Periodontitis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Periodontitis, is the name of a collection of inflammatory diseases affecting the tissues that surround and support the teeth. Periodontitis involves progressive loss of the bone around teeth which may lead to loosening and eventual loss of teeth if untreated. Periodontitis is caused by bacteria that adhere to and grow on tooth surfaces (microbial plaque or biofilms), particularly in areas under the gum line. Periodontitis is very common in most populations but the severe forms of the disease are less common. Dentists diagnose periodontitis by inspecting the tissues around the teeth with a probe and by radiographs to detect bone loss around the teeth. Although the different forms of periodontitis are bacterial diseases, a variety of factors affect the severity of the disease. Important “risk factors” include smoking, poorly controlled diabetes, and inherited (genetic) susceptibility.

Periodontitis is a very common disease affecting approximately 50% of U.S. adults over the age of 30 years.

One of the most predominant risk factors of periodontal disease is tobacco use. Another very strong risk factor is one’s genetic susceptibility. Several conditions and diseases, including Down syndrome, diabetes, and other diseases that affect one’s resistance to infection also increase susceptibility to periodontitis.

Dentists or dental hygienists “measure” periodontal disease using a device called a periodontal probe. This is a thin “measuring stick” that is gently placed into the space between the gums and the teeth, and slipped below the gum-line. If the probe can slip more than 3 millimetres length below the gum-line, the patient is said to have a “gingival pocket” around that tooth.

Typically dental hygienists (or dentists) use special instruments to clean (debride) teeth below the gumline and disrupt any plaque growing below the gumline. This is a standard treatment to prevent any further progress of established periodontitis. Studies show that after such a professional cleaning (periodontal debridement), bacteria and plaque tend to grow back to pre-cleaning levels after about 3-4 months. Hence, in theory, cleanings every 3-4 months might be expected to also prevent the initial onset of periodontitis.

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Factor that makes periodontitis a difficult disease to study is that human host response can also affect the alveolar bone resorption. Host response to the bacterial insult is mainly determined by genetics, however immune development may play some role in susceptibility.

Periodontitis is thought to occur in people who have preexisting gingivitis – an inflammation that is limited to the soft tissues surrounding the tooth and does not cause attachment or bone loss. The cause of gingivitis is the accumulation of a bacterial matrix at the gum line, called dental plaque. In some people, gingivitis progresses to periodontitis – the gum tissues separate from the tooth and, with loss of periodontal ligaments, form a periodontal pocket. Subgingival bacteria (those that exist under the gum line) that exist in periodontal pockets can cause further inflammation in the gum tissues and further loss of attachment and bone.

Periodontitis is an inflammation of the periodontium, or one of the four tissues that support the teeth in the mouth:

• the gingiva, or gum tissue
• the cementum, or outer layer of the roots of teeth
• the alveolar bone, or the bony sockets into which the teeth are anchored
• the periodontal ligaments (PDLs), which are the connective tissue fibres that connect the cementum and the gingiva to the alveolar bone.

If left undisturbed, bacterial plaque calcifies to form calculus. Calculus above and below the gum line must be removed completely by the dental hygienist or dentist to treat gingivitis and periodontitis. Although the primary cause of both gingivitis and periodontitis is the bacterial plaque that adheres to the tooth surface, there are many other modifying factors. If left untreated, periodontitis causes progressive bone loss around teeth, looseness of the teeth and eventual tooth loss.

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Periodontitis is a very common disease affecting approximately 50% of U.S. adults over the age of 30 years.

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Please help WikiDoc by adding more content here. It’s easy! Click here to learn about editing.

One of the most predominant risk factors of periodontal disease is tobacco use. Another very strong risk factor is one’s genetic susceptibility. Several conditions and diseases, including Down syndrome, diabetes, and other diseases that affect one’s resistance to infection also increase susceptibility to periodontitis.

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Please help WikiDoc by adding more content here. It’s easy! Click here to learn about editing.

If a patient has 5 mm or deeper pockets around their teeth, then they would risk eventual tooth loss over the years. If this periodontal condition is not identified and the patient remains unaware of the progressive nature of the disease then, years later, they may be surprised that some teeth will gradually become loose and may need to be extracted, sometimes due to a severe infection or even pain.

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