Special forms of periodontal disease


Special forms of periodontal disease: ulcerative necrotic gingivitis

Ulcerative necrotic gingivitis, periodontitis, and periodontosis are specific conditions that affect the teeth, gums, and bones.

How does it happen?

Favoring causes:

  • Defective hygiene.
  • The presence of tartar, often accompanied by gingivitis.
  • Local conditions favoring plaque retention.

Triggering causes:

There is a sudden breakdown in the microbes / immune system balance, which occurs more by a drop in defenses than by aggravation of the aggression.

  • Intense psycho-emotional shock.
  • Mourning.
  • Stress.
  • Painful living conditions.
  • The student in the final period of revisions: fatigue added to insomnia, tobacco, stimulants (coffee, amphetamines), and fear of the exam.

How to recognize it?

  • Intense pain with sharp flares.
  • Burning sensation.
  • Spontaneous bleeding from the gums.
  • Very bad breath (halitosis).
  • The temperature at 38 ° or 38.5 ° .;
  • Very red swollen gums.
  • The disappearance of the gingival papillae affected by necrosis.
  • The gingival scallop is more or less affected.
  • The ulcers are covered with a blackish-gray coating, they are very painful on palpation.

It is often accompanied by the painful swelling of a node under the jawbone.

Where is it located?

The lesions may involve only one papilla, a segment of the mouth, or the whole mouth. In some cases, the severity of the involvement is such that lesions develop on the edge of the tongue, inside the lips and cheeks, opposite the initial gum lesions.

How is it evolving?

Without treatment, it lasts 8 to 15 days. Then there is a regression of the acute manifestations and transition to chronicity. Recurrences are more or less frequent. The interdental papilla completely disappears. There is more or less significant loss of interdental bone (septum).

What treatment?

It must be as early as possible, at the first signs, to prevent or limit tissue destruction which, otherwise, will be irreversible.

Antibiotics :

If the physical distress is deep: high temperature, large lymph nodes, the existence of a general disease (heart, diabetes, etc.).

Local treatment:


The responsible microbes are anaerobic microbes (which live without oxygen). The treatment will therefore consist of mouthwashes with 10% hydrogen peroxide with a little lukewarm water for sensitivity to cold. Force the liquid between the teeth for at least a minute. To be renewed 5 to 6 times a day.


During the first session, tissue disinfection with an oxygenating solution is performed. If the pain is too severe, the entire affected area is anesthetized. Then the lesions are unbridled: the surface membranes that prevent the penetration of oxygen must be removed. Then, we roughly remove the local irritants: dental plaque, tartar, etc. There is almost immediate relief.

During the second session: that is to say, 24 to 48 hours later, the cleaning is continued. We can see better: the gum has swollen and bleeds less.
The third session and following spaced 8 to 15 days than a month, allows to polish the cleaning of the dental surfaces and to remove the remains of tartar. Then, the oral cavity is conditioned by removing all irritating elements: cavities, overflowing fillings, ill-fitting prostheses, gingival and bone remodeling, etc. We must inform the patient about oral hygiene and give him appropriate dietary advice so that he takes charge to avoid recurrence.

At the same time, the use of a psychotherapist may be necessary in the case of intense emotional disturbances.


Treated at the very beginning, the lesions are minimal and the sequelae are nil. Immediate local treatment is essential, general treatment alone (antibiotics) does not prevent the development of lesions that evolve too quickly. The disappearance of the causes prevents recurrence.

Special forms of periodontal disease: acute juvenile periodontitis

Fortunately rare, it affects young people around puberty.

How to recognize it?

  • Few inflammatory signs, the gum seems fairly healthy.
  • Little or no dental plaque or tartar.
  • It mainly affects the incisors and the first molars. The affected teeth are very mobile, they move. There is devastating bone destruction around the teeth which are found “in the void”.

How is it evolving?

There is a spontaneous fall of the affected teeth, in a few months.

Special forms of periodontal disease: rapidly progressing periodontitis

It affects young adults, from puberty to around 30 years old.

How to recognize it?

It affects almost all of the teeth.

How is it evolving?

Rapid and severe bone loss resulting in tooth loss.

Special forms of periodontal disease: Periodontosis

She starts around fifty. It is more of a physiological process than a disease.

How to recognize it?

Regular loss of gum and bone over all of the teeth without inflammation: the teeth “come loose”.

How is it evolving?

Evolution is slow. Usually, the teeth are not movable and stay in place. This mainly creates an aesthetic problem.