A red, swollen, sensitive gum that bleeds easily when brushing or if you bite an apple, this is a sign of gingivitis, an inflammation of the gums caused by excess dental plaqueor even tartar. The microbes are deposited on the teeth in the form of a colorless film, the dental plaque, which contains a multitude of bacteria. If it is not removed by brushing, this film turns into tartar, a rough and porous deposit that accumulates mainly between the teeth and at the junction with the gums.
“Very common, the gingivitis is favored by tobacco and cannabis, alcohol but also stress, pregnancy, menopause, diseases like diabetes and certain medications. In smokers, the bleeding is masked, so they must be particularly vigilant, ”emphasizes Dr Virginie Monnet-Corti, dental surgeon.
The elderly, people with dental braces, diabetics, those who take drugs that reduce the production of saliva (neuroleptics, etc.) are also more affected. But there may be family land which exposes to a greater production of tartar and more difficult to eliminate.
If you neglect your gums, the risk is to develop periodontitis, the cause of chronic inflammation that affects the whole body. At an advanced stage, it promotes the development of atheromatous plaques in the arteries and increases the risk of cardiovascular disease by 25%. By increasing insulin resistance in tissues, it can make diabetes worse. Finally, in pregnant women, the risk of giving birth prematurely to a low-weight baby is multiplied by 3 to 7.
Gingivitis: a simple scaling is enough
One descaling supragingival (above the gums) removes plaque and tartar in one session. It is sometimes accompanied by air polishing with bicarbonate and the application of antiseptics under the gum tissue. Then a specific toothpaste and an antiseptic mouthwash are used for about a week, until the gums return to their normal pink appearance.
And above all, we adopt a rigorous hygiene and we scrupulously follow the dentist’s instructions. A check is usually scheduled after four months. To prevent gingivitis, the ideal is to make an appointment with your dentist every six months, who will offer one or two scalings per year as needed.
Periodontitis: in-depth scaling
If you notice swelling of the gums, bleeding, teeth that move or come apart, a bad breath, it is high time to consult! When the gum peels off, “pockets”, veritable nests for bacteria, can form between the gum and the tooth. This time, it is the bone and ligaments that are affected by the inflammation.
The practitioner first looks for the possible causes of infection (caries, poorly adapted crown) to treat them. He assesses bone loss using a graduated probe slipped gently between the gum and the tooth, which reveals periodontal pockets. From 4-5 mm deep, it is indeed a periodontitis.
A radiographic assessment completes the examination. The dentist then proceeds to a root plan to remove tartar and bacteria stuck to the roots using ultrasound. This treatment is generally carried out in two one-hour sessions, under local anesthesia. The teeth remain sensitive to the cold for a few days. After a few weeks of effective oral hygiene, the gums firm up and adhere to the roots again.
If the stage is more advanced: room for surgery
Two to three months later, the situation must be reassessed. In 5 to 10% of cases, pockets larger than 6 mm remain and surgical treatment is necessary. Under local anesthesia, the surgeon incises the gum tissue to strip roots, clean pockets and remove inflammatory tissue otherwise inaccessible. The gums are then sewn up and the stitches removed eight days later.
“Sometimes we use regeneration or filling materials to stabilize the teeth, like adding soil to a flower pot. The gum heals in two weeks, the bone in six months. In cases of aggressive periodontitis, antibiotic treatment is necessary, ”explains Dr Virginie Monnet-Corti. To avoid recurrence, you should always schedule check-ups every four to six months.
The roots are bare: the graft solution
If the surgeon finds that the gum is retracting on one or two teeth, he can strengthen it with a graft that covers the exposed root, removing a small piece of tissue from the palate. Sometimes the front teeth “grow” in an unattractive way and the “collars” become very sensitive to cold and brushing, but the gums are not swollen.
The dentist will confirm that it is not a question of a bacterial loosening, but of a “gum recession”, sometimes the consequence of age or of too energetic and badly oriented brushing which can tear a too thin gum. Here too, tissue grafts taken from the palate allow the gum to be reconstructed.
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