Introduction
Periodontitis means “inflammation around the teeth.” Periodontitis, also called gum disease, is a serious gum infection that damages the soft tissue and, without treatment, can destroy the bone that supports the teeth. As a severe form of periodontal disease (gum disease), it harms the pink tissue holding your teeth in place.
Periodontitis can cause teeth to loosen or lead to tooth loss. It is a very common condition but largely preventable. It’s usually the result of poor oral hygiene. Brushing at least twice a day, flossing daily and getting regular dental check-ups can prevent the occurrence and greatly improve chances of successful treatment for periodontitis.
Signs & symptoms
- Swollen gums
- Bright red, dusky red or purplish discolouration of gums
- Tenderness of gums
- Bleeding gums
- Pink discolouration of toothbrush after brushing
- Spitting out blood when brushing or flossing the teeth
- Bad breath
- Pus between the teeth and gums
- Loose teeth or loss of teeth
- Painful chewing
- New spaces developing between the teeth
- Recession of gums from teeth, making the teeth look longer than normal
- A change in the way the teeth fit together when biting
Causes
- Gingivitis
- Poor oral health habits
- Smoking or chewing tobacco
- Hormonal changes, such as those related to pregnancy or menopause
- Recreational drug use, such as smoking marijuana or vaping
- Obesity
- Inadequate nutrition, including vitamin C deficiency
- Genetics
- Certain medications that cause dry mouth or gum changes
- Conditions that cause decreased immunity, such as leukemia, HIV/AIDS and cancer treatment
- Certain diseases, such as diabetes, rheumatoid arthritis and Crohn’s disease
Pathophysiology
Mostly it starts with plaque — a sticky film mostly caused by and composed of bacteria. If not removed from time to time, this plaque can develop into more serious diseases, like periodontitis:
Plaque is formed when the high amount of starch and sugar interacts with the bacteria in the mouth. It can be removed easily but reforms quickly. Cleaning up is needed from time to time in a proper way. If it stays longer in the mouth, plaque hardens to form a thicker substance called tartar which gets deposited under the gumline. It is filed with bacteria and difficult to remove. This can lead to gingivitis, the mildest form of gum disease. Gingivitis is irritation and inflammation of the part of the gum tissue around the base of the teeth (gingiva). Gingivitis can be reversed with professional treatment and good home oral care. But if not treated, it can cause periodontitis, eventually causing pockets to develop between gums and teeth that fill with plaque, tartar and bacteria. In time, these pockets become deeper, filling with more bacteria. If not treated, these deep infections cause a loss of tissue and bone, and ultimately loss of one or more teeth. Also, ongoing chronic inflammation can put a strain on the immune system.
Diagnosis
- Medical history
- Mouth examination
- Measure the pocket depth of the groove between the gums and teeth by placing a dental probe
- Take dental x-rays
Treatments
Treatment should be performed by a professional. The goal of periodontitis treatment is to thoroughly clean the pockets around teeth and prevent damage to surrounding bone. Following a daily routine of good oral care, managing health conditions that may impact dental health and stopping tobacco usage are also very important.
Nonsurgical treatments (In initial stages)
- Root planing.
- Antibiotics – Topical or oral
Surgical treatments (In advanced periodontitis)
- Flap surgery (pocket reduction surgery).
- Soft tissue grafts.
- Bone grafting.
- Guided tissue regeneration.
- Tissue-stimulating proteins.
Prognosis
Periodontitis is a serious condition. It can lead to permanent tooth loss and other infective conditions. But most people get cured with treatment.
Complications
Loss of teeth
Spread of infection through blood
Disease & Ayurveda
Upakusa
Nidana
Causative factors for the vitiation of Pitta along with raktadhatu
Purvaaroopa
Not mentioned
Samprapti
Due to the causative factors, Pitta along with rakta vitiates and reaches the mouth. When they get lodged in the gums, it causes paaka of gums leading to the manifestation of the disease upakusa
Lakshana
Dantamamsani dahyante Burning sensation, itching, and red colour of gums along with inflammation. Bleeding follows. Once the bleeding stops, teeth become loose and fall apart. Pain will be there but not so severe. Foul odour of mouth will be present.
