By Dr Lucas Naccache – Lyon – France

Sheila’s note: When I launched the search for dental health issues, I was puzzled by the bits and pieces of information that were hard to read. I therefore took the liberty to ask my dentist friend Dr. Lucas Naccache in Lyon, France to write an article for you about dental health. He graciously agreed. I will combine Dr. Naccache’s comments with some data from the CDC. 

Dr. Naccache’s credential is as below and let us learn from his experience. 

Dr en Chirurgie Dentaire   Dr en Sciences Odontologique CES De Prothèse Fixée et CES d’Anatomie-Organogénèse
Diplôme Universitaire d’Implantologie Paris VII Garancière
Ancien Assistant Hospitalo-Universitaire

The ultimate goal of dentistry is to rehabilitate, as much as possible, a mouth, so as to allow the patient to eat properly, but also to preserve his social life.

There are different ways to achieve these goals.

The clinical state of the patient will require one or more means to achieve the goal. The primary care is to allow us to be preventive and care for our teeth properly. We will also talk about how to respond to an emergency, infectious, periodontal or aesthetic disorders. The overall treatment plan is to promote dental health and identify problems early to get proper treatment.

The common conditions encountered in dentistry are:

Periodontal damage: The periodontium is the supporting tissue of the tooth: alveolar bone, periodontal ligament and gum. The majority of patients, estimated at 90% worldwide, are more or less affected by periodontal problems. These can be extreme and range from a total loss of teeth at the age of 20, as they can be minor with a loss of 3 mm of bone height at 70 years. So the damages are very variable. For some they are dramatic and for others, barely perceptible 

The etiology of periodontal damage is multifactorial. Hereditary: this is a very important factor. There is a strong autoimmune component. Without maintenance, scaling and regular deep cures, bone loss is inevitable.

Another aspect of periodontal disease is gum recession. It is characterized by the loss of the external gum (under the lips and cheeks), but without necessarily resulting in bone loss. 

Gum (Periodontal) Disease (from CDC)

About 4 in 10 adults aged 30 years or older had gum (periodontal) diseases in 2009–2014.⁵ Gum disease is mainly the result of infections and inflammation of the gums and bone that surround and support the teeth. Certain chronic conditions increase one’s risk for periodontal disease including diabetes, a weakened immune system, poor oral hygiene, and heredity. Tobacco use is also an important risk factor for gum disease. If early forms of periodontal diseases are not treated, the bone that supports the teeth can be lost, and the gums can become infected. Teeth with little bone support can become loose and may eventually have to be extracted.

Your homework from the Care Ministry this week: can you identify if you have periodontal/gum disease that needs your attention?

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