January 6, 2021  Although the majority of research has focused on type 2 diabetes, type 1 diabetes appears to have an identical effect on the risk for periodontitis. The "extent" of disease refers to the proportion of the dentition affected by the disease in terms of percentage of sites. If your gums are red, swollen, bleed easily, or sore, you … The main goal of treatment is to control the infection. Periodontal disease is a group inflammatory disorder of the tissues surroundings of the teeth called “Gum diseases”. Classification of Periodontal Diseases 2017. A form of periodontitis that occurs in patients who are otherwise clinically … Gingivitis is often caused by inadequate oral hygiene. The prognosis can be classified in two ways.  New finger prick tests have been approved by the Food and Drug Administration in the US, and are being used in dental offices to identify and screen people for possible contributory causes of gum disease, such as diabetes.  As of 2017 it was not certain what species were most responsible for causing harm, but gram-negative anaerobic bacteria, spirochetes, and viruses have been suggested; in individual people it is sometimes clear that one or more species is driving the disease. This page was last edited on 1 January 2021, at 01:32.  In certain cases antibiotics or dental surgery may be recommended.  A meta analysis of local tetracycline found improvement. Periodontal disease (also known as periodontitis and gum disease) is a progressive disease which affects the supporting and surrounding tissue of the gums, and also the underlying jawbone. Generally, six searching sites around each tooth may show; Added, Gingival disease; Non-dental biofilm induced – there are six subtypes of periodontal disease such as; genetic/developmental disorder, specific infection, inflammatory and immune conditions, reactive process, neoplasm, endocrine, nutritional and metabolic, and traumatic lesions, or gingival pigmentation. Periodontitis (per-e-o-don-TIE-tis) is a serious gum infection that damages the soft tissue and destroys the bone that supports your teeth. It is very important to understand that in many cases, periodontal disease can progress without symptoms like pain.  Recommended oral hygiene include daily brushing and flossing. Gingivitis is a type of periodontal disease. PLAY. This is especially true in molar tooth sites where furcations (areas between the roots) have been exposed. This includes twice-daily brushing with daily flossing. Dentists and dental hygienists measure periodontal disease using a device called a periodontal probe. Examine your mouth to look for plaque and tartar buildup and check for easy bleeding. All of these infections will require immediate treatment and action by you and a dentist, or a periodontist (specialist in periodontal diseases and infections) in order for the progression of the infection to be halted and bone and gum tissue to be saved.  The word pyorrhea (alternative spelling: pyorrhoea) comes from the Greek pyorrhoia (πυόρροια), "discharge of matter", itself from pyon, "discharge from a sore", rhoē, "flow", and the suffix -ia. Periodontal diseases are infections of the gums and bone that hold the teeth in place. However, the risk increases exponentially as glycaemic control worsens. Diabetes is a disorder in the way the body uses digested food for growth and energy. If left undisturbed, microbial plaque calcifies to form calculus, which is commonly called tartar. Nonetheless, the continued stabilization of a person's periodontal state depends largely, if not primarily, on the person's oral hygiene at home, as well as on the go. ... Periodontal disease – symptoms, causes, and types. It is possibly the most important environmental risk for people. Periodontists are experts in the diagnosis and treatment of gum disease and may provide you with treatment options that are not offered by your dentist. The tradition-al systems were based on tooth mortality19 and did not look at the possibility of classify-ing a tooth’s prognosis, based on the ability to control the disease process and success-  The dentist or hygienist must perform a re-evaluation four to six weeks after the initial scaling and root planing, to determine if the person's oral hygiene has improved and inflammation has regressed. Chronic periodontal disease, unlike gingivitis, involves the destruction of the supporting jawbone around the teeth. The different types of diseases have distinct symptoms and characteristics. According to the Sri Lankan tea laborer study, in the absence of any oral hygiene activity, approximately 10% will suffer from severe periodontal disease with rapid loss of attachment (>2 mm/year). 0. a prediction of the course or outcome of a disease or disorder. Persons with periodontitis must realize it is a chronic inflammatory disease and a lifelong regimen of excellent hygiene and professional maintenance care with a dentist/hygienist or periodontist is required to maintain affected teeth. Removal of microbial plaque and calculus is necessary to establish periodontal health. If people have 7-mm or deeper pockets around their teeth, then they would likely risk eventual tooth loss over the years. There is usually little or no discomfort at this stage. If left untreated, periodontal disease can result in … without treatment? Probing should be avoided then, and an analysis by gingival index should determine the presence or absence of inflammation.  