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Parodontite : Déchaussement, mobilité, perte de dents

1. What is paradontity?

Periodontitis is an infectious disease that can affect one or more teeth. It is due to an accumulation of pathogenic bacteria on the surface of the tooth (plaque and tartar), between the teeth and on the gum. The bacteria then pass under the latter and ignite it: it is gingivitis.

 

Although it represents the first stage of paradontitis, gingivitis is common and reversible. On the other hand, without treatment, the bacteria will continue to weaken and even destroy the periodontium. The bone that surrounds the tooth and which provides its main support may be destroyed, as well as the cementum (the tissue that covers the root), eventually causing the tooth to loosen, and potentially, losing the tooth. At this point, the state of the periodontium is irreversible. However, the process usually takes time. Taken in time, periodontitis can be stopped and stabilized by appropriate care.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2. Symptoms of periodontitis

Periodontitis often settles slowly sometimes even without pain. Its first signs are often:

  • gums that bleed when brushing

  • swelling gums

  • chronic bad breath

  • bad taste in the mouth

  • one or more teeth that are starting to get loose

  • mobility of one or more teeth

  • gum pain (sometimes)

 

As soon as these symptoms appear, a quick consultation is recommended. The earlier the periodontitis is diagnosed, the more the treatment required is simplified.

 

UFSBD file - Periodontal assessment


3. Causes of periodontitis

There are two major causes of periodontitis:

  1. inadequate dental hygiene: bacteria naturally present in the mouth are replaced by pathogenic bacteria that attack the periodontium

  2. a weakened immune system that lets these pathogenic bacteria grow

Other factors are likely to favor the appearance of periodontitis:

  • smoking

  • a poor diet

 


4. People at risk

The people most at risk of periodontitis are:

  • People over 60

  • Pregnant or menopausal women (due to hormonal changes)

  • People with type 2 diabetes

  • People with certain illnesses such as diabetes, cardiovascular disease, HIV infection, leukemia

 


5. Treatment of gingivitis

The treatment of gingivitis, the first stage of paradontitis, combines (1) in-office care by the periodontologist and (2) rigorous oral hygiene by the patient.

 

(1) Office care

In order to destroy the bacterial sites promoting gingival inflammation, we will have to carry out:

  • for dental plaque and tartar:

  • regular descaling. Descaling can be either manual or ultrasonic, supplemented by tooth polishing

  • root planing

  • for retention areas: repair of old crowns or fillings

  • for occlusal forces: a gentle grinding of the too strong contacts of certain teeth with their antagonist.

 

(2) Patient care

The patient will strive to ensure rigorous dental hygiene aimed at daily elimination of dental plaque and tartar:

  • Use a toothbrush, with soft bristles (manual or electric)

  • Use appropriate toothpaste

  • Establish an effective brushing method to eliminate bacteria

  • Use inter-dental brushes if necessary

  • Mouthwash if necessary

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

6. Treatments for Paradontitis

(1) Descaling and surfacing
To completely eliminate the bacteria, we must therefore attack the bacterial sites on the surface of the teeth by a complete scaling of the jaws and also by a root planing. Using manual curettes or ultrasonic devices, this surfacing technique eliminates subgingival bacteria. It is performed under local anesthesia.

 

(2) Surgery

If this treatment is insufficient, the periodontist may need to open the gum to thoroughly clean the root of the tooth. In the event that the bone loss is significant, we can initiate a regeneration or even a bone graft.
The operation is performed under local anesthesia.

 

7. Prevention

The basis for preventing periodontal pathologies is good oral hygiene with effective and regular tooth-brushing.

 

A regular visit to his dentist is also advised.