PERIODONTITIS
A COMMON DISEASE
Periodontitis is a disease that affects more than half the adults in the world, though it also exists in young people. The prevalence (proportion of people affected in a population) increases with age. This is a cosmopolitan disease, which affects the whole planet with few local differences.
Map of periodontitis prevalence in young adults (25-44 years old) in the 6 regions defined by the World Health Organization.
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Data from WHO:
The WHO Global Oral Health Data Bank. Geneva: World Health Organization; 2003
FIRST STEP: GINGIVITIS
Gingivitis, or gum inflammation, is the health state previous to periodontitis. The inflammation can be caused by several factors: dental plaque accumulation, overhanging restoration, mechanical damages...
Gingivitis can be diagnosed by the colour of the gums, which are in general swollen and bleed upon brushing.
The bone is not affected and, thus, gingivitis can be reversed.
Picture of a patient undergoing gingivitis, with a visible tartar deposit (calculus, yellowish)
Illustration of scaling and root planing
Copyright Authority Dental, CC BY 2.0
ABOUT CLASSICAL TREATMENTS
Classical treatment mainly rely on mechanical strategies consisting in taking off dental plaque and affected tissues. Scaling removes dental plaque; root planing, the affected cement; curettage, the damaged or inflamed soft tissues and/or bones. This strategy does not tackle the cause of the disease: the infection. The microbes are still present and keep on destroying the bone. After a short improvement, mainly due to the debridement and to the removal of infectious material, patients damages go on, and the same treatment is proposed again. With the same result.
Finally, the evolution towards tooth loss is inevitable, and, with no other alternatives, palliative care is accepted as the only possible solution.