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The 5 most Serious Periodontal Disease:

prevalence of periodontal disease in the United States

Periodontal disease affects most adults. It's an inflammation of the gums and supporting structures of the teeth due to an imbalance of the oral flora.

The causes of this imbalance are numerous, among them we recognize local factors (Bacterial plaque) and general factors (general diseases, genetics, failure of the immune system) in addition to other factors such as bad habits, poor oral hygiene, exhaustive consumption of tobacco and alcohol...
There are different types of periodontal diseases, their appearances depends on several factors including the type of bacterial flora, caries, age, habits.
Here are the 5 most serious periodontal diseases.

1-Plaque-induced gingivitis:

Also called plaque-related gingivitis, it's an inflammatory process that affects only the gum. The main factor is the bacterial plaque. It releases toxins that attack our gums. An imbalance of the immune system can also be a decisive factor.

What are the Signs?

Signs are localized to the gum.

healthy and unhealthy gums
  • Signs of inflammation: swelling, bleeding, redness, pain.
  • Presence of bacterial plaque or tartar
  • Virulent bacterial flora able to destroy tissues
  • Cure after removal of the cause of the disease

Treatment:

The treatment aims to control the bacterial plaque and its retention factors.
The treatment of gingivitis is effective and prevents its progression to other more Severe periodontal disease.
Here is the treatment procedure that must be followed
  • Motivation to oral hygiene and teaching brushing techniques: A good oral hygiene can be enough to treat it. Use a soft-bristled toothbrush associated with interdental cleansing.
  • Scaling: Tartar must be removed from tooth surfaces to promote healing.
  • Polishing: After each descaling, the teeth must be polished by the dentist, because rough surfaces facilitate the accumulation of plaque.
  • Prescriptions of local antiseptics: after scaling or in case of severe gingival inflammation.
Plaque related gingivitis is reversible if the treatment went well.
The key to successful treatment is the maintenance of good oral hygiene and frequent visits to the dentist for better plaque control.

2-Chronic Periodontal Disease

It's an infectious disease, characterized by inflammation of the tissues surrounding the tooth, loss of bone and the attachment system of the tooth, causing mobility and loss of teeth.
Chronic periodontitis are the most common form of periodontal disease, it can occur at any age, but most often in adults.
The causes are virulent bacteria in addition to stress, tobacco, alcohol that can increase the severity of the disease.

What are the Signs?

  • Possible association with local factors related to teeth such as plaque, tooth decay or malposition of teeth.
  • General diseases can be associated such as diabetes or HIV infection.
  • The person is under stress, or addictive to alcohol and tobacco.
  • Depending on its severity, it can be defined on a single tooth, group of teeth or even all the teeth.

Treatment:

The treatment is similar to plaque-related gingival disease. Antibiotic may be associated in case of abscess or pus.
After a good plaque control by the patient and the dentist, surgical therapy may be necessary if the periodontal pocket is deep and persistent with bleeding.
Chronic periodontitis is an infectious and inflammatory pathology due to bacterial biofilm, plaque retention factors and imbalance between immunity and oral flora.
The success of the treatment depends on:
  • The elimination of local factors that depends on the motivation of the patient and the quality of treatment.
  • The general state of health of the patient.
  • The severity of the disease.
The treatment of periodontitis is effective if plaque control is effective.

3-Aggressive Periodontal Disease:

Aggressive periodontitis is characterized by the rapid evolution of the lesion and advanced destruction of the tissues surrounding the tooth. They reach all ages even patients with good general health.
Wide variations in prevalence by race, age and sex have been reported.
Region Aggressive Periodontitis
North America 0.4 - 0.8%
South America 0.3 - 1%
Western Europe 0.1 - 0.5%
Africa 0.5 - 5%
Asia 0.4 - 1%
Caucasian 0.1 - 0.2%
There are 2 main causes:
Oral contamination by virulent bacteria responsible for tissue destruction and genetics factors that can influence the response of our immunity to infections.

Treatment:

Like other forms of periodontal disease, treatment requires good plaque control combined with antibiotic therapy to remove the most infiltrated bacteria in the tissues.
Depending on the severity of the disease, a surgery may be applied to restore the destroyed tissues.
Aggressive periodontitis is a periodontal disease that progresses rapidly causing the destruction of tissues surrounding the tooth including the bone and gum.
It leads to early dental migrations and tooth loss, hence the need for early detection and periodontal examination for all members of the patient's family.

4- Periodontal Abscess:

Periodontal abscess requires urgent care. It is usually pain associated with an inflammatory or infectious process.
The causes are mainly oral bacteria: Aggressive bacteria stimulate our immunity resulting in the appearance of an abcess.
The presence of a foreign body in the gum such as food debris or braces can also cause inflammatory reactions.

What are the Signs?

The symptoms are easily detectable:
  • Purulent infection localized in periodontal tissues.
  • Accumulation of pus.
  • Destruction of periodontal tissues.
  • Localized tumefaction that may be associated with pain.

Treatment:

The treatment of the abscess depends on the lesion stage.
  • The treatment of the gum abscess consists in applying a local anesthesia, removing the foreign body and carrying out a descaling if necessary.
    After treatment, oral hygiene should be maintained to avoid infection of the treated area.
  • For periodontal abscess the treatment is done by draining the infection from the periodontal pocket by debridement of the abscess or by tooth extraction.
    Prescription of analgesic and antiseptic are associated. The antibiotic is prescribed if the abscess has impacted the general health (fever, headache) or in some cases (heart disease, diabetes).
  • For the periapical abscess, the treatment is done by performing an endodontic treatment accompanied by a drainage of accumulated pus at the root apex.

5- Periodontal disease as a manifestation of systemic diseases:

They are part of rare diseases. Systemic diseases can reduce the ability of the immune system to fight against periodontal disease.
This type of periodontitis will have the same characteristics as the aggressive periodontitis in progression and severity.
There are 2 types of this periodontal disease:

Periodontitis associated with blood disorders:

The alteration of the immune cells circulating in the blood will cause an imbalance between the immunity and oral bacteria.
The signs are variable, the most common are ulceration of the gum with deep periodontal pockets.

Periodontitis associated with genetic disorders:

This type of periodontitis are characterized by:
  • A very marked gingival inflammation.
  • Aggressive and virulent bacterial flora.
  • Severe and aggressive periodontitis resulting in mobility and loss of teeth.
The variability of periodontal diseases requires accurate diagnosis and effective treatment to avoid severe complications. However, after treatment, good oral hygiene should be maintained for better results in the long term, otherwise the treatment will have no effect.