Periodontitis is the leading cause of tooth loss in adults. More than 80 percent of the population suffers from gingivitis, according to results of the Third German Oral Health Study. One in three adults shows signs of moderate periodontitis, and one in seven even that of severe periodontitis. But this dramatic situation does not have to be, because today the dentist has the most modern diagnostic and therapeutic methods at his disposal. With early diagnosis and early therapy, gingivitis and periodontitis can be successfully treated. However, due to inadequate diagnostics, many periodontal diseases still remain undetected in their early stages. With regular check-ups by the dentist, he or she can take appropriate measures at an early stage if necessary, such as a quick test to check the gum pockets. The test works without effort and is completely painless. With the help of a so-called rapid test probe (“screening”), the gum pockets are measured. Here, every millimeter counts.
Periodontal screening index
A periodontal screening index (PSI) is an inexpensive procedure for the early detection of periodontitis that can be performed relatively quickly and does not require a great deal of equipment. The examination is carried out with a special periodontal probe (WHO probe), with which the bleeding tendency of the gingiva and roughness of the subgingival tooth surfaces can be determined in a simple manner and the depth of gingival pockets can be measured. The dentist uses the probe to check the depth of the so-called gingival pockets. These are the invisible spaces between the gums and the teeth. “Although representations of the use of the probes seems somewhat unpleasant at first glance, the test is painless even in the case of inflammation,” comments proDente expert Dr. Dietmar Oesterreich on the examination. At the same time, existing bleeding is registered and the presence of tartar as well as overhanging fillings and crowns are assessed by the dentist. Likewise, existing loosening, exposed tooth necks and root spaces are recorded.
Examination and treatment
For examination, the dentition is divided into sextants in which the findings are collected and assigned to five different codes. The result of this examination is an accurate classification of the patient’s dental health. Five severity levels (from 0-4) are distinguished with the help of an index. For each area, only the highest value is noted, Wolfgang Bengel explained the procedure. With code 0, the gingiva and periodont are healthy. Codes 1 and 2 indicate gingivitis, codes 3 and 4 indicate a moderately severe or severe form of periodontitis, respectively. Based on the results, the dentist will perform a more extensive periodontal examination, if necessary, and initiate appropriate therapeutic measures.
| Severity | Treatment measures |
|---|---|
| Grade 0 | Gums and periodont are healthy, no further therapy is needed. |
| Grade I | The gums are inflamed. Thorough dental cleaning should be performed. In addition, the patient should be accurately informed about home dental care. |
| Grade II | The gums are inflamed and there is tartar or overhanging fillings and crowns. After professional teeth cleaning and information about better oral hygiene, fillings and crowns are refinished or renewed. |
| Grade III | Mild periodontitis is present. In addition, the above findings may also be present. In addition to the treatment measures mentioned in I and II, systematic periodontal therapy should be performed. |
| Grade IV | Severe periodontitis is present. In addition, the above findings may also be present. In addition to the measures listed in I and II, systematic periodontal therapy should be urgently performed, possibly with further surgical measures. |
Genes also bear responsibility
In some families, periodontitis occurs more frequently. Who now immediately thinks of occurring infections in people who are in close contact with each other, is not always right. Researchers were also in the dark for a long time with regard to people who attach great importance to their oral hygiene and yet developed periodontitis.Although poor oral hygiene promotes the development of periodontitis, it is not exclusively due to this.
Greatly increased risk for one-third of the population
Meanwhile, science knows more answers to these questions: for example, certain patients are genetically at higher risk of developing periodontitis. Meanwhile, there is a simple new test that can bring clarity to a possible risk of periodontitis. To do this, a cotton swab is simply swabbed across the oral mucosa, and the result is evaluated in a laboratory. If an increased production of interleukin-1 is detected, there is a greater tendency to inflammation. Finally, there is a risk of bone loss at the affected site. In any case, with regular prophylactic care, it is possible to improve the situation accordingly. A very high risk factor – smoking – should be avoided at all costs by the persons concerned.
