. Periodontal disease and its treatment by ionic medication . adually the deposit increases, and itself becomesa source of further irritation to the inflamed area immediatelycovering it. It further increases, until it is readily discerniblein the form of granular nodules or a hard, smooth, brownishcrust, which adheres firmly to the necks of the teeth. Subgingival calculus having once been deposited, inflamma- 1 Kirk: Operative Dentistry, p. 484. 2fi ETIOLOGY OF PERIODONTAL DISEASE tioii seems to take on a more acute form, the gums becometurgid and heaped up in the interdental spaces (increasin
. Periodontal disease and its treatment by ionic medication . adually the deposit increases, and itself becomesa source of further irritation to the inflamed area immediatelycovering it. It further increases, until it is readily discerniblein the form of granular nodules or a hard, smooth, brownishcrust, which adheres firmly to the necks of the teeth. Subgingival calculus having once been deposited, inflamma- 1 Kirk: Operative Dentistry, p. 484. 2fi ETIOLOGY OF PERIODONTAL DISEASE tioii seems to take on a more acute form, the gums becometurgid and heaped up in the interdental spaces (increasingthe depth of the gingival trough), and become loosened fromthe necks of the teeth, forming a suitable receptacle forparticles of food. The inflammation extends to the peri-odontal membrane and the alveolar bone, the former becomesdetached and recedes, forming a small pocket, the latteris absorbed gradually from its free margin toward the bodyof the bone, and a process of rarefying osteitis starts (). At this stage bacteria undoubtedly exercise a great. Fig. 2.—Starting rarefying osteitis. influence—hastening the progress of the disease. The con-tents of the gingival trough now consist of desquamationof the epithelial lining of the gingival trough, dead tissuecells, leucocytes and serum exuding from the inflamedsurface, mixed with mucus and particles of decomposingfood, altogether providing a most admirable culture mediumwhich is kept at the right temperature for the developmentand maintenance of pathogenic organisms. Up to this stage no pus is visible and pressure on the gumsonly produces bleeding, but the soft tissues are in a diseasedstate and bacteria contained in the gingival trough find SUBGINGIVAL CALCULUS 27 ready access into the intercellular spaces and capillaries, andprobably penetrate into the alveolar bone. In many well kept mouths some of these symptoms areentirely absent—there is no swelling or turgidity of the gums,no discomfort, the gingival trough,
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