Causes of the periodontal disease:
Periodontal therapy involves different approaches in the elimination of bacteria out of the periodontal tissue. The presence of bacteria in periodontal tissue is the main cause of the periodontal disease known as gingivitis and periodontitis. These two conditions may be similar but actually has a lot of differences in clinical presentation, chief complaints in patients, a progression of the condition and consequential therapeutic approaches. While gingivitis affects only a soft tissue around the tooth, periodontitis affects entire periodontal tissue that consists of a dental root, alveolar bone, gums and periodontal space with its ligaments and other, mostly immune cells. Aetiology of both conditions is the same. Bacteria in these spaces lead to inflammation of periodontal tissue, whether it affects only gums or all parts of the periodontal tissue. Many researchers tried to define exact bacterial flora in periodontal diseases, and as predominated species following microbes were defined: A. actinomycetemcomitans, P. gingivalis, P. intermedia, Treponema sp. and many others.
Bacteria are mainly present in dental plaque and calculus. Therefore, lack of hygiene leads to greater accumulation of dental plaque. Besides the greater amount of dental plaque, the pH value raises above 7 which benefit bacteria as a better surrounding for their metabolic activities and growth. These bacterial activities lead to the development of acute, local infection followed by swelling redness, swelling and sometimes pain. The gums became swollen and red, more prone to bleeding during chewing and teeth brushing. In this stage gingival pockets may appear, which means that the space between the gums and the tooth became larger and deeper, leaving more empty space for new bacterial retention and multiplication and progressive impairment of the initial condition. If this condition persists without improvement of hygienic habits and removal of plaque and calculus that contain bacteria, the infection progresses and the condition gets worse. More bacteria colonize the site of infection, the objective clinical signs became more obvious and subjective complaints became more intense. In this stage the periodontal pockets start developing, that is followed by a bone loss, intensive pain and may be followed by fetor. Further propagation of infection leads to serious bone loss with the formation of deeper periodontal pockets and latest loss of teeth due to loss of periodontal ligament and bone that keeps the teeth in their place. It is important to have in mind that some other health problems or medications may affect the periodontal ligament and gums. Some In the way of affecting microcirculation in the soft tissue of oral cavity, while others may affect the salivation and consequential easier retention of dental plaque or even lead to a hyperplastic proliferation of gingiva.