The periodontitis also known as pyorrhea is an infectious inflammatory disease, which occurs in the tissues of the tooth insert (bone, cementum and periodontal ligament).

The periodontitis is associated with plaque , and more specifically to groups of bacteria that colonize and reside in the subgingival space is the space that is immediately after the gumline.

The pyorrhea unlike gingivitis is characterized by the loss of structural insertion apparatus tooth while gingivitis is inflammation of the gums without involving the insertion apparatus tooth.

Signs and symptoms of pyorrhea

There are different types of periodontitis , but the most common signs and symptoms regardless of the type of periodontitis are:

  • Edema.
  • Erythema (redness).
  • Gum enlargement or recession.
  • Bacterial plaque or calculus supra (above the gum) or subgingival (below the gum).
  • Local factors that increase the accumulation of bacterial plaque, such as dental restorations in poor condition or dental crowding.
  • Bleeding or suppuration when using dental floss or other stimuli.
  • Accentuated dental mobility.
  • Loss of teeth
  • Inflammation of the gums.
  • Loss of alveolar bone (which is the bone around the tooth) can be seen directly or on an x-ray.

tipos deperiodontitis

Pyorrhea can be cataloged in different ways:

Chronic periodontitis

It can be localized or generalized, but both have the same characteristics.

  • It is more common in adults than in children
  • It evolves slowly or moderately.
  • The extent of destruction of periodontal tissues is generally related to the level of oral hygiene, plaque levels, smoking, stress, and systemic diseases.
  • The number of bacteria is proportional to the severity of the tissue destruction.
  • Destruction of the attachment tissue is widespread.
  • Subgingival calculus is common.

Aggressive periodontitis

It’s divided in:

Localized aggressive periodontitis

  • It generally affects teenagers.
  • Its progression is rapid.
  • The amount of bacteria present is not proportional to the severity of the tissue destruction.
  • The periodontal destruction is located in the first molars and incisors.
  • The gingival stone is generally absent.

Generalized aggressive periodontitis

  • It normally affects people under 30 years of age, although it can occur in older individuals.
  • It is of rapid progression.
  • The number of bacteria is normally proportional to the severity of the tissue destruction.
  • Periodontal destruction affects the first molars and incisors and other teeth.
  • Gingival calculus present or absent.

Causes of pyorrhea

One of the most common causes is the presence of bacterial plaque, but periodontitis is related to the person who suffers from it, that is, if their immune system works effectively, even some people have a genetic predisposition, and for this reason only some people develop advanced destruction.

The periodontitis develops when there is an increase in the number of bacteria (adhering to plaque) and aggregation of pathogenic bacteria, caused a decrease in the response of the immune system, in addition to factors such as:

  • Genetic predisposition.
  • Tobacco use.
  • Diabetes and other diseases that decrease the response of the immune system.
  • Stress and / or depression.
  • Age.
  • Poor oral hygiene
  • Immunosuppressive drugs.


The American Academy of Periodontology recommends following a series of guidelines for the treatment of periodontitis :

  • Educate the patient regarding oral hygiene
  • Supra and subgingival scrapings.
  • Scraping and root planing.
  • Periodontal surgeries, which will depend on the severity of the periodontitis . These can be to help regenerate both bone tissue and gums.
  • Constantly reassessing the case.
  • Antibiotic therapy depending on the patient and the severity of periodontitis.

These treatments are purely dental, it is recommended to go to your dentist to improve your oral health in case of periodontitis.

How to prevent periodontitis

Both to prevent periodontitis and to have a greater evolution in its treatment, it is important to control the following factors:

  • Maintain good oral hygiene.
  • Regular visits to the dentist, at least every 6 months.
  • Removal or replacement of dental restorations in poor condition.
  • Caries removal.
  • Treatment for those who have occlusion problems.
  • Extraction of teeth that have a poor prognosis.
  • Improve those dental conditions that favor the accumulation of food.
  • Those people who are diabetic or have diseases that alter their immune system, should go to check with their doctor.

By Dr. Eric Jackson

Dr. Eric Jackson provides primary Internal Medicine care for men and women and treats patients with bone and mineral diseases, diabetes, heart conditions, and other chronic illnesses.He is a Washington University Bone Health Program physician and is a certified Bone Densitometrist. Dr. Avery is consistently recognized in "The Best Doctors in America" list.

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