Periodontal diseases

Periodontal (gum) diseases are infections of the gums and bone that surround and support the teeth. Teeth are supported by the gums, or gingiva. A tooth's root is anchored to its socket by fibers called periodontal ligaments. The gums do not attach to the teeth as firmly as one might think. A shallow, V-shaped gap called a sulcus exists between the teeth and the gums. Periodontal disease affects this gap. Eventually, in periodontal disease, the tissues supporting the tooth break down. If only the gums are involved in this breakdown, the disease is called gingivitis. If only the connecting tissues and bone are involved, it is called periodontitis.

Bacteria in the mouth infect tissue surrounding the tooth, causing inflammation around the tooth leading to periodontal disease. When bacteria stay on the teeth long enough, they form a film called plaque, which eventually hardens to tartar, also called calculus. Tartar build-up can spread below the gum line, which makes the teeth harder to clean. Then, only a dental health professional can remove the tartar and stop the periodontal disease process.

The following are warning signs of periodontal disease:

· Bad breath or bad taste that won't go away

· Red or swollen gums

· Tender or bleeding gums

· Painful chewing

· Loose teeth

· Sensitive teeth

· Gums that have pulled away from your teeth

· Any change in the way your teeth fit together when you bite

· Any change in the fit of partial dentures

Certain factors increase the risk for periodontal disease: smoking, diabetes, poor oral hygiene, stress, heredity, crooked teeth, underlying immuno-deficiencies (e.g. AIDS), fillings that have become defective, taking medications that cause dry mouth, bridges that no longer fit properly, female hormonal changes, such as with pregnancy or the use of oral contraceptives.

During any routine dental examination, a dentist will do a periodontal exam of the gums.

The dentist may use a probe to measure the depth of the pocket between the teeth and the gums.

Special X-ray films may be used to evaluate the teeth, the bones supporting the teeth, and other mouth structures. If periodontal disease is present, the dentist will make recommendations or refer the person to a specialist (periodontist).

Good oral hygiene prevents periodontal disease. Brush the teeth at least twice every day. Brushing removes plaque from the inner, outer, and chewing surfaces of each tooth. A dental hygienist can demonstrate the proper technique. Get a new toothbrush every 3 months. Use a toothpaste that contains fluoride. Floss every day. Flossing removes plaque between the teeth that a toothbrush cannot reach. Use a mouthwash that kills bacteria. Eat a well-balanced diet; avoid too many sweets.

The goals of gum disease treatment are to promote reattachment of healthy gums to teeth; reduce swelling, the depth of pockets, and the risk of infection; and to stop disease progression. Treatment options depend on the stage of disease, how you may have responded to earlier treatments, and your overall health. Options range from nonsurgical therapies that control bacterial growth to surgery to restore supportive tissues.

Ex.10. Find in the text the English equivalents for the following word-combinations:

Оцінити стан зубів, спадковість, неглибокий проміжок, між зубами і яснами, навколо зуба, зубний камінь, неприємний присмак, чутливі зуби, вагітність, вимірювати, направити пацієнта до пародонтолога, двічі на день, знищувати бактерії, лікування без хірургічного втручання.

Ex.11. Answer the following questions:

1. What diseases are called periodontal ones? 2. What are periodontal ligaments? 3. What is sulcus? 4. What is the primary cause of periodontal diseases? 5. How is calculus formed on teeth? 6. Why should the tartar be removed? 6. What are the signs of periodontal diseases? 7. What factors increase the risk for periodontal diseases? 8. What instrument is used to measure the depth of the pocket? 9. What is the best way to prevent periodontal diseases? 10. How often should you get a new toothbrush? 11. What is the purpose of toothbrushing and flossing? 12. What are the goals of gum diseases treatment?

Ex.12. Insert prepositions where necessary (by, between, of, in, around, on) and translate:

Gingivitis is an irritation ____ the gums. It is usually caused ____ bacterial plaque that accumulates __ the small gaps ______ the gums and the teeth and by calculus (tartar) that forms __ the teeth. These accumulations may be tiny, even microscopic, but the bacteria in them produce foreign chemicals and toxins that cause inflammation __ the gums ______ the teeth. This inflammation can, over the years, cause deep pockets _______ the teeth and gums and loss of bone _____ teeth—an effect otherwise known as periodontitis.

Ex. 13. Complete the following sentences and translate:

Gingival diseases are classified into two _________: dental plaque induced gingival diseases and non-plaque induced _________lesions. Dental plaque induced gingival diseases is the most ______form of gingival disease. Plaque-induced gingivitis may _________on a periodontium with no attachment loss. Gingivitis associated with dental ________ only is the result of an interaction between the microorganisms found in the dental plaque and the tissues and inflammatory ________. Non plaque induced gingival lesions are oral manifestations of systemic conditions that produce lesions in the _______ without plaque formation. Gingival diseases of specific bacterial origin have become increasingly prevalent as a result of sexually transmitted _________. Gingival diseases of viral origin may be caused by DNA and RNA _____ for example herpes. Allergy to certain restorative materials, toothpastes, ____________, etc. has also been shown to cause __________in the absence of plaque.

