Preventive Procedures - PP week 3 (2.1-2.6) Flashcards
Periodontal Disease
Periodontal disease is an infectious disease process that involves inflammation of the structures of the periodontium
* Causes a breakdown of the periodontium, resulting in loss of tissue attachment and destruction of the alveolar bone
Prevalence of Periodontal Disease
- Periodontal disease is the leading cause of tooth loss in adults
- 47%+ of adults 30+ have a form or periodontal disease; 70%+ of adults 65+
- Almost all adults and many children have calculus on their teeth
Seven out of 10 Canadians will develop gum disease at some time in their
lives. It is the most common dental problem, and it can progress quite painlessly until you have a real problem.
That’s why it is so important to prevent gum disease before it becomes serious
What is the periodontium?
The periodontium is made up of structures that surround, support, and are attached to the teeth
Gingivae
commonly referred to as gums. This mucosa covers the alveolar process of the jaws and surrounds the necks of the teeth
Epithelial attachment
Tissue at the base of the sulcus where the gingiva attaches to the tooth
sulcus
space between the tooth and the free gingiva
periodontal ligaments
dense connective fibers that connect the cementum covering the root of the tooth with the alveolar bone of the socket wall
cementum
covers the root of the tooth. The primary function of the cementum is to anchor the tooth to the bony socket with the attachments of the periodontal ligaments.
alveolar bone
bone that supports the tooth in its position within the jaw. The alveolar socket is the cavity in the bone that surrounds the tooth
Is gingivitis reversible?
YES - it is reversible. If you do not treat gingivitis, then periodontitis follows.
Causes of Periodontal Disease
- Bacterial plaque (dental plaque, oral biofilm)
- Calculus (tartar)
◦ Provides a surface to which biofilm can attach
◦ Two types:
▪ Supragingival calculus found above the margin of the gingiva
▪ Subgingival calculus on root surfaces below the gingival margin
that can extend into periodontal pockets
Although biofilm is the primary factor causing periodontal disease, the type of
bacteria, length of time bacteria are left undisturbed on the teeth, and patient
response to bacteria are all critical factors in the risk for periodontal disease.
Biofilm cannot be removed simply by rinsing the mouth. Bacteria in biofilm cause
inflammation by producing enzymes and toxins that destroy periodontal tissues and
lower host defenses
Signs and Symptoms of Periodontal Disease
- Red, swollen, or tender gingiva
- Bleeding gingiva while brushing or flossing
- Loose or separating teeth
- Pain or pressure when chewing
- Pus around the teeth or gingival tissues
Risk Factors for Periodontal disease
- Smoking
- Diabetes Mellitus
- Poor Oral Hygiene
- Osteoporosis
- HIV/AIDS
- Stress
- Medications
- Local Factors
What helps neutralize sugary/sticky/acidic foods?
Cheese
Risk Factor: Smoking
Smokers have greater loss of attachment, bone loss, periodontal pocket depths, calculus formation, and tooth loss. Periodontal treatments are less effective in smokers than in non-smokers.
Risk Factors: Diabetes Mellitus
Diabetes is a strong risk factor for periodontal disease. Individuals with diabetes are 3 times more likely to have attachment and bone loss. Persons who have their diabetes under control have less attachment and bone loss than do those with poor control.
Risk Factor: Poor Oral Hygiene
Lack of good oral hygiene increases the risk for periodontal disease in all age groups. Excellent oral hygiene greatly reduces the risk for severe periodontal disease.
Osteoporosis
An association has been reported between alveolar bone and osteoprosis. Women with osteoporosis have increased alveolar bone resorption, attachment loss, and tooth loss compared with women without osteoporosis. Estrogen deficiency also has been linked to decreases in alveolar bone.
Systemic Risk Factors: HIV/AIDS
Increased gingival inflammation is noted around the margins of all teeth. Often, patients with HIV/AIDS develop necrotizing ulcerative periodontitis.
Systemic Risk Factor: Stress
Psychological stress is associated with depression of the immune system, and studies show a link between stress and periodontal attachment loss. Research is ongoing to identify the link between psychological stress and periodontal disease.
Systemic Risk Factors: Medications
Some medications, such as tetracycline and nonsteroidal anti-inflammatory drugs, have a beneficial effect on the periodontium, and others have a negative effect.
Decreased salivary flow (xerostomia) can be caused by more than 400 medications. Antseizure drugs and hormones can cause gingival enlargement.
Systemic Risk Factors: Local Factors
Overhanging restorations, subgingival placement of crown margins, orthodontic appliances, and removable partial dentures also may contribute to the progression of
periodontal disease.
Oral conditions that increase an individual’s susceptibility to
periodontal disease:
- Calculus
- Tooth position
- Tooth morphology
- Occlusion
- Poor oral hygiene
- Habits
- Food impaction
- Faulty restorations and appliances
- Periodontal disease is an inclusive term describing any disease of the
periodontium and includes the following:
- Gingivitis
- Periodontitis