What Is Periodontitis?
Periodontitis is a chronic inflammatory condition affecting the tissues that support the teeth: the gums, periodontal ligament, cementum and jawbone.
It begins as gingivitis and, if left untreated, progresses to destruction of the periodontal tissues, with the formation of periodontal pockets, loss of bone support and, ultimately, tooth mobility or tooth loss.
It is one of the most widespread chronic diseases worldwide and is associated with systemic conditions such as diabetes mellitus, cardiovascular disease and rheumatoid arthritis.
Severe or treatment-resistant forms, particularly in immunocompromised patients, people with diabetes or smokers, require a multifaceted approach that extends beyond mechanical cleaning and antibiotic treatment.
Characteristics of Periodontitis
The periodontal pocket—the pathological space that forms between the gum and the tooth—creates an anaerobic microenvironment that favors the most aggressive periodontal pathogens, including Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola.
These bacteria thrive under hypoxic conditions and form biofilms that make them more resistant to conventional antibiotic treatment.
Chronic periodontal inflammation is further aggravated by the impaired blood supply that develops within the affected tissues. Hypoxic periodontal tissue cannot regenerate effectively, even after plaque has been removed and the infection brought under control.
Restoring adequate oxygenation is therefore an important prerequisite for successful periodontal healing and regeneration.
Scientific Studies
Studies evaluating hyperbaric oxygen therapy as an adjunct to periodontal treatment have reported reductions in periodontal pocket depth, improvements in clinical attachment levels and decreases in inflammatory markers among patients with severe or treatment-resistant periodontitis.
Its direct bactericidal activity against anaerobic pathogens within periodontal pockets, enhancement of phagocytic function and improvement of the periodontal blood supply are the principal mechanisms involved.
Particularly encouraging findings have been reported in patients with both diabetes mellitus and periodontitis, two conditions with a harmful bidirectional relationship in which each can aggravate the other. Improvements in periodontal health following adjunctive hyperbaric oxygen therapy may also have a positive effect on glycaemic control.
The Role of Hyperbaric Oxygen Therapy
In periodontitis, hyperbaric oxygen therapy may be used as an adjunctive option for severe or treatment-resistant forms. It is always administered alongside and in support of primary periodontal treatment, including thorough mechanical debridement and regenerative surgery where indicated.
Increasing oxygen tension within the microenvironment of the periodontal pocket creates unfavorable conditions for anaerobic pathogens while simultaneously enhancing white blood cell activity and bacterial clearance.
Over the longer term, neovascularisation improves the blood supply to the periodontal tissues and supports their natural regenerative capacity.
A typical treatment course consists of 15 to 25 sessions, planned in collaboration with the periodontist.