Maladies gingivales induites par la plaque

Dental plaque-induced gingival diseases are infectious diseases. They reflect the local inflammatory and host-specific immune responses to the dental bacterial biofilm. According to the new classification, they include those gingivitis associated with dental plaque only, and the gingival diseases that are modified by general factors. The diagnosis of gingivitis is based on gingival changes in colour, consistency and texture, without epithelial connective attachment loss. Systemic factors such as the modification of the endocrine system, diabetes, blood dyscrasias, stress, tobacco or medications can modify the initial clinical signs of gingivitis. Moreover, localized tooth-related factors can modify or predispose to plaque-induced gingival diseases. The evolution of a plaque-induced gingival disease in periodontitis, as well as its prognosis, will depend on the periodontal risk which is determined by the reaction of the host immune system and the nature of the dental biofilm. The medical and dental care of a patient with dental plaque-induced gingival disease depends on the diagnosis of periodontal risk. It includes the management of host-specific parameters, bacterial aetiology, correction of localized tooth-related factors and periodontal maintenance care.