Además de la predisposición genética, la presencia de placa bacteriana o biofilm, provocado por una mala higiene, es el factor desencadenante de las enfermedades periodontales: gingivitis y periodontitis.
Phases of gingivitis and periodontitis.
Superficial inflammation of the gingiva. Bleeding is the main warning sign. If not treated properly it can lead to periodontitis. Gingivitis is one of the most common pathologies in humans. It is reversible and can appear at any age.
Deep infection of the gingiva and other tissues that hold the tooth. It can cause tooth loss. Repercutes in general health: increases cardiovascular risk, diabetes decompensation or premature delivery. Periodontitis increases its frequency with age, and is not reversible. It is a chronic disease and as such requires a chronic treatment and thorough maintenance both by the patient performing proper oral hygiene, and by the professional in the control visits in which he must do a superficial or deep cleaning wherever required. In periodontitis the gingiva detaches from the tooth, creating bags that store bacteria, which can destroy the tissues of the tooth (bone and periodontal ligament). Redness and bleeding are obvious symptoms. A healthy gingiva does not bleed. Displacement of the teeth (migration), increasing the separation between them, and mobility, are symptoms of the most advanced disease. Tobacco aggravates the progression of periodontitis and reduces the effectiveness of treatment. The negative effects are also related to the daily dose of tobacco. In patients who stop smoking, after a few months, the gingiva acquires characteristics that make it similar to that of a person who never smoked, so elimination of smoking habit favors periodontal health and improves the effectiveness of treatment in case of suffer from periodontitis. Other factors that may aggravate the prognosis of periodontal disease are the virulence of the bacterial strains of which certain individuals are carriers, as well as the presence of diabetes and cardiovascular diseases.