The Pyorrhoea: Definition, Causes, Symptoms, Diagnosis, Treatment and Prevention

It refers to an advanced stage of periodontal disease in which the ligaments and bones that support the teeth become inflamed and infected.

Also known as Periodontitis, it is usually the result of gingivitis. This periodontal disease infects the gum through the plaque that leads to the formation of a pocket between the teeth that trap the plaque.


  • Poor oral hygiene is the leading cause of pyorrhea. If the mouth is not cleaned correctly, the food particles will remain trapped in the crevices between the teeth, which will cause pyorrhea due to a bacterial infection.
  • Incorrect eating habits include consuming white bread, sugar, excess meat, and refined grains. The concentration of blood in the gums increases, which accelerates bacterial growth.
  • Improper brushing and incorrect use of toothpicks also cause pyorrhea. Both cause lesions in the gums and provide an entrance for the bacteria that cause pyorrhea.
  • Lack of calcium in the daily diet; this element is vital in strengthening the maxilla that holds your teeth.
  • Smoking is another risk factor for Periodontitis.
  • Other factors are the physical and chemical irritation of the mouth, allergy, pregnancy, contraceptive pills, and prolonged tension.


The signs and symptoms of the appearance of pyorrhea are intimately associated with the stage in which the disease is found in the patient’s mouth.

Pyorrhea has three stages:

Stage 1

  • The gum margin is the first clinically involved tissue in this first stage.
  • When this initial stage is observed, there is no apparent clinical implication of the alveolar process, the bacterium, for its part, has started its attack on the gums that begin to look reddish, and minor bleeding is experienced every time there is a minimal provocation.
  • The teeth become very sensitive to sweet, sour, and too-hard food and will not be able to chew correctly.
  • There is a slight recoil of the gum from the enamel in some cases.
  • The teeth become highly sensitive, and there is bad breath.

Stage 2

  • The second stage of pyorrhea is much more severe.
  • In the second stage, there is the involvement of the expert ligament.
  • Unlike stage 1, where most symptoms can be treated with adequate care, the most common problems are discoloration of the gums and inflammation in stage two.
  • There is a complex substance of yellowish or brown color like tartar around the membranes.
  • There is pus formation, and when the gums are pressed, the pus usually comes out, indicating that the internal bone has been attacked. Prolonged exposure to this situation will eventually cause the tooth to be lost.

Stage 3

  • All the symptoms of stages 1 and 2 are exhibited in this stage but in a more severe form.
  • In the third stage of Periodontitis, pus bags become more dangerous and are seen throughout the mouth.
  • If surgery is not performed to remove the parts and pus at this time, it can cause gangrene and, finally, the patient’s death in extreme situations.


The diagnosis of Periodontitis is based on the description of the symptoms by the patient and on the oral examination to detect plaque, tartar, or bleeding gums.

The health of the gums is examined by measuring the depth of the gingival sulcus, the channel between the gums and the teeth, using a metal probe.

An x-ray may be necessary to study bone loss.


Enzymatic test for gum disease

MMP-8 is an enzyme capable of degrading the collagen of the extracellular matrix of periodontal tissues; it is beneficial to detect the early stages of periodontal inflammation.

The test is quick and painless and allows the specialist to take immediate measures to prevent periodontal and peri-implant damage.

The enzymatic test is the first step of the periodontal diagnosis; if the result is positive, it is essential to deeply review the mouth’s situation with the microbiological examination.

Microbiological test

The microbiological test allows for creating a report that shows the presence of the main bacteria in the patient’s mouth.

In two sectoral diagrams, the percentage of pathogenic bacteria found in the total amount of bacteria in the mouth is grouped first. These pathogenic bacteria are assigned to the various groups to which they belong.

This allows the identification of a predominant category of microorganisms that “attack” the patient’s mouth.

The microbiological test can be repeated several times until the patient has completely recovered.

Periodontal disease risk test

The periodontal disease risk test is only done once, and its purpose is to calculate the patient’s specific susceptibility to periodontal disease.

The exfoliated cells found in saliva are collected in a small sample taken from the inside of the cheek and on the tongue.

According to the results of this test, the risk of periodontal disease can be classified as low, medium, intermediate, high, or very high.

The periodontal test reveals bleeding, pus, and lost teeth and measures the periodontal pockets and the depth of the gums retracted.

X-ray images

Finally, X-ray images are taken to determine the bony levels of the jaw.


Because a diet of refined foods is the common cause of pyorrhoea, eliminating all refined fats, refined sugars, and refined proteins can be helpful; switching to a diet rich in fresh and raw fruits, fruits and vegetables, cereals whole, and some nuts and seeds.

Avoid sandwiches between meals of any kind. Studies show that the more times a person eats, the greater the plaque accumulation and the likelihood of pyorrhea.

It should consume large amounts of water, from 8 to 20 glasses per day, because it encourages bacterial growth when the mouth is dry. Dehydration reduces the resistance of the tissue to infection.

The use of an astringent tea, comfrey root, or chamomile can be used as a mouthwash after each brushing. The astringent action promotes healing.

Do not use commercial toothpaste; you should use medicated tooth cleaning products and brush your teeth after each meal. Use a small, soft toothbrush with rounded bristles and a flat surface to brush.

Use short horizontal movements and an oscillating movement, holding the brush at a 45-degree angle with the teeth to allow the bristles to slide between the gums and the teeth. After brushing and rinsing, floss carefully; if possible, floss not waxed.

Use the same measures used for osteoporosis to prevent the loss of bone structure.

Do not smoke; this doubles the risk of pyorrhea. Do not use oral contraceptives, coffee, tea, cola, chocolate, or Dilantin, because they increase the risk of gum disease.

Exercise helps build the body’s resistance to infection.

A dental hygienist’s regular and thorough cleaning of the teeth helps eliminate plaque buildup, promoting inflammation and leading to pyorrhea.


The teeth can be protected if the pyorrhea is treated in time.

Pyorrhea can develop in adults and children; however, the risk increases in the older age group.

Good oral hygiene can reduce the risk of pyorrhea in most people.

Visiting the dentist at least twice a year for oral diagnosis is a significant prevention measure for preventing dental diseases.

Healthy eating habits should be adopted to improve the immune system, such as eating foods rich in vitamin C and calcium such as oranges, broccoli, milk, cheese, etc.

Foods rich in vitamin C helps heal bleeding and swollen gums, while calcium-rich foods strengthen your teeth.

When the patient eats radishes, apples, guavas, or cucumbers after the meal, these foods work as a natural cleanser for the mouth and gums.