Periodontal disease and stomatitis Flashcards
How common is periodontal disease in SA?
Very - affects to some extent at least 70% of all cats and dogs >3 years of age. Preventable in most cases. Can progress significantly before the owner notices the first signs.
What causes periodontal disease? 2 categories + examples
Multifactorial - primary and secondary factors
PRIMARY - plaque-bacteria and their toxic products
SECONDARY - lack of oral hygiene, calculus deposits, nutrition lacking in EFAs and anti-oxidants, genetics, stress, systemic illness (DM), (humans - smoking, drugs etc)
What is plaque? Where?
a biofilm, therefore a mucoid matter on teeth.
found on teeth especially near and under the gingival margin
What is calculus?
=mineralised plaque (common term = tartar)
Does calculus cause perio-disease?
Not per se but it offers a porous surface for easier plaque adhesion
True/False: you will (almost) always find periodontal disease where there is calculus, but periodontal disease can be present without calculus as long as there is plaque.
True
What are the components of the periodontium? 3
gingiva, periodontal ligament and alveolar bone
what are the different stages of periodontal disease?
stage 0-4
Describe the different stages of periodontal disease.
0 = healthy gingiva 1 = gingivitis, no evidence of attachment loss 2 = mild periodontosis with 50% attachment loss
Describe stage 1 periodontal disease: gingivitis
Hyperaemia, oedema and tendency of gingiva to bleed
Gingivitis is plaque-induced (mixed frlow of predominantly gram+ and a few gram- bacteria)
Reversible with consistent regular (daily) plaque removal
Gingivitis is always the first stage of periodontal disease (but doesn’t lead to perio-disease in all patients)
Pathogenesis - why can disease progress form gingivitis to grade 2-4?
plaque in the subgingival sulcus favours disease progression - with decreasng O2 saturation in plaque there is a shift of bacteria type (gram + to gram - obligate anaerobes).
Why does the epitheliuen that lines the gingival sulcus faciliatate the microbial invasion of periodontal tissues?
the epithelium here is not keratinised
What happens in the irreversible stages?
tissue destruction (caused by gram - bacteria - obligate anaerobes e.g. Porphyromonas spp, Fusobacterium, Prevotella, Spirochaetes. Destruction caused by the tissue’s immune response.
Are there systemic risks of periodontal disease?
Yes - association betwen severity of periodontal disease and the prevalence of cardiac lesions as diagnosed with ECG in dogs and also systemic inflammatory parameters and also the following: myocardial disease, renal disease (glomerular and interstitial) and hepatitis.
How to diagnose periodontal disease?
Full diagnostics under general anaesthesia - complete dental charting and dental radiography (essential e.g. so you don’t miss a fractured jaw!)