Parodontal diseases known also under the name of gum  diseases, are considered among the most common infections.

Most of the subjects over the age of 35 years present some tartar and\or average pockets.

In France there is a need of parodontic care for 96,7 % of the population  (simple treatment or complex treatment ) (Ref: M Goldberg-on 1999 INSERM)

The periodontal diseases are painless up to an advanced stage. If they are not treated, they can lead to:

• Bad breath,
• Red and bleeding gums,
• Teeth loss,
• An unsightly (unaesthetic) smile.

In spite of these facts, the periodontal diseases are a part of diseases which we can most prevent.

What do periodontal diseases mean?

Parodonte means anything that supports the tooth (bone, ligament, gum)

The periodontal diseases are bacterial infections of the gums which destroy fibers and bone supporting the tooth in your mouth.

The main cause of these diseases is the dental plaque, this whitish product which accumulates on your teeth. A good daily brushing with the passage of the dental floss and\or the dental small brushes that can fit between your teeth is the best mean to fight against this periodontal disease

If this deposit is not eliminated, it can be transformed, within 2 days, into a harder substance which is the tartar. The tartar is so hard that only a professional cleaning can eliminate it. If this tartar forms under the gum under the roots of teeth, the elimination of the plaque is even more difficult, this increases the risks of having a periodontal disease.

Toxin produced by the bacteria of the tartar can irritate gums and lead to an infection. This toxin can also destroy tissues that support the tooth including the bone.

When this happens, gums part from the tooth, forming pockets which are going to be filled with more plaque and leading to more infections. With the progress of the periodontal disease, these pockets deepen and more gum and bones are going to be destroyed, entailing in certain cases teeth mobility and their loss.

Periodontal diseases can affect one or several teeth. For example, your front teeth can be healthy whereas the back ones can become very mobile.

There are several kind of periodontal diseases. The most common ones are

Gingivitis (see sketch)

It is the most minor form of periodontal disease, its signs: red gums,  which bleed easily. There is little or no sensibility at this stage. The inflammation of the gums is reversible by a professional treatment and a good oral hygiene.

Superficial periodontisis

If the gums inflammation is not treated, it can evolve towards Periodontitis. At this stage, the periodontal disease begins to destroy the bone and the tissues that support the tooth.

Moderate and severe periodontisis (see sketch)

At a moderate stage, the periodontal diseases can entail even more of osseous and tissular loss. In the advanced forms, the loss is widened, this leads to ones teeth the mobility and to  the possibility of losing them.

What are the other factors which contribute to the periodontal diseases?

Although the plaque is the direct cause of the periodontal diseases, the other factors can contribute to their development or to their escalation.

• The cigarette

  The cigarette, an important risk factor for periodontal diseases, inhibits the micro vascularization in the mouth

• The pregnancy and the puberty (hormonal disorders).

  Some hormonal changes can turn gums more red, sensitive with an increased tendency to the bleeding. A pre-existent periodontisis can become more severe.

• The Stress

  The stress reduces the body immunity of the body against infections, among others the periodontal diseases.

• Medecine taking

  Some medicines such as the contraceptive pill, the antidepressants and antiepileptic or other for cardiac diseases for example can affect your oral health. For that purpose, you have to inform regularly your dentist of medicines you take and of any evolution of your general health.

• Teeth grinding

  These habits make the teeth bear excessive loads which can accelerate the process of tissues destruction .

• Malnutrition

  A malnutrition is going to reduce the capacities of the body to defend itself and thus to favor the development of the periodontal diseases.

• The diseases of systematic order

  The diseases which affect the immune systems of the body can contribute to aggravate certain forms of periodontal disease.

Incidences of periodontal diseases on the general state:

The persons presenting severe periodontitis (Ref: a Hour Tenenbaum Encyclopédie Médico-Chirurgicale 23-447-A-10) have a greater frequency of:

• Cardiovascular diseases,

• Badly balanced diabetes

• For the pregnant woman, more spontaneous premature birth,

• Bacterial pneumopathies treatment resistance.

