Periodontal Diseases

Periodontal diseases are infectious diseases with multiple causes that affect the supporting tissues of the teeth: the gums, bone and periodontal ligament.

What are periodontal diseases?

Periodontal diseases affect the tissues of the teeth, gums and bone. It is essential to practice good oral hygiene in order to prevent these diseases, which can result in serious long-term consequences. They are caused by a biofilm, a buildup of bacteria that forms a layer of dental plaque and tartar on the surface of the teeth.  

What should I know about the mouth?

The mouth is a complex organ whose diverse anatomical structures are inhabited by billions of bacteria. An imbalance in these bacteria populations can have both “local” and “remote” consequences.

Besides the loss of teeth, periodontal disease can impact one’s general state of health.

There is a risk of developing a remote infection in which the bacteria responsible for the periodontal disease enter the bloodstream, latch on to other organs in the body, and multiply:

  • Periodontal diseases increase the risk of heart valve infections by 25 percent
  • Bacteria can lodge in other locations, causing sinusitis; pulmonary or brain abscess; joint prosthesis infection

In pregnant women, periodontal disease multiplies by three to seven the risk of giving birth prematurely.

It is estimated that people with a periodontal disease have a greater risk of developing cardiovascular disease, in particular heart attack. 

Diabetes also can lead to periodontal disease and, inversely, periodontal disease can worsen diabetes.

What are the symptoms of periodontal disease?

Periodontal disease begins with dental plaque. This sticky film, composed of bacteria, accumulates on the surface of the teeth and gums and in the spaces between the teeth.

Plaque eventually hardens and calcifies, turning into tartar, a solid concentration of bacteria.

Plaque and tartar cause an inflammation of the gums known as gingivitis

The first symptoms of gingivitis should serve as a warning:

  • Bleeding from the gums when brushing the teeth or chewing, or occurring spontaneously
  • Swollen gums that are redder than usual, sometimes tender

Action must be taken at this stage, while the process can still be easily reversed.

Periodontitis is another, more advanced form of periodontal disease.

Pockets form under the gums and gradually expand deeper toward the roots of the teeth. The bacterial populations grow, and more aggressive strains develop leading to infection and inflammation in the deep tissues.

The gums progressively pull away from the teeth, exposing their roots. In this process, commonly referred to as receding gums, the tissues holding the teeth in place (bone, periodontal ligament) weaken and the teeth gradually loosen.

Warning signs:

  • Receding gum line (the teeth appear longer)
  • Extreme sensitivity to hot or cold in the exposed areas
  • Bad breath
  • Abnormal looseness or shifting of the teeth

If left untreated, the tooth or teeth will eventually fall out.

What are the risks factors for periodontal disease?

Periodontal disease is closely related to oral hygiene. However, some people are more vulnerable to periodontal disease than others despite having equivalent oral hygiene practices. 

In addition to the well-known risk factors such as cavities and tartar, other factors include:

  • Age (periodontal disease frequency increases with age)
  • Gender (men are more at risk than women)
  • Hereditary factors
  • The bacteria in the mouth, which differ from one individual to the next and are transmissible
  • Certain diseases, including diabetes and HIV, as well as medical treatments which weaken the immune system, carry a greater risk
  • Hormonal factors (pregnancy and menopause both increase vulnerability to periodontal disease)
  • Tobacco use (smoking increases the risk of developing a periodontal disease by five and lowers the average age of onset)
  • Local factors such as a dental prosthesis or orthodontic device

How are periodontal diseases diagnosed at the American Hospital of Paris?

A rigorous clinical and radiological examination allows us to determine the presence and severity of periodontal damage.

Plaque, tartar and any bleeding from the gums are clinically evaluated, and pocket depth (the space between the gum and the tooth) is also measured.

Radiological exams provide additional information: a panoramic x-ray and images obtained using the long cone paralleling technique are often prescribed. 

Key figures

In France, 50 percent of children under 15 suffer from gingivitis. This figure surpasses 80 percent in adults between 35 and 44 years old.

Dental plaque is found in 50 percent of children, and tartar is detected in 30 percent of children under 15.

Between the ages of 35 and 64, 47 percent of French patients have severe periodontal pocket depth exceeding 4 mm.

American Hospital of Paris