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Periodontal care provided - Introduction

The backbone of natural, restored or implanted teeth is healthy gums and bones. According to statistics, 90% of adults have gum disease of varying degrees of severity at some point in their lives, and three quarters of adults over the age of 50 suffer from a disease called periodontitis, which is a disease of the superficial and deep periodontal tissues with loss of attachment and inflammation of the gums. Periodontitis or periodontal disease can be either limited to a single tooth or generalized.
The more severe the periodontitis, the more bone is lost, with periods of remission and exacerbation, which can lead to the loss of the tooth itself. Recent research shows that periodontitis has links to various diabetics, heart disease, low birth weight of newborns and general immune system vulnerability.
Before and after
Before and after
Our goal is to diagnose this disease early so that you can reduce its spread and related bone loss so that you can keep your smile for a long time. Anyway, daily home care and annual visits to your dentist are essential in the prevention program that follows.

What is causing periodontitis?

Dental plaque

The most common cause of periodontal disease is bacterial plaque. Every day, a small invisible and sticky film is deposited on the teeth. This film is plaque, in which bacteria colonies live and multiply. Plaque also contains some food fragments and saliva. When there is a lot of plaque, it can be seen at the edge of the gums; it calcifies to form tartar if it remains stuck on the teeth.
The bacteria in the plaque produce toxins that inflame the gums, and this inflammation signals the beginning of periodontitis. If the inflammation is not controlled, the progressive destruction of the bone sets in, without any symptoms at the beginning of the disease. When a significant part of the bone has been lost, the tooth begins to be unstable, without being noticed most of the time (since there is no pain). As early as a tooth wobbles, the destruction of the surrounding bone speeds up, especially if there is also a problem with the occlusion. Eventually, deprived of a good part of the bone that supported it, the tooth becomes so unstable that it falls out or has to be extracted.


Part of our body is dependent on what we eat. Healthy, whole foods and a healthy lifestyle help keep our bodies healthy.


Negative stress is also a contributing factor to the emergence of illness. For instance, a person's resistance, which has been normal for years, can suddenly decrease for no apparent cause. Subsequently, periodontitis occurs or a previously controlled periodontitis resurfaces. It is difficult to find out why resistance varies from person to person, and why it varies from time to time in the same person. Dental research teams around the world are looking into this question. How can we manage our resistance and immune response?


Smoking is a major risk to develop severe periodontitis. Those who are moderate smokers, meaning ten or more cigarettes per day, and those who are heavy smokers are more likely than others to develop severe periodontitis (two and seven times more likely, respectively). Smoking also leads to more frequent recurrence of the disease and a slower response to treatment. It is commonly believed that this is due to the fact that smokers accumulate more bacteria under the gums than non-smokers, and there is a deficiency of vitamin C. Following surgical or non-surgical treatment, healing in these cases may be delayed.

In addition, smoking reduces tissue inflammation and bleeding, even when the tube is inserted. In such cases, periodontal pockets and severe bone loss are likely to be obscured. Smokers are more at risk than non-smokers for recurrent development of other diseases. In this respect, they should be closely monitored and receive hygiene care four times a year to help them meet the challenge of eliminating these germs.

How is periodontal disease assessed and diagnosed?

01. Inspection and visual appearance:
(Redness and swelling) Dr. Montazeri uses magnifying glasses that magnify the area observed 4.5 times; during the complete examination, each tooth is scrutinized.
02. Measurement of depth:
The 3 mm shows a normal situation; the 4 mm and more indicates the presence of disease, in most cases.
03. Bleeding and swelling:
Means that there is inflammation.
04. Instability:
Can be linked to bone loss.
05. Loss of bone up to the furcation:
That means the bone lost between the roots of the molars or between the roots of the first upper premolars.
06. Recession - exposed root surface:
May mean lost bone or overly vigorous tooth brushing.
07. Consistent bad breath:
May be a sign of periodontitis.
08. Bone loss:
Can be captured by digital X-rays.

How can you prevent them?

 Brush your teeth thoroughly (at least three times a day after meals) and floss (at least once a day) to remove all plaque.
Have your gums and periodontium checked regularly by your dentist.
Follow through with recommended treatments.
Manage your stress.
Eat healthy, whole foods.
Quit smoking if possible.
Examen dentaire complet 1.1

Periodontitis diagnosis

01. Health
02. Active gum disease
✔ Periodontal pockets of less than 4 mm with bleeding
03. Onset of periodontitis
✔ Beginning of bone loss
✔ Periodontal pockets of 4 to 6 mm (with bleeding)
✔ Furcation: level of severity
04. Periodontitis media
✔ 30-50% bone loss
✔ Periodontal pockets of 5 to 8 mm
✔ Furcation: severity level I and II
05. Advanced periodontitis
✔ More than 50% bone loss
✔ Periodontal pockets greater than 8 mm
✔ Furcation defect: severity level II and III

Recommendations and treatments

Preventive cleaning and examination: 6 to 12 months, according to risk factors
Manual toothbrush
Periodontal hygiene instruments
Nutritional supplements
Surgical treatment
Antibiotic treatment
Removal of teeth
Antibacterial mouthwash
Electric toothbrush
Non-surgical management
Scaling and scraping of teeth
Local application of medication
Restorative work to maintain stability
Cleaning every 2, 3, 4 or 6 months

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