Chronic periodontitis can be described as a chronic infection. The treatment of this disease therefore involves controlling this infection. To do this, it will be necessary to achieve control of the quantity of bacteria on the one hand, and control of their aggressiveness on the other.
By definition one does not cure a chronic disease, one stabilises, one obtains a remission. This stabilisation in the face of the disease is sought by a specific treatment strategy: to move from an initial treatment following an assessment, to re-evaluate it and correct it if necessary by complementary actions to place the patient in a situation of stabilisation by regular maintenance.
Excessive bacteria are linked to poor dental hygiene and tartar. It would therefore be sufficient to control these two parameters in order to control the quantity of bacteria, which would already be a huge step forward.
The presence of a high proportion of aggressive bacteria is induced by the presence of periodontal pockets; areas of gum detachment where these bacteria proliferate more easily. If, therefore, it were possible to reattach the gum, it would be possible to control the proportion of aggressive bacteria.
There are four possible courses of action:
After this work, a first control is carried out. In this first check, about 80% of the sites treated should be resolved. The remaining 20% should show progress and this progress can continue over the next 12 months. To promote this further healing and to maintain it when it is achieved, the patient is enrolled in a maintenance periodontal care protocol called "periodontal maintenance".
This periodontal maintenance will be applied at a variable frequency depending, in particular, on the quality of the patient's plaque control, his or her state of health, and the number and extent of residual lesions.
By FrÃ©dÃ©ric De Beule, Member of BSP's Board