Plaque is simply a sticky yellowish-white film composed of bacteria, small particles, proteins, and mucus. This plaque continuously accumulates on the teeth and gums.

With proper brushing and flossing plaque is easily removed. If plaque is not removed by brushing and flossing, over time, plaque will calcify (harden).

This hardened plaque is known as tartar and can no longer be removed with simple brushing and flossing. It must be removed by a dentist.

The more harmful bacteria release toxins which damage the gums. They also cause gum infection and inflammation which activates the immune system. This inflammation of the gums is called gingivitis and is the first stage.

To prevent gingivitis all you need to do is keep the bacterial populations low by flossing and brushing. Proper home dental care can remove plaque. Professional cleanings during routine dental visits remove tartar which harbours and nurtures the proliferation of the undesirable bacteria.

If left unchecked, gingivitis may progress to periodontitis. Periodontitis is often "silent", that is, the bacterial infection of the bone and ligaments which hold the teeth in place frequently occurs without pain.

Periodontal disease will cause bone to erode and teeth to progressively
loosen to a point where normal chewing causes them to fall out!

In periodontal disease the inflamed gums will pull away from the teeth. Normally there is a small 1-3 mm space between your gums and teeth. This space is known as the periodontal pocket. In periodontal disease, this space becomes much deeper. A dentist can check the depth of this space with a probe and determine if you have periodontal disease.

Signs of periodontal disease

• Bad breath
• Red or swollen gums
• Loose teeth
• Sensitive teeth
• Pus coming from around the teeth
• Pain on chewing
• Tender gums
• Bleeding gums.

Predisposing factors of periodontitis

1. Stress
2. Smoking
3. Hormonal changes
4. Uncontrolled diabetes
5. Diseases that interfere with the body’s immune system, such as leukaemia and AIDS.

Treatment

1. Root scaling and planning: with special hand instruments the plaque from the root is removed. This procedure is performed under anesthesia. The therapeutic method is completely painless. Its disadvantage is the remaining of toxins leading to the continuing destruction but at a slower rhythm.
   
   
2. Surgical procedure: A flap is opened so the roots can be cleaned and then sutures are done. Disadvantages of the method are the, sensitivity of the teeth and the remaining of toxins and the progress of the disease.
   
   
3. Laser treatment: We can apply laser treatment additionally, following the above treatments. In the case of the scaling and root planning, the added benefit is that of toxins destruction, resulting to the stopping of the periodontal disease. Moreover, the combination of surgical treatment and the use of laser is a benefit to the patient through faster healing.