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Periodontal Disease Introduction |
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Periodontal disease,
or periodontitis, is an inflammation
of the periodontium, which is made
up of the periodontal ligament, the
gingival (gum), cementum and the
alveolar bone. [1]
Periodontal disease is closely
linked to gingivitis and can almost
be considered the progression from
gingivitis (inflammation of the gingiva, or gums). Gingivitis is
most commonly caused by poor dental
hygiene, which leads to the accumulation
of plaque, or calculus. One unique
factor of periodontal disease is the
necessary presence of microorganisms, such as Porphyromonas gingivalis
and Actinobacillus
actinomycetemcomitans.
Both of which
appear to be more important than
plaque deposits.
Conditions or
diseases that can
predispose to periodontitis, other
than poor oral hygiene, include [1];
Vitamin C deficiency can lead to the
development of scurvy. Periodontal
infections and gingival swelling are
also characteristics of this nutritional
deficiency. [2]
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There are subtypes of periodontitis
that are less common:
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Localized juvenile periodontitis
occurs in healthy adolescents and
results in more rapid bone loss.
This condition is likely due to a defect in a
specific type of white blood cells
that kills bacteria. [1]
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HIV-associated periodontitis is very
progressive and is characterized by
pain, intense redness of the gum and
spontaneous bleeding.
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Prepubertal
and rapidly progressive
periodontitis are two other, less
common types of the disease.
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Periodontal Disease Symptoms
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Patients with periodontitis generally present with
gingivitis first (inflammation of
the gingiva or gum). Gingivitis is
characterized by red, inflamed gums
at the neck of the tooth. [3] There is also noticeable swelling of
the gum between the teeth, as well
as bleeding with impacts such as
brushing the teeth. There is
usually no pain.
However, when the
condition progresses to periodontal
disease after a course of years with
gingivitis, the patient will
experience more severe signs and
symptoms. Pain is again not present
unless there is an acute local
infection, or food becomes impacted
in the area. The condition can
result in sensitivity to hot and
cold substances, facial pain, and
halitosis (foul breath). [4]
A visit to the
dentist often reveals calculus
deposits below the gum line. [1] The gum becomes detached from the
a given tooth, and deep pockets form in the periodontium. These pockets are
measured by depth using a probe. Plain film radiographs
may reveal bone
destruction as well. Pockets exceeding six
millimeters, paralleled with bone loss
demonstrated by x-ray, are diagnostic
of periodontal disease. As the
disease progresses, the patient can
notice receding gum lines and
loosening of the teeth. There may
also be an evident exudate from the
affected area.
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Periodontal Disease Statistics |
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Most patients are
diagnosed with periodontal disease
after 35 years of age. [1]
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The rates are; 15% at
10 years of age, 38% at 20 years of
age, 46% at 35 years of age and 54%
at age fifty. [5]
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Males are more affected than females
and the severity of disease is
usually worse. [5]
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Factors that are inversely related
to periodontal disease include
increasing level of education and
income, and urban dwellers. [6]
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Learn More About
Periodontal Disease |
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