Periodontitis

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Periodontitis, a severe gum disease, is an inflammation of the periodontium (Periodontal ligament, alveolar bone, gingiva and cementum.

Causes

  • Poor Oral Hygiene
  • Infection

Signs and symptoms

  • Swollen or puffy gums
  • Bright red, dusky red or purplish gums
  • Pus between the teeth and gums
  • Loose teeth
  • New spaces developing between the teeth
  • Bleeding gum
  • Bad breath
  • Painful chewing

Complications

  • Tooth loss
  • Systemic disease such as respiratory disease, rheumatoid arthritis, coronary artery disease and problems controlling blood sugar in diabetes

Investigations

  • Physical examination
  • Dental X-ray to check for bone loss

Treatment objectives

  • Reduce pain and inflammation
  • Prevent further bleeding from the gum
  • Treat infection

Non-pharmacological treatment

  • Scaling
  • Root planning
  • Use of mouthwash
  • Bone grafting
  • Soft tissue grafts
  • Flap surgery (pocket reduction surgery)

Pharmacological treatment

Paracetamol oral

Adult:

500mg-1g every 6-8hours

Child:

6-12 years: 250-500mg every 6-8 hours

1-5 years: 120-250mg every 6-8 hours,

3months-1 year: 60-120mg every 6-8 hours when required

OR

Ibuprofen oral

Adult:

200-400mg every 8 hours 

Child:

100-200mg every 8 hours

AND

Amoxicillin oral:

Adult:

500mg every 8 hours for 7days

Child:

6-12 years: 250mg every 8 hours for 7 days

1-5 years 125mg every 8 hours for 7 days,

<1 year: 62.5mg every 8 hours for 7 days

 

OR

Metronidazole oral

Adult:

400mg every 8 hours for 7 days

Child:

100-200mg every 8 hours for 7 days                                                 

Referral

Refer to a dental specialist for further treatment

Prevention

  • Maintain good oral hygiene specifically twice daily brushing and flossing
  • Regular dental check-up