Periodontitis
Right at the beginning: the disease we call periodontitis is an incredibly complex process, which I can’t explain in full detail here. Instead, I’ll give you some illustrations so that you can understand the principle behind this complex process.
What is periodontitis?
Periodontitis describes an inflammation of the periodontal ligament.
You have “perio” (that’s how we professionals abbreviate the word “periodontitis”) when the bone supporting your teeth continues to deteriorate. And at some point, your teeth will wobble. Now you’ll lose teeth. – Too bad, because we could have prevented this condition… almost always.
Risk factor hereditary factors
People are unique. For example, in their genes. This is the first risk factor for developing periodontitis. Genes account for approximately 55%. Another fact: in approximately 80% of all people, the PARO gene is activated. These people therefore have the risk of developing periodontitis, although this does not necessarily mean they will get it. Incidentally, this occurs in all peoples of the world. So it must be a very old gene from the early days of human evolution.
Risk factor smoking
You can’t argue with that. So now would be a good opportunity to quit smoking. This includes all other forms of smoking cessation! Roughly estimated, smoking accounts for 25% of the overall risk of periodontitis.
Risk factor oral hygiene
The remaining 20 percent concerns individual oral hygiene. Surprisingly, this is slightly less important than smoking.
Could it have been prevented?
We dentists can recognize very early signs of developing periodontitis. It’s not just now that every compromise backfires! Because we’re now battling a cocktail of diverse bacteria.
The key element is prevention, prevention, prevention!
How periodontitis develops
I need to back up a bit now. I’ve already mentioned elsewhere that you can never brush your teeth perfectly. There’s always at least 20%-40% of the tooth surface still covered in plaque.
When this plaque grows again (e.g., after prophylaxis), it contains bacteria that are harmless to periodontitis for the first three months. After that, the more dangerous bacteria appear in greater numbers, and they also network and communicate with each other. We call this a biofilm.
In this biofilm, the bacteria work together to produce substances that the immune systems of 80% of people can’t specifically defend against… see above: DNA! Of course, the immune system wants and must fight these substances, but this now leads to the body’s own immune system destroying its own bones as collateral damage.
What you may notice
You know it from commercials: bleeding gums. If you have them, see your dentist as soon as possible. It won’t go away on its own.
If you’re a smoker, it can be really dangerous. Smokers don’t have bleeding gums. And why not? Because smoking constricts the smallest blood vessels so much that bleeding gums can’t occur. And yet, you can still have severe periodontal disease!
What you can do now
If you want to believe the advertising, then you’ll buy the most expensive toothpaste. I’ll tell you right away: it won’t help you.
We’ll start with intensive prophylaxis and create optimal conditions: no plaque, no niches for plaque. And then a dental care training session… yes, with success monitoring. Remember: there are no compromises with bacteria!
We’re also talking about dietary habits. – Simple rule: avoid all foods that have been advertised. We’ve already won a lot with that. After that, avoid everything that contains wheat and/or sugar. Remember: no compromises!
Once you’ve overcome this phase, your dentist will decide what to do next. Describing the options here is beyond the scope of this article, as the options are so diverse.
So what should you do now
If you want to join the winning side, then visit your dentist regularly for preventative care. They’ll also explain your weaknesses when brushing your teeth (dentists have these too!) and what you can do better. And this won’t be explained to you by a health column in the newspaper, but by someone who knows the subject inside out!
If you want to know more, take a look here, for example:
https://pubmed.ncbi.nlm.nih.gov/38666373/
And here’s a great talk by Bonnie Bassler, who discovered how bacteria communicate with each other. So, not just Bavarians with Bavarians and Swabians with Swabians, but also how Bavarians communicate with Swabians or Palatinate residents, etc. It’s in English, but you can get German subtitles on YouTube!
