Teeth have an important job. They have to grind and chew the food we eat every day. In order to perform this task, they must be stably anchored in the jaw.
What is the periodontium?
The term periodontium, also known as the dental bed or periodontium, is the generic term for various supporting tissues that surround the tooth and provide anchorage in the jaw. It consists of four different structures:
- Dental compartments (alveoli, which form the bony compartment in the jaw in which the tooth is firmly anchored.
- Gum (gingiva), which surrounds the lower part of the tooth to the tooth crown.
- Root skin (desmodont), which secures the tooth in the alveolar bone and provides more elastic cushioning during chewing movements
- Dental cement that surrounds the root to the crown of the tooth.
These various structures in the periodontium ensure that the teeth are firmly anchored in the bone and can withstand regular chewing pressure. In addition, the retaining apparatus shields the oral cavity environment from the roots of the teeth.
Anatomy and structure
Each tooth is surrounded at the root in the jaw by dental cementum and a periodontal membrane that is connected to the dental compartments (alveoli). The root membrane is composed of collagen fibers, called Sharpey fibers, which yield somewhat to provide elastic support for chewing pressure, connective tissue, blood vessels, and nerves. The blood vessels supply the root membrane with nutrients and the nerves regulate the chewing pressure. On the outside of the tooth root, the tooth is surrounded by tooth cementum, which is connected to the root membrane on the inside and to the alveoli in the jaw on the outside. The tooth cementum extends to the neck of the tooth, where the enamel begins. The root membrane and the sensitive tooth necks are covered by the gum, which is the only visible part of the tooth supporting apparatus. It surrounds the teeth like a coat, but it is sensitive, can become inflamed gum and periodontal diseases.
Function and tasks
All teeth are normally strong enough to withstand regular chewing pressure. Their weak point is formed by acid attacks from bacteria, which can damage teeth and gums, and thus the periodontium. Each individual tooth helps to keep chewing in balance. When teeth are missing, neighboring teeth move into the gaps, triggering a chain reaction, and the physiology of biting is altered so that teeth can no longer bite together properly. This can damage the periodontium and overload the temporomandibular joints and masticatory muscles. Due to its finely tuned structure, the periodontium ensures that the teeth are anchored in the jaw in a stable but easily movable manner and at the same time can react somewhat flexibly to chewing movements. In orthodontics, these conditions are used for therapy and teeth are deliberately moved by means of braces. With implants, this slight mobility is no longer given; they are rigidly anchored. The gum seals the sensitive root area from the oral cavity and thus protects it from contamination. Normally, it lies very close to the tooth. If the periodontium, the bed of the tooth, is no longer functional, it recedes with fatal consequences for the teeth. Therefore, dentists attach great importance to the timely detection and treatment of periodontal diseases through regular preventive care.
Diseases
Bacteria in the oral cavity can cause periodontal diseases if the gums are not intact, for example, because they are injured when brushing the teeth or because bacteria settle, causing gum pockets to form. Soft deposits (plaque) accumulate on the teeth as a result of eating and drinking, and bacteria settle on them. If they are not sufficiently removed during dental care, these plaques become harder and tartar develops at the gum line and irritates the gums. Bacteria can easily penetrate the gums via plaque and form inflammations that lead to gum pocket formation. As a result, the sensitive root area is no longer adequately protected, and the germs can penetrate the periodontium and severely damage it, even causing teeth to fall out. Initially, the bacteria trigger a chronic inflammation of the gums (gingivitis), which can be recognized by redness and slight swelling of the gums.The gums may bleed and unpleasant bad breath may occur. Because the inflamed gums are no longer as close to the tooth, the pockets become larger, the inflammation progresses and becomes periodontitis. When the inflammation reaches the jawbone, bone loss occurs in the jawbone and the tooth loses its support. Due to the bone loss, the tooth changes its position and loses its stability when chewing. The bone loss causes gum recession, which initially makes the teeth appear longer. How severe the inflammation is and how quickly the bone degrades depends largely on the type of bacteria and the immune system. In the worst case, inflammation can spread through the body via periodontal disease and damage the heart. It is therefore important to detect periodontal disease as early as possible and to prevent loosening of the teeth in good time. When the periodontium is damaged to an advanced degree by periodontitis and the jawbone recedes, the disease is irreversible and the loss of teeth cannot be stopped.