Periodontitis is a chronic infectious disease of the periodontal tissues. It is produced as an unfavourable consequence of the host-parasite relationship (oral-pathogens periodontal cavity). The bacterial role is fundamental in the pathogenesis of the periodontal disease, and it is favoured by local factors (dental anatomy, poorly positioned teeth, fixed equipment, defective orthodontics, etc.), which facilitate its growth, besides systematic conditions that influence the development and expression of the disease.

Advances and research in recent years have allowed changing some concepts of the model of periodontal disease. In the mid 70´s it was considered that all individuals were susceptible to having severe Periodontitis, that all gingivitis progresses to periodontitis and that susceptibility to periodontitis increases with age; concepts that are currently not considered correct.

To stop the advance of periodontal disease, our specialist may very well recommend that you undergo a curettage or deep cleaning. The curettage will eliminate the bacteria from the periodontal bag and will provide the necessary conditions so that healing will take place.

Dental curettage basically consists of scraping the surface of the roots of the teeth, performing this with instruments called curettes. This scraping aims to eliminate the tartar which accumulates on these surfaces to later make them smooth and leave them free of impurities.

Smoking as a risk factor for periodontal disease

The smoking patient with periodontitis shows clinical characteristics different from those of a non-smoking patient with periodontitis. These clinical signs can hide the periodontal disease present if a correct exam is not carried out on the patient.

In the gum of a smoking patient, one can notice a tendency for it to be fibroid and hyperkeratosic with thick margins. Smokers have a minimum erythema and oedema in relationship to an equal severity of the disease in non-smoking patients.

With relationship to the severity of the disease, smokers show a greater loss of periodontal insertion in the front teeth, in the upper as well as the lower, and in the last ones mentioned, the palatine region shows more damage, probably due to the location of the cigarette to the smoker.

There is a greater gingiva recession in the upper front teeth. Usually the periodontal disease in smoking patients has a greater extension with regard to non-smokers, that is, it is more generalised.

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If the periodontal bag that has formed is inaccessible or has not healed after a curettage, it may be necessary to perform a periodontal surgery with anaesthesia to be able to reach the area and clean it.

The periodontal surgery consists of lifting up the gum to clean and disinfect the affected area and later putting it back in place again, applying some stitches so that it heals correctly.

The importance of prevention

Curettages and other periodontal treatments can be avoided if one is careful about oral hygiene. One of the reasons for going to periodical revisions at our clinic is precisely to avoid this type of problem.


Frequent Periodontics questions.

 What is tartar?

If plaque is not eliminated regularly, it can calcify with the calcium of the saliva and harden to form tartar. Once tartar is formed, only a dentist or hygienist can eliminate it. The rapid and effective elimination of plaque is the best way to avoid the accumulation of tartar.

What is periodontal disease?

Periodontal disease is the inflammation of the tissues that hold the teeth. If plaque is allowed to accumulate on the teeth, the toxins produced by bacteria will inflame the gums. This initial state of the periodontal disease is called gingivitis and is reversible. If it is not treated, it can become peritonitis.

Can gingivitis be treated?

 Yes. The gums affected only by gingivitis can be treated relatively easily to be re-established as healthy gums. In our Dental Clinic we will eliminate all tartar and plaque with a professional teeth cleaning.

Is periodontal disease hereditary?

The fundamental element for suffering from periodontal disease is the individual predisposition and this is conditioned genetically. Nevertheless, it is an error to think that only a genetic predisposition is enough to have Periodontitis, seeing as the presence of bacteria is necessary. Frequently, people that have periodontitis, above all, the most severe forms, have parents or siblings who are affected, which speaks of a hereditary family character. Considering that nowadays there is little that we can do to modify genetic predisposition, the way to prevent periodontitis is by control of bacterial plaque.

Does diet have an influence on the gum´s health?

Unlike dental cavities, the type of nourishment does not seem to play an important role in the health of the gum, although eating foods that facilitate auto oral hygiene, like fruits and vegetables, has a beneficial effect. A diet with vitamins is very important.

Are gum diseases very frequent?

They are among the most frequent in the human race. Research studies have demonstrated that gingivitis affects the whole population, children as well as adults. Although periodontitis hardly affects children, one out of every two adults from the age of 35 is afflicted by this disease.

At what age can gum diseases appear?  

They rarely appear in children, although if they do, they are very severe forms that threaten the dentition in very seriously and even the health of the child. The most frequent forms appear in adults, starting from its first manifestations in young people about 30 years old. The younger the person is when it appears, the more severe the periodontitis will probably be and the more care will be needed.

Are women at greater risk to suffer from periodontitis?

No. it is often believed that they are, but it has not been proven. The thing is that certain stages of a woman´s life, related to hormonal changes like pregnancy and menopause, cause fleeting alterations on the gums which make them need special care.

How do I know if my gums are diseased?

The symptoms are spontaneous bleeding or with brushing, the appearance of pus on the gum, a bad flavour in the mouth or a bad smell from the mouth, redness, retraction, a change in the position of the teeth, thermic sensitivity, pain and even mobility. The accurate diagnosis can only be given by a dentist, so in case any of these symptoms are present, you must consult with him in order for him to assess the situation and advise you on how to take action.

Is it normal for the gums to bleed?

The earliest sign that alerts us to the existence of problems is spontaneous bleeding or upon brushing. A gum that bleeds can have gingivitis (minor problem) or periodontitis (serious problem), the difference between both situations requires and evaluation by a dentist.

Is brushing enough to prevent gum diseases?

No. Brushing does not reach the inter-dental spaces and to keep these areas free of bacteria, you need to use dental floss. Although learning to use dental floss is rather complicated at first, with a little bit of patience one can achieve enough skill to apply it correctly in the whole mouth in just a few minutes.

Can I have implants implanted if I have periodontal disease?

 Yes. Implants implanted in the mouth are subject to the same risk of infection as the teeth. Implants must never be implanted without an adequate control of periodontitis, but once this is achieved, they act the same way as in a patient who is not affected by the disease. The best way to ensure a good long term result in your treatment with implants is to make sure you do not have a periodontal disease, or in case of having one, to treat it beforehand.

What risks does a pregnant woman with periodontal disease have?

 There is clear evidence that uncontrolled periodontal disease increases the risk of having an immature new born baby, Preterm birth constitutes an important health problem, seeing as, although the perinatal mortality rate has been reduced drastically in developed countries like Spain, it is among premature children where the few deaths that still exist are concentrated. Besides, the economic cost of hospital care to these children is very high, and the suffering of the parents of the newborn is immense. Studies of research carried out show that periodontal disease in pregnant women can be a significant risk factor for premature births of low weight. The influence of this factor could even be compared to the habit of smoking and drinking.