Ex.14. Translate Ukrainian words in brackets into English:

The (симптоми) of gingivitis are as follows: swollen (ясна); mouth sores; bright-red, or purple gums; shiny gums; swollen gums that emit (гній); severe oral odor; gums that are (безболісний), except when (тиск) is applied; gums that (кровоточити) easily, (навіть) with gentle brushing, and especially when (чищення зубною ниткою); gums that itch with varying (ступені) of severity. (Гінгівіт) can be prevented through (регулярний) oral (гігієна) that includes (щоденний) brushing and flossing. Mouth wash is optional, (зазвичай) using a saline (розчин) (water and salt) only by prescription.

It is recommended that a dental (гігієніст) or dentist be seen after the (ознаки) of gingivitis appear. A dental hygienist or dentist will (перевіряти) for the symptoms of gingivitis, and may also (оглядати) the amount of (наліт) in the oral (порожнина). A dental hygienist or dentist will (також) look for signs of periodontitis using (рентген) or periodontal probing as well as (інші) methods.

Ex.15. Read the following text and entitle it:

Periodontal diseases are often classified according to their severity. They range from mild gingivitis, to more severe periodontitis, and more uncommon but serious acute necrotizing ulcerative gingivitis, which can be life-threatening.

Gingivitis is an inflammatory process limited to the mucosal epithelial tissue surrounding the cervical portion of the teeth and the alveolar processes. Gingivitis has been classified by clinical appearance (eg, ulcerative, hemorrhagic, necrotizing, purulent), etiology (eg, drug-induced, hormonal, nutritional, infectious, plaque-induced), and duration (acute, chronic). The most common type of gingivitis is a chronic form induced by plaque.

The direct cause of gingivitis is plaque - the soft, sticky, colorless film of bacteria that forms constantly on the teeth and gums. If the plaque is not removed by daily brushing and flossing, it produces toxins (poisons) that can irritate the gum tissue, causing gingivitis. At this early stage in gum disease, damage can be reversed, since the bone and connective tissue that hold the teeth in place are not yet affected. Left untreated, however, gingivitis can become periodontitis and cause permanent damage to your teeth and jaw.

Classic signs and symptoms of gingivitis include red, swollen, tender gums that may bleed when you brush. Another sign of gum disease is gums that have receded or pulled away from your teeth, giving your teeth an elongated appearance. Gum disease can cause pockets to form between the teeth and gums, where plaque and food debris collect. Some people may experience recurring bad breath or a bad taste in their mouth, even if the disease is not advanced.

Periodontitis is defined as an inflammatory disease of the supporting tissues resulting in progressive destruction of the periodontal ligament and alveolar bone with pocket formation, recession or both. Three main categories exist: chronic periodontitis, aggressive periodontitis, and periodontitis as a manifestation of systemic diseases. Minor classifications include necrotizing periodontal disease, abscesses and periodontal disease due to other factors.
Chronic periodontitis is the most common form of periodontitis. It is most prevalent in adults but can occur in children. It can also be modified by systemic disease such as HIV, diabetes as well as local factors such as smoking.

Aggressive periodontitis is otherwise seen in a clinically healthy patient. Rapid attachment loss and bone destruction are present.

Periodontitis as a manifestation of systemic diseases can be seen in hematologic, genetic and other non-specified conditions.

Symptoms of periodontitis may include the following:

• Occasional redness or bleeding of gums while brushing teeth, using dental floss or biting into hard food
• Occasional gum swellings that recurs
• Halitosis, or bad breath, and a persistent metallic taste in the mouth
• Gingival recession, resulting in apparent lengthening of teeth.
• Deep pockets between the teeth and the gums
• Loose teeth (in the later stages)

Patients should realize that the gingival inflammation and bone destruction are largely painless. Hence, people may wrongly assume that painless bleeding after teeth cleaning is insignificant, although this may be a symptom of progressing periodontitis in that patient.

Notes:

Ex.16. Insert the words given below and translate:

Periodontitis refers to a number of ____________ diseases affecting the periodontium — that is, the tissues that surround and _______ the teeth. Periodontitis involves progressive ____ of the ________ bone around the teeth, and if left untreated, can lead to the loosening and subsequent loss of._______. Periodontitis is caused by _______ that adhere to and grow on the tooth's __________, along with an overly aggressive immune response against these bacteria. A diagnosis of periodontitis is established by inspecting the soft gum ______ around the teeth with a probe and radiographs by visual _________, to determine the amount of bone loss around the teeth.