Treatment of Periodontitis (Tooth Root Inflammation)

• Professional equipment allows for accurate diagnosis of the disease stage and thorough cleaning of root canals;
• Micro-invasive methods minimize intervention: we remove only affected tissues, preserving as much of the healthy tooth structure as possible;
• High-quality filling materials ensure long-term results and prevent re-inflammation.

Early diagnosis of periodontitis is important for preserving the tooth and preventing complications, such as granuloma or cyst.

The first stage is a dentist’s examination: checking sensitivity, tooth mobility, percussion, palpation of the gums, and probing of periodontal pockets. This allows evaluating the inflammation around the root. Next, radiology is appropriately prescribed as the main diagnostic method. On an image, periodontitis looks like a darkening near the apex of the root. Targeted X-ray, panoramic, or CT are used for accurate determination of the lesion. Additionally, electroodontodiagnostics is used, which helps to evaluate the condition of the nerve and distinguish periodontitis from pulpitis.

Periodontitis is a serious inflammatory disease of the tooth, which, with untimely treatment, can lead to dangerous consequences. Local complications include periostitis (flux), abscess, and phlegmon. They manifest as severe pain, swelling, and fever, requiring urgent dental intervention.

If periodontitis is left without treatment, the tooth can become mobile and eventually fall out. Inflammation destroys bone tissue, which complicates further implantation and increases the risk of affecting adjacent teeth.

In addition to local problems, the disease can affect the body as a whole. A chronic infectious focus is capable of spreading bacteria into the blood, increasing the risk of sepsis and damage to internal organs. For a long time, asymptomatic periodontitis can weaken immunity and worsen the general condition.

Understanding these consequences helps to realize the seriousness of periodontitis and motivates to timely consult a dentist to preserve teeth and the health of the entire body.

How to treat inflammation of the tooth root? Treatment of periodontitis is selected individually depending on the stage of the disease and the condition of the tooth. The main approaches are divided into conservative (therapeutic) and surgical.

The conservative method includes thorough cleaning of the root canals, disinfection and filling. This approach is effective in most forms of periodontitis, if the canals are open, the tooth is intact, and the surrounding bone tissue has not yet undergone significant destruction.

Surgical treatment is used in difficult cases: with large granulomas, tooth cysts, root perforations or when conservative treatment has not yielded results. It may include removal of granulations, bone grafting or apicoectomy (removal of the root apex).

In many cases, a combined approach is effective, when conservative methods are combined with surgical ones to preserve the tooth as much as possible and restore the tissues around it. The choice of method depends on the form of periodontitis, patency of the canals, the condition of the tooth and the general condition of the patient.

Conservative (endodontic) treatment of periodontitis

Conservative or endodontic treatment allows you to save the tooth even with inflammation of the tissues around the root.

The procedure begins with anesthesia, after which the doctor opens the tooth and, if necessary, removes the old filling. Then the root canals are mechanically cleaned with modern instruments and antiseptic treatment is performed to reduce the risk of infection.

Sometimes a temporary filling with calcium preparations is used to heal the tissues. After that, the canals are permanently sealed with gutta-percha and a control X-ray is taken. The treatment ends with the restoration of the crown part of the tooth.

Chronic periodontitis treatment protocol

The treatment of chronic periodontitis is based on a standardized protocol and depends on the form of the disease and the condition of the tooth. In simple cases, 2–3 visits are sufficient, while complex forms require more sessions for high-quality cleaning and filling of the canals.

• The fibrous form is treated endodontically: cleaning of the canals, drug treatment and filling.
• Granulating periodontitis requires careful removal of granulations and treatment with antiseptics, sometimes surgery is used.
• Cysts are treated comprehensively: conservatively plus surgical removal of the affected tissue and bone restoration.

A temporary filling is applied between visits to allow tissue healing, and a permanent one is applied after inflammation is controlled. Success criteria: absence of pain and swelling, normal tooth mobility, bone restoration, and repeat X-ray. Following the protocol allows you to save the tooth and avoid complications.

Periodontitis in children has its own characteristics, because tooth and bone tissues are still actively forming. The disease can proceed faster and more aggressively than in adults, so timely treatment to the dentist is especially important.

Baby teeth are treated if they are still able to perform the chewing function and support the development of the bite. Treatment of periodontitis of temporary teeth in children includes cleaning the canals, antiseptic treatment and temporary or permanent filling. Removal is indicated only in cases of severe destruction or the impossibility of effective treatment. Preservation of baby teeth is important for the correct formation of the jaw and the prevention of problems with permanent teeth.

Permanent teeth with unformed roots require a particularly delicate approach. Treatment of periodontitis of permanent teeth in children includes cleaning the canals, fillings and X-ray control.

In addition to the medical aspects, a psychological approach is important: the dentist explains the procedure to the child, uses playful methods and calms them down to reduce fear and form a positive attitude towards dental treatment.

Proper treatment of periodontitis in children allows you to save your teeth, avoid complications and ensure normal development of the jaw and bite.

Periodontal treatment usually requires 2–4 visits, depending on the complexity of the case and the condition of the tooth.

Typical scenarios:

• 2 visits — a simple case: cleaning the canals and permanent filling.
• 3 visits — a chronic or partially affected canal: temporary filling, repeated cleaning and permanent filling.
• 4+ visits — complex cases when treatment of chronic granulating periodontitis is required or there are already cysts.

At each appointment, the doctor administers anesthesia, cleans the canals, treats them with antiseptics and fills the tooth. The time between visits is 5–10 days, so that the tissues can recover. The number of visits depends on the form of periodontitis, the complexity of the canals and the condition of the bone. Knowing this helps to plan time and budget and increases the chances of saving the tooth.

Rehabilitation after periodontitis treatment

After periodontitis treatment, it is important to properly care for your tooth to speed up healing and avoid complications:

• Diet: the first few days — soft, non-hot food; avoid hard, sticky, and spicy foods. Gradually, the diet can be expanded.
• Physical activity: limit activity for 1–2 days so as not to provoke swelling or bleeding.
• Hygiene: brush your teeth with a soft brush, carefully going around the treated tooth; you can use alcohol-free mouthwashes.

Normal sensations: slight discomfort, sensitivity to cold or hot.

Alarming symptoms: severe pain, swelling, discharge of pus or blood — consult a dentist immediately. Most patients recover in 5–10 days; a follow-up examination confirms successful treatment.