Periodontitis as a manifestation of systemic disease part1 - periodontitis

Question 1

Name and briefly describe systemic diseases/conditions that may modify the host response to periodontal pathogens

Answer 1

1. osteoporosis; a chronic long-term disease in which bone density decrease. so basically osteoblasts are less than osteoclast activity. this happens because of low vitamin D, gender, smoking or early menopause. Low bone mineral density in the oral bones may be associated with low systemic bone density. May lead to more rapid resorption of alveolar bone- invasion of pathogenic bacteria. Osteoporosis- increased systemic production of cytokines (IL-1 and IL-6) that may have effects on bone throughout the body- including the oral cavity. for example, a low level of oestrogen during the menopausal stage can result in a greater risk of periodontal disease in the woman
2. obesity; obesity refers to excess body weight which is a factor for many diseases. the association between obesity and periodontal disease is that both produce the same pro-inflammatory mediators cytokines. results in increased susceptible bacterial infection. the risk factors may influence is genetic factors, low socioeconomic, lack of physical activity, food choice and medications
3. diabetes; No difference between type one or type two diabetes. Diabetes is the condition that results in greater risk of attachment loss and bone loss due to poor insulin. this is due to the release of cytokines when advanced glycogen end products bind to their receptor
4. pregnancy; Increased hormones and a change in oral microbiome can lead to periodontitis during pregnancy. inflammatory mediators cytokines released during Periodontal Disease can be associated cause: preeclampsia, gestational diabetes, gestational hypertension, pre-term birth, low birth weight, miscarriage/early pregnancy loss.Gingival tissues during pregnancy: inflamed, redness, bleeding and pain - plaque induced but exacerbated by increased levels of sex hormones of estrogen and progesterone.
5. Alzheimer’s disease; is a brain disorder that slowly destroys memory and thinking skills and, eventually, the ability to carry out the simplest tasks.Both Alzhiemer’s disease and periodontitis induce inflammatory responses, and this inflammation is the connecting link between the two diseases. It is proposed that periodontitis can lead to progression of Alzhiemer’s through two methods.
   Through the increase in levels of proinflammatory biological molecules that are capable of entering the cerebral regions and causing neuronal damage
   Invasion of the brain by microorganisms present within plaque via bloodstream or peripheral nerves.
6. smoking; can increase the tooth decay because it reduces the amount of the saliva in the mouth which may lead to dry mouth and causing more loss of attachment, alveolar bone loss and tooth loss.

Question 2

Recognise the importance of educating patients about the relationship between oral health and systemic disease

Answer 2

osteoporosis: it is important to be aware and educate patients on how osteoporosis link to oral health conditions because osteoporosis is a major impact on the jawbone that may lead to tooth loss or mobility. so it is important to assist them in maintaining their diet, getting regular exercise and consuming vitamin D for preventing oral conditions.
obesity: it is important to educate about healthy diet and lifestyle changes for people overweight/obese to reduce bacterial infection from the same pro-inflammatory mediators cytokines
diabetes: it is important of showing diabetics to take care of their oral health as they have an exaggerated response to plaque. so making sure they control their diabetes as well as offering them an individualism response to their oral health care. so if the diabetes is controlled then their oral health care will control
pregnancy; it is important for a pregnant woman to have effective communication between dental and medical disciplines. it is needed to ensure expectant mothers receive the best oral, obstetric and general health care to reduce associated risks
Alzheimer’s disease: Alzheimer’s patients have a greater risk of poor oral health conditions. it is important for reminding and assisting with their brushing and care. it is important for them to have regular visits to dentist.
smoking: smoking can affect oral health conditions such as gum disease, and oral dryness, and may lead to oral cancer. it is important for us to help them to reduce the amount of smoking that they are taking. or applying smoking cessation to the patient to prevent dental problems.