Raktani utsedhavanti
Kandoomanti
Asram sravanti
Asrji sthite aadhmayante
Chalaa dantaa
Mandaruja
Pootivaktra
Divisions
Not mentioned
Prognosis
Kricchrasadhyam
Chikithsa
Samana
Swedanam with hot water
After the sastrakarma, gandoosha with nalpamara kwatha
Sodhana
Chedana
Bhedana
Lekhana with yasti, sunthi, saindhava etc.
Commonly used medicines
Anutailam
Nalpamarachoornam
Thriphalachoornam
Brands available
AVS Kottakal
AVP Coimbatore
SNA oushadhasala
Vaidyaratnam oushadhasala
Home remedies
Try these measures to reduce or prevent periodontitis:
- Brush your teeth twice a day or, better yet, after every meal or snack.
- Use a soft toothbrush and replace it at least every three months.
- Consider using an electric toothbrush, which may be more effective at removing plaque and tartar.
- Floss daily.
- Use a mouth rinse to help reduce plaque between your teeth, if recommended by your dentist.
- Supplement brushing and flossing with an interdental cleaner, such as a dental prick, interdental brush or dental stick specially designed to clean between your teeth.
- Get regular professional dental cleanings, on a schedule recommended by your dentist.
- Don’t smoke or chew tobacco.
Diet
- To be avoided
Heavy meals and difficult to digest foods – cause indigestion.
Hard substances difficult to chew
Sugar and other artificial sweeteners which can cause plaque formation
Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
Carbonated drinks – makes the stomach more acidic and disturbed digestion
Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)
Milk and milk products – increase kapha, cause obstruction in channels and obesity
Curd – causes vidaaha and thereby many other diseases
- To be added
Light meals and easily digestible foods
Green gram, soups, honey
Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc
Behaviour:
Protect yourself from cold climate.
Better to avoid exposure to excessive sunlight wind rain or dust.
Maintain a regular food and sleep schedule.
Avoid holding or forcing the urges like urine, faeces, cough, sneeze etc.
Avoid sedentary lifestyle. Be active,
Yoga
No exercise or yoga is advised during the time of severe pain and infection.
Regular stretching and mild cardio exercises are advised during normal times. Also, specific yogacharya including naadisuddhi pranayama, bhujangaasana, pavanamuktasana is recommended.
Regular exercise helps improve bioavailability of the medicine and food ingested and leads to positive health.
Yoga can maintain harmony within the body and with the surrounding system.
Pavanamuktasana
Nadisudhi pranayama
Bhujangasana
Simple exercises for lungs and heart health
All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.
Research articles
https://pubmed.ncbi.nlm.nih.gov/3522650/
These statements have not been evaluated by the Food and Drug Administration, United States. This product is not intended to diagnose, treat, cure or prevent any disease. Please consult your GP before the intake.
Writer:
Dr. Rajesh Nair, the co-founder and chief consultant of Ayurvedaforall.Com, is a graduate of prestigious Vaidyaratnam Ayurveda College (affiliated with the University of Calicut), Kerala, India. Additionally, he holds a Postgraduate Diploma in Yoga Therapy from Annamalai University.
Dr. Nair offers consultation at two busy clinics in and around Haripad, Alleppey, Kerala, the southern state famous worldwide for authentic ayurvedic treatment and physicians. While offering consultation on all aspects of ayurvedic treatments Dr. Nair has a special interest in Panchkarma, Yoga, and Massage.
Through Ayurvedaforall Dr. Nair offers online consultation to patients worldwide and has served hundreds of patients over the last 20 years. In addition to his Ayurvedic practice, he is the chief editor of ayurveda-amai.org, the online portal of Ayurveda Medical Association of India, and the state committee member of Ayurveda Medical Association of India.
Dr. Nair is a regular speaker at Ayurveda-related conferences and has visited Germany to propagate Ayurveda. You can write directly to him-
rajesh@ayurvedaforall.com
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