II. PERIODONTAL INFLAMMATION
1. General
1.1. Definition
Periodontitis is inflammation of the connective tissue surrounding the teeth.
periodontitis (gingivitis) and alveolar bone loss in multiple teeth.
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1.2. Cause:
- Bacteria in dental plaque and tartar play a major role, combined with immune factors causing reactions in patients.
- Favorable factors:
+ Whole body: diabetes, cirrhosis, endocrine diseases, genetics.
+ Abnormal postural forms of
teeth, errors in treatment and orthodontics.
2. Symptoms
2.2. Periodontitis:
- Bleeding or gingival discharge during examination
- The patient's breath and speech have a foul odor.
- Pathological gingival pocket > 3mm
- Loss of adhesion around the tooth > 2mm . May lose adhesion on one or all tooth surfaces.
- Loose teeth, difficult to chew and painful.
- There may be pus in the gum pocket area.
- X-ray images include:
- Alveolar bone resorption, can be horizontal or vertical
- Widening of the periodontal ligament
- Continuous loss of hard leaves
- There may be some other pathological signs such as diarrhea.
root, root cyst, fractures
2.2. X-ray: There is an image of alveolar bone loss, horizontal bone loss.
or vertical
3. Treatment:
Initial treatment
- Remove tartar, smooth tooth root surface, instruct on oral hygiene.
- Treating cavities and tooth decay complications
- Extract teeth as indicated
- Correct errors in restoration and treatment
- Temporarily fix loose teeth
- Bite correction
- After performing the initial treatment steps, the results should be re-evaluated after 1-3 months .
Supportive treatment
- Periodontal surgery: performed after initial treatment, no more local acute inflammation. Purpose: Remove pathological tissue in the area around the teeth, restore all or part of the lost tissue around the teeth. Methods such as gingival curettage surgery, gingival resection surgery, gingival shaping, bone grafting surgery, biologically guided tissue regeneration surgery, etc.
- Endodontic surgery: Includes apical resection surgery, cyst curettage surgery... The purpose is to remove the accessory root canals and accessory roots in the area around the root of the tooth, which are the cause of failure of endodontic treatment.
- Regeneration and restoration: Purpose: Restoration of chewing function, restoration of physiological bite, aesthetic restoration. Including methods such as: Orthodontics, fixed restoration and removable restoration.
Maintenance treatment
- Regular dental check-ups
- Oral hygiene instructions
- Control of systemic diseases related to dentistry
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Lesson 24
PREVENTION OF ORAL DISEASES
1. General
- Although oral diseases do not affect life, they are becoming more common today, so treatment has become a social issue.
- The disease affects health due to pain, especially when eating and drinking. Therefore, many countries attach importance to the prevention of oral diseases.
- Tooth decay causes many complications such as pulpitis, periapical inflammation leading to tooth loss.
2. Systemic disease prevention
2.1. Eating problems
2.1.1. Pregnant mother
Children need to eat a nutritious diet. If they lack calcium , phosphorus , and vitamins , it will negatively affect their teeth later on.
2.1.2. Lactation period
The mother's diet and medication both affect the baby. The baby should be breastfed for the full amount of time and not weaned early, otherwise it will affect the baby and cause
rickets malnutrition, affecting the development of teeth.
2.1.3. Diet for children and adults:
You should not eat hot or cold foods. Your diet should ensure adequate calcium , phosphorus , and vitamins.
2.2. Food processing issues
When processing food, it is necessary to retain as much trace elements as possible: B1 , K, E, fluoride (which helps prevent tooth decay) found in meat, fish, vegetables, tea, and drinks.
3. On-site disease prevention
3.1. For infants
Every day after eating and before going to bed, use gauze soaked in cooled boiled water to clean the baby's mouth. After 6 months of age, it is necessary to increase hygiene for the baby.
3.2. For children:
- Regular check-ups and use of preventive medications
filling grooves, treating newly decayed teeth
- Only pull teeth when they are old enough to change teeth. Don't pull them out too early because it will cause permanent teeth to grow in a mess due to lack of space.
- Daily guide children to eat slowly, chew thoroughly, and brush their teeth.
teeth at night and morning wake up
- Don't eat sweets before going to bed.
3.3. For adults:
3.3.1. Oral hygiene
- Brush teeth in 3 ways: horizontally, circularly, vertically up and down along the teeth (vertically is considered the cleanest)
- Brush all three sides of your teeth before going to bed and when you wake up in the morning.
- Use toothpaste with sodium fluoride to strengthen teeth.
3.3.2. Topical application:
Use 5% alcohol and 75% sodium fluoride on suspected tooth decay.
3.3.3. Note:
- Don't cover your teeth with gold for no reason.
- Do not use teeth instead of pliers.
- No sawing or grinding teeth
- Do not use abrasives to whiten teeth.
- When you have dental problems, you should go see a doctor.
early
Lesson 25
PULPITIS
1. Characteristics of dental pulp anatomy and physiology
Dental pulp is a soft tissue consisting of blood vessels, nerves, lymphatic vessels and interstitial tissue located in a cavity between the dentin called the dental pulp cavity. The dental pulp tissue communicates with the body through a very small hole in the root of the tooth.
The pulp cavity has two parts: the crown cavity (pulp chamber) and the root cavity (root canal).
1.1. Pulp chamber:
- The pulp chamber in teeth number 1 and number 2 is shaped like a swallow's tail, in canines it is like a flame.
- The pulp chamber in molars is box-shaped, consisting of 4 walls and 2 surfaces:
- Upper surface (pulp chamber ceiling): the pulp chamber ceiling is not flat, it has many raised papillae corresponding to the tooth cusps , called pulp horns.
- Lower surface (pulp floor): dome-shaped, with root canal openings.
1.2. Root canal.
- A tooth root can have 1 or more root canals. The root canal is round, oval or flat , gradually narrowing, constricting about 1mm from the root hole.
- The pulp chamber and canal are large when the tooth first grows, but become narrower as it matures due to the gradual formation of secondary dentin layers.
- Pulp tissue is a soft connective tissue similar to young connective tissue. The structure of the dental pulp consists of two regions: the middle region of the dental pulp and the region adjacent to the pulp.
- The dental pulp has many blood vessels and nerves. The blood vessels pass through the root foramen and form a dense network in the dental pulp. Nerves and terminal branches of the V nerve.
- Some authors say there is a lymphatic system in the dental pulp, while others say there is no lymphatic system in the dental pulp.
- Dental pulp has 4 main tasks:
- Secondary dentin formation
- Nourish dentin
- Gradually transmit feelings
- Protect tooth pulp
2. Causes