• The amount and type of bacteria found in periodontal pockets;
• The presence of certain diseases that influence the effectiveness of the patient’s immune system and its ability to fight the bacterial infection that has set in;
• Genetics;
• Smoking;
• Diabetes.

• Complete cleaning and descaling;
• Root planing;
• Laser treatment;
• If necessary, surgical treatment to remove periodontal pockets;
• If necessary, antibiotic treatment.

The most convincing result is the loss of teeth surrounded by the periodontium affected by the disease.

The damage caused by periodontitis is associated with the periodontal pockets that form around the teeth where tartar has accumulated. Over time, the bacteria in these pockets destroy the periodontium and, more specifically, the periodontal ligament and alveolar bone. Teeth begin to loosen, which can make them appear longer.

Teeth then become loose and eventually fall out if no intervention by a dental professional is performed. The mobility of one or more teeth is what usually leads a patient to see his or her dentist rather than the pain that is usually not present at this stage of the disease.

Gingivitis and periodontitis can be prevented by simple means:

• Tooth brushing: it should be done at least twice a day, ideally after meals, but especially before going to bed at night to remove the film created by bacteria with food deposits accumulated during the day;
• Dental flossing: when flossed properly once a day, ideally before bedtime, it removes food debris and bacteria from between the teeth, areas that are difficult for the toothbrush to reach. IMPORTANT: Contrary to what most people think, it is important to floss BEFORE brushing your teeth, because when flossing leaves the interdental space, it can propel food debris and bacteria onto the teeth;
• An annual visit to an oral health care professional is essential to prevent the risk of periodontitis. Closer follow-up may be recommended for people who have gums and teeth that pose special challenges;
• Smoking cessation: Smoking significantly increases the risk of developing periodontal disease. It is therefore in a smoker’s best interest to stop smoking if he or she wants to keep teeth and gums healthy for a long time;
• It is important for pregnant women to have their mouth examined by a dental health professional at least once during pregnancy, preferably during the second trimester. A woman with gum disease at this time of life is at greater risk of having a premature or low birth weight baby.