection goes down to the root apex, and through the root canal comes out.


Typically, an experienced physician after describing manifestations can assume the appearance of the disease. This is what does the classical clinical diagnosis comprises:

  • a survey of the patient;
  • visual examining the oral cavity;
  • sensing an input to the tooth;
  • passing temperature tests;
  • palpation (feeling);
  • if there is a mobility, determining its extent.

The pretty big difficulty is a diagnosis for children, as they are often unable for various reasons to accurately describe their feelings. In this case, it is desirable to make an X-ray.

X-rays when periodontitis is not only done for children because it clearly shows the localization of the process and the condition of the tissue.

Why does it appear?

why periodontitis appearsWith the development of all types of periodontitis, there may be their individual factors that lead to its emergence and development. Exactly by them, there is the differentiation of different forms of the disease. However, you can create a short list of common reasons which cover all types of a typical disease.

This list shows the two groups of reasons – infectious and non-infectious.

  • Not completely mended carious process.
  • Delays in treatment of pulpitis – already in the stage where the inflammatory process enters the periodontal tissue from the root canal.
  • Poorly performed canal filling after treatment. Infection can develop in the part that has not been sealed. Almost always it is the root apex.
  • Prosthesis with a poorly performed removal of the tooth pulp or filling.
  • The occurrence of a very deep periodontal pocket, which is the “conductor” of infection from the mouth.
  • Trauma (perhaps just a blow), where the nerve and vascular bundle in a root are being damaged.
  • Contact of infection from the lymph or blood.
  • Permanent traumatic factor. For example, it may be a habit to strongly pinch something between the teeth, or just wrong installed seal, bending the coronal part and creating a permanent pressure.
  • Contact with periodontal of various strong substances, mainly of medicinal purposes.

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Different types and classification

Periodontitis is classified in two main directions.

According to the factors that cause the disease

  • Infectious. Can be subdivided by the manner in which the infection penetrates into the tissue – and interdental and extradental, i.e. from the inside or outside.
  • Traumatic. There may be acute or chronic, which are characterized by different symptoms and injury character.
  • Medication. This includes disease resulting from allergic reactions to medications.

By the nature of discharge and flow

  • Acute. There are purulent and greyish kinds.
  • Chronic. Sub kinds: granulomatous, granulated or fibrous.
  • Separately, there is an exacerbation of the chronic form.

Acute form

acute periodontitisThe acute form is characterized by the fact that its development takes place in the limited area where there is a strong defensive reaction of the surrounding tissues.

The process is accompanied by different types of discharge, at the beginning – grayish, and after that- purulent. During his raised microabscesses merge into one purulent inflammatory center.

There are many symptoms, which can determine the shape and they are quite specific.

  • Moderate pain that occurs in the affected area of the tooth. This pain can occur spontaneously, without any particular reason. Often – as a reaction to hot or warm food and drinks.
  • The duration of “painful” period varies. This usually takes a few hours. At this time, growing of pain and its disappearance take place gradually. There are even painless periods of extinction.
  • When biting a food or anything else on the affected tooth, the pain usually intensifies and becomes acute.
  • At night or at a time when a person lies (i.e., the body is in a horizontal position), there often is a feeling that the tooth has grown and become bigger. This can be explained by the fact that in this position there is a total redistribution of blood weight. It rushes to the inflammatory center, thereby increasing edema.
  • When the inflammation process becomes purulent, all the sensations become stronger. The pain becomes constant, quite strong and has aching nature. The process of chewing is almost impossible since it leads to a significant increase in pain.
  • The quite frequent phenomenon is the inability to close the mouth, as there is pressure on the affected tooth with the closing jaws.
  • Fever (99-100 °F), which does not drop for a long time.
  • Growing and painfulness in lymph nodes (possibly one from the side of inflammatory center).
  • Swelling of the mucosa of the gums and tooth mobility of the first or second degree.
  • All this causes indirect symptoms – constant fatigue, poor sleep, stress, weakness and deterioration of general condition.

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Chronic form

Quite often, this form of the disease takes place virtually without any severe symptoms.

  • Quite often the only manifestation of chronic periodontitis is not strong pain when pressing, biting on the ill tooth, but as well as when knocking on it.
  • In some cases, on the gum, in the inflammation spot, there is a fistula hole. Small quantities of pus will appear from it. Often patients for a long time do not notice it because it is too far from the neck of the tooth.
  • The color of the enamel may change. It ceases to be shiny, becomes dull andyish.
  • Rarely, especially when having a cold, you may receive an unpleasant feeling of heaviness in the ill tooth.

The chronic form is much worth than an acute because it does not encourage the person to consult an expert until a strong pain appears. It becomes a common cause of a tooth loss. When waiting too long, even the formation of cysts of a root is possible.

Manifestation of acute exacerbation of chronic forms of periodontitis

Here the symptoms are substantially the same as those in the acute form. The only difference is that the patient indicates the presence of long-time minor pain when pressing on the affected area, including when you press on the gum.

However, when a fistulous occurs an inflammation can be greatly reduced. Then the pain and other symptoms almost disappear.

Toxic form

toxic form of periodontitisThere are several major medications that cause toxic or drug-induced periodontitis in contact with the tissues surrounding the tooth. These are arsenic, tricresol or formalin.

Now, such cases are relatively rare, as in the treatment of complex dental diseases more modern drugs are used.

The toxic form of periodontitis in almost all cases occurs just as an acute. Symptoms are identical, which causes great difficulties in the diagnosis:

  • very strong tooth sensitivity and pain when pressed on, the nature of pain is almost always nagging, continuous;
  • feeling that the tooth has grown and thus greatly distinguished from the total number;
  • the mobility often appears (usually the first, rarely the second degree).

One of the manifestations of specific general increase in sensitivity is considered from the side where the inflammation is located.

One of the symptoms, which may be called common, is an unpleasant smell, resulting from inflammation. This manifestation is typical for almost all types and forms of the disease.

Traumatic form

This kind also has two forms of flow – chronic and acute. Chronic appears almost the same as the total infectious kind. This insignificant pain with pressure or biting.

The more severe form varies in symptoms, which can be caused by sports or any other injury. Almost always it is a root fracture or dislocation.

  • Sudden and unreasonable pain.
  • The mobility of the coronal part.
  • Unpleasant sensations arising from the closing of the jaws.
  • Staining of a visible (crown) part in a light pink color. This usually occurs at a break in the pulp in the area of a neck of a tooth or hemorrhage. Later, you can observe a change in the color from light pink to yellow.

Among the complications of periodontitis, there are many that lead to the removal of the tooth. Therefore, the appearance of even minor symptoms must make you contact a dental clinic.

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