Causes and mechanisms

A healthy mouth is colonized with more than 700 different species of bacteria, of which most are completely harmless and live in harmony with their host.


However, when oral hygiene is not properly performed, near gums microbial deposits appear, forming the bacterial plaque and creating a premise for the development of more dangerous and aggressive species, in parallel with alteration of the body’s local defense mechanisms. Now balance is lost – dangerous bacteria multiply and local immunity decreases!

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In case the bacterial plaque is not removed daily through proper brushing on the teeth and especially in between, under the action of minerals from saliva it hardens (petrifies) and turns into scale.

Dental scale presence favors bacterial plaque buildup and advancement towards the dental roots. Normally, between the gum and tooth and between root and bone, periodontal fibers are found that seal the space and support the tooth into bone alveoli. As inflammation penetrates deeply between root and bone, periodontal fibers are destroyed a funnel-shaped space appears called periodontal pocket.

Locally secreted substances by the body’s defense mechanisms destroy a part of the bacteria but unfortunately also destroy periodontal fibers supporting the tooth within bone. Therefore, periodontal disease evolves by autoimmune mechanism.

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The space resulting from bone destruction (periodontal pockets) enlarges until full bone destruction around the root, leading in the end to tooth loss.

Severity and progression speed of periodontal disease depends on the balance of several factors such as:

  • Number and type of present bacteria,
  • Reaction and force of the patient’s defense mechanisms (immunity),
  • Presence or absence of risk factors

Thus, the more bacteria from aggressive species and the weaker the patient’s defense mechanisms (decreased immunity), the more active the periodontal disease will be. Certain risk factors such as smoking or diabetes further weaken the body’s immunity, accelerating periodontal disease progression.

In the same way, certain medication such as immunosuppresses, vasodilators or antihypertensive affect the inflammatory response to the bacterial plaque making these patients more susceptible to gingivitis.

That is why we remind that without bacterial plaque buildup (determining factor), periodontitis (periodontal disease) will not show up!