Periodontitis

By: Stepfanie Ochinang
Tuesday May 17th, 2011
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Image courtesy of: Irina Dentistry


Abstract:


Periodontitis is inflammation and infection of the ligaments and bones that support the teeth. This disease occurs when the teeth and/or gums are not maintained by good oral hygiene. It is preventable and usually does not occur unless one fails to remove the plaque and bacteria from their teeth on a regular basis. If treated at the first signs, one will typically make a full recovery from the disease; if not, the disease could result in tooth loss and/or degradation of the jaw bones along with receding gums. Because plaque contains bacteria, infection is also likely and a tooth abscess could occur, which would cause severe pain and discomfort and increases the rate of bone destruction. Periodontitis is the primary cause of tooth loss in adults.


Introduction:


As disgusting as this topic may be, I think everyone should find it interesting considering we all have teeth to take care of. If it's not interesting, it's a reminder of what can happen if we neglect our mouths or don't practice good oral hygiene. I'll admit, I've gotten home late from the bars and hopped right in bed without brushing or washing my face... I might leave my makeup on, but I'm not gonna hop right in bed anymore! Just like we all have a normal microbiota, we all also have a normal amount and type of bacteria that live in our oral cavities and throats. They aren't uncommon, but they should be brushed away at least twice a day because, normal or not, they can still cause major damage to our mouths. Dentists typically recommend brushing at least two times a day, flossing two times a day, and using a mouthwash. To protect against even more bacteria, they recommend using an interdental brush or pick to get the space between the teeth. People with periodontitis have a chronic inflammatory disease and must practice a lifelong regimen of excellent hygiene and professional maintenance care with a periodontist to maintain affected teeth.

Discussion:


Causes:


Periodontitis is caused by a convergence of bacteria that adhere to and grow on the tooth's surfaces. Some risk factors for the disease are: smoking, poorly controlled diabetes and genetic susceptibility. Even though there are different forms of the disease, they are all caused by bacterial infections.

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Image courtesy of: Viral Patel Dentistry

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Image courtesy of: Viral Patel Dentistry

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Image courtesy of: Viral Patel Dentistry






Bacteria associated with the disease include:


  • Actinomyces Naeslundii:
    • Non-motile, non-spore-producing, anaerobic to facultatively anaerobic, gram-positive bacteria that is pathogenic to humans.
    • Normally present in oral cavity & throat. Disease usually limited to periodontal disease and actinomycosis.
  • Campylobacter rectus:
    • Gram-negative, microaerophilic, and motile bacterium, has been proposed to play a pathogenic role in human periodontitis. Surface components, such as the flagellum, and cytotoxin have been reported as possible virulence factors of the microorganism.
  • Streptococcus mutans:
    • Coccoid shaped, Gram-positive, facultatively anaerobic bacteria that is part of the normal bacterial flora of the mouth.
    • Leading cause of tooth enamel decay - (metabolizes sucrose to lactic acid) - combination of plaque and acid that leads to tooth decay
    • Equipped with receptors for adhesion to teeth (one of the few specialized organisms that live in the mouth)
  • anaerobes


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Image courtesy of: Internet Scientific Publications

Treatments:


Non-surgical:
Removal of bacterial plaque and calculus is required to establish periodontal health. There is a non-surgical procedure called Scaling and Root planing, which is cleaning below the gumline. It may require several visits and local anesthesia before this procedure is complete.
Surgical:
If the non-surgical treatment was not successful in controlling the periodontitis, surgery may be necessary to control the disease. There are procedures that are tooth-specific, depending of the specific disease pattern on the site. Some of these surgical procedures include:

  • Pocket Reduction Procedures
  • Regenerative Procedures
  • Crown Lengthening
  • Soft Tissue Grafts

Literature Cited:


"Gum Disease (Gingivitis and Periodontitis) Symptoms, Treatments, Causes." WebMD - Better Information. Better Health. Web. 08 May 2011. <http://www.webmd.com/oral-health/guide/gingivitis-periodontal-disease>.
North Capitol Dental Care | Irina Ganzha | Invisalign, Dentures, Dental Bridges, Crowns, Veneers, Oral Sedation. Web. 12 May 2011. <http://www.irinadental.com/index.php?page=problem>.
"Oral Bacterium - Streptococcus Mutans : Dennis Kunkel Microscopy, Inc, - Scientific Stock Photography." Dennis Kunkel Microscopy - Electron Microscopy Science Stock Photography. Web. 12 May 2011. <http://www.denniskunkel.com/DK/Bacteria/26644C.html>.
"Periodontal (Gum) Disease: Causes, Symptoms, and Treatments." NIDCR Home. Web. 10 May 2011. <http://www.nidcr.nih.gov/OralHealth/Topics/GumDiseases/PeriodontalGumDisease.htm>.
"Periodontitis - Symptoms, Treatment and Prevention." Consumer Health News, Information and Resources Updated Daily. Web. 08 May 2011. <http://www.healthscout.com/ency/68/254/main.html>.
"Periodontitis: MedlinePlus Medical Encyclopedia." National Library of Medicine - National Institutes of Health. Web. 10 May 2011. <http://www.nlm.nih.gov/medlineplus/ency/article/001059.htm>.