Video:Periodontal disease

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Periodontitis is an inflammatory disease of the teeth and gums, [1] that occurs in roughly 50% of those over 30, and 70% of those over 65.[1]

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Causes

It is caused by the build-up of bacteria on teeth, otherwise known as plaque, that collects when someone has poor oral hygiene.

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Calculus

Left in place, the plaque hardens into calculus (or tarter), causes inflammation, bone loss, and loose teeth.[2]

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Bone Loss and Loose Teeth

Eventually the gums detach, pull away from the tooth, bone is lost, and teeth become loose, uncomfortable, and fall out.[2]

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Contributing Causes

Aside from plaque, we know that smoking, diabetes, family history, and certain diseases or medications, also contribute to periodontitis.[3]

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Symptoms

While it is usually painless, periodontitis does cause redness, swelling, bleeding, and recession of the gums along with bad breath.[1]

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Diagnosis

The diagnosis of periodontitis involves measuring the gap between the gum and tooth, typically referred to as the probing, or pocket depth, and bone loss on dental x-rays.

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Severity

The severity of the disease is judged by a combination of probing depths, bone loss, and risk factors such as diabetes and smoking.[4]

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Treatment

Since periodontitis is an inflammatory disease, it does not respond well to antibiotics or mouth rinses.

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Hygiene and Scaling

Instead, it is managed with improving the patient’s ability to clean their teeth, managing risk factors, and regular dental cleanings, called scaling and root planing, to remove the plaque around the teeth .

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Surgical Treatment

If the pockets become too deep, periodontal surgery is required. During surgery the gum is pulled back to clean the teeth, smooth uneven bone, and reshape areas of the tooth that are prone to trapping bacteria.

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Regeneration

In some cases, the tissues that have been lost can be regenerated through the use of bone grafts and other materials.

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Prognosis

Once the teeth are cleaned and the inflammation controlled, evidence shows that the disease can be halted as long as the patient cleans their teeth daily, has scaling and root planing multiple times per year, and regular check-ups to control any new areas of inflammation.

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References

  1. 1.0 1.1 1.2 "Periodontal Disease". CDC. 10 March 2015. Retrieved 13 March 2018.
  2. 2.0 2.1 "Gingivitis". Mayo Clinic. Rochester, Minnesota: MFMER. 2017-08-04. Retrieved 10 May 2018.
  3. "Gum Disease Complications". nhs.uk. Retrieved 13 March 2018.
  4. Jepsen S, Caton JG, Albandar JM, Bissada NF, Bouchard P, Cortellini P, Demirel K, de Sanctis M, Ercoli C, Fan J, Geurs NC, Hughes FJ, Jin L, Kantarci A, Lalla E, Madianos PN, Matthews D, McGuire MK, Mills MP, Preshaw PM, Reynolds MA, Sculean A, Susin C, West NX, Yamazaki K (June 2018). "Periodontal manifestations of systemic diseases and developmental and acquired conditions: Consensus report of workgroup 3 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions". Journal of Clinical Periodontology. 45 Suppl 20: S219–S229. doi:10.1111/jcpe.12951. PMID 29926500.