What are the signs of the periodontal diseases?

• Gum bleeding when brushing

• Red gums, sensitive or bleeding

• Gums appear when no teeth

• Persistant bad breath

• Some pus between teeth and gums giving a bad taste in the mouth

• A change in the teeth  impaction between them

• Mobile (moving) teeth that part from one another

• Recessions (receding of gums)

You can also have a periodontal disease without having any of these symptoms. The majority of the persons do not feel pain with periodontal diseases.

If you have one of the symptoms that we quoted, you have to see your dentist who will treat you or will direct you to a periodontists. From 35 years, a significant number of persons develop a form of periodontitis.

A periodontist is a dentist who followed a particular program in this discipline and who has the skills to make a diagnosis, prevent and treat the periodontal diseases and if necessary place implants and insures their maintenance.

What examinations are performed ?

During the clinical examination, a small probe graduated in mm is gently placed between the gum and the tooth to estimate the health of your periodontium (Charting or topographic account of the pockets).

A radiographic examination is performed to estimate the health of the bone under the gum.

Additional examinations can be also performed, such as the bacterial tests to determine the types of bacteria in cause. A genetic test is also available; it allows to determine a predisposition to the periodontal disease and to direct the treatment.

How do we treat periodontal diseases ?

Once the evaluation of your periodontal state is established, your periodontist will determine with you the best therapeutic option which will allow to stop the progress of the disease and to restore you a good health to your gums.

According to the stage of the periodontal disease, treatments can vary:

At early stages, the procedures are simple. All it takes is to eliminate the plaque and the tartar from under the gum and by this way  the direct bacterial cause.

If the disease is more advanced with deep periodontal pockets  and osseous losses, more advanced treatments will be necessary

Whatever the recommended treatment, the purpose of this one is that you find a good periodontal state and to help you to maintain it.

What are the benefits of a periodontal treatment?

• Regain a good breath,

• Improve in certain cases the aesthetics and the appearance of gums and teeth,

• Improve the chewing

And above all to clean up your gums by eliminating the infection.

The follow up

Once the periodontal diseases are treated, the patients are regularly seen for maintenance purposes. There is no periodontal treatment without maintenance. During these sessions, the periodontist is going to estimate the periodontal state and to make sure that the infection is under control. Your mouth is examined, the reappeared tartar will be eliminated as well as the plaque and if need be your teeth will be polished. The impaction of your teeth can be also estimated.

The periodontal diseases like the diabetes are chronic diseases. Without appropriate treatment and a continuous and regular follow-up, these diseases have strong risks of recurrence.

How to prevent periodontal diseases ?

To keep your teeth all your life, you have to eliminate the dental plaque of your teeth and gums every day by brushing and using the dental floss. check your technique of brushing and  dental floss use by your dentist’s surgery. The periodontist is going to help you to adjust your technique so that you can do it in a comfortable and effective way.

Regular visits are also important. In spite of a daily brushing, some dental plaque will remain and thus the tartar in certain places. A meticulous descaling at least once a year is necessary. If you were treated for a periodontal disease, you will need more regular visits which can go once every three months.

Remember that a good oral hygiene and  a regular professional follow-up are the key to periodontal diseases  prevention . Teeth are supposed to last a whole life and by taking care of them a little is possible to have them everlast. For those who lost one or several teeth, implants allow today to find the sensation of a real tooth.

Dental hygiene rules :

La technique de brossage : développer la technique de Bass modifiée. Les accessoires nécessaires :

• Dental floss

• Super dental floss

• Rubber simulators

• Wooden sticks

• Little brush that can go between teeth

• Mono bundle

• Plaque revealing device

• Electrical teeth brush

• Regular visits to your dentist’s

For further information on the periondontal diseases or for a check visit, do not hesitate to contact us.