The extent of the increased risk of periodontitis is dependent on the level of glycaemic control. In its early stage, called gingivitis, the gums become swollen, red, and may bleed. Research has shown that smokers have more bone loss, attachment loss and tooth loss compared to non-smokers. It causes the gums to become red, swollen, and sore. , An ancient hominid from 3 million years ago had gum disease. Red, swollen, painful, bleeding gums, loose teeth, Redness or bleeding of gums while brushing, Gingival recession, resulting in apparent lengthening of teeth (this may also be caused by heavy-handed brushing or with a stiff toothbrush), Deep pockets between the teeth and the gums (, Loose teeth, in the later stages (though this may occur for other, Slight: 1–2 mm (0.039–0.079 in) of attachment loss, Moderate: 3–4 mm (0.12–0.16 in) of attachment loss, Severe: ≥ 5 mm (0.20 in) of attachment loss, Systemic disease of conditions affecting the, Peri-implant soft and hard tissue deficiencies, Amount and percentage bone loss radiographically, History of tooth loss related to periodontitis, Tooth hypermobility due to secondary occlusal trauma, Grade A: Slow progression of disease; no evidence of bone loss over last five years, Grade B: Moderate progression; < 2mm of bone loss over last five years, Grade C: Rapid progression or future progression at high risk; ≥ 2mm bone loss over five years. Aggressive periodontitis – Causes rapid bone destruction and gum loss. , Local drug deliveries in periodontology has gained acceptance and popularity compared to systemic drugs due to decreased risk in development of resistant flora and other side effects.  Systemic disease may develop because the gums are very vascular (have a good blood supply).  This is likely due to several effects of smoking on the immune response including decreased wound healing, suppression of antibody production, and the reduction of phagocytosis by neutrophils. In its more serious form, called periodontitis, the gums can pull away from the tooth, bone can be lost, and the teeth may loosen or fall out. A very strong risk factor is one's genetic susceptibility. Although the primary cause of both gingivitis and periodontitis is the microbial plaque that adheres to the tooth surfaces, there are many other modifying factors. There are 3 main types: type 1, type 2, and gestational diabetes. The microorganisms traveling through the blood may also attach to the heart valves, causing vegetative infective endocarditis (infected heart valves). As in other tissues, Langerhans cells in the epithelium take up antigens from the microbes, and present them to the immune system, leading to movement of white blood cells into the affected tissues. Without daily oral hygiene, periodontal disease will not be overcome, especially if the person has a history of extensive periodontal disease. This involves regular checkups and detailed cleanings every three months to prevent repopulation of periodontitis-causing microorganisms, and to closely monitor affected teeth so early treatment can be rendered if the disease recurs. Adults are the most affected. Calculus above and below the gum line must be removed completely by the dental hygienist or dentist to treat gingivitis and periodontitis. Copyright © 2021 | WordPress Theme by MH Themes. Treatment is available in many procedures but dentists may recommend antibiotics and surgery in certain cases. Periodontitis is very common, and is widely regarded as the second most common dental disease worldwide, after dental decay, and in the United States has a prevalence of 30–50% of the population, but only about 10% have severe forms. Chronic periodontitis affects about 750 million people or about 10.8% of the world population as of 2010. Calculus – Calculus is a strong form of the plague. Prognosis. It is believed genetics could explain why some people with good plaque control have advanced periodontitis, whilst some others with poor oral hygiene are free from the disease. In some people, gingivitis progresses to periodontitis – with the destruction of the gingival fibers, the gum tissues separate from the tooth and deepened sulcus, called a periodontal pocket. In addition to initial RSI, it may also be necessary to adjust the occlusion (bite) to prevent excessive force on teeth that have reduced bone support. Nonsurgical scaling and root planing are usually successful if the periodontal pockets are shallower than 4–5 mm (0.16–0.20 in). The monthly reevaluation of periodontal therapy should involve periodontal charting as a better indication of the success of treatment, and to see if other courses of treatment can be identified. Hence, people may wrongly assume painless bleeding after teeth cleaning is insignificant, although this may be a symptom of progressing periodontitis in that person. Periodontal disease can range from mild to severe. . Questionable prognosis: Local and/or systemic factors influencing the periodontal status of the tooth may or may not be controllable. Favorable prognosis: Comprehensive periodontal treatment and maintenance will stabilize the status of the tooth. An additional way to stop the inflammation would be for the person to receive subgingival antibiotics (such as minocycline) or undergo some form of gingival surgery to access the depths of the pockets and perhaps even change the pocket depths so they become 3 mm or less in depth and can once again be properly cleaned by the person at home with his or her toothbrush. However, such treatments do not address calculus formations, and so are short-lived, as anaerobic microbial colonies quickly regenerate in and around calculus. By smoking, males are affected more than females.  Research in 2004 indicated three gram negative anaerobic species: Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Bacteroides forsythus and Eikenella corrodens. There is a periodontal disease listed in 7 major categories and in which 2-6 forms of destructive periodontal disease because the damage is significantly irreversible. The 2017 classification of periodontal diseases is as follows:, Periodontal health, gingival disease and conditions, Other conditions affecting the periodontium, The goals of staging periodontitis is to classify the severity of damage and assess specific factors that may affect management.. 1 New technology, research, and information has emerged in the past 18 years which led to the new revisions.  Diabetics must be meticulous with their homecare to control periodontal disease.
- GOOD PROGNOSIS
- EXCELLENT PROGNOSIS
- No bone loss, excellent gingival condition, good patient cooperation, no systemic environmental factors. Dr Ismail Hossain This thin "measuring stick" is gently placed into the space between the gums and the teeth, and slipped below the gumline. If the probe can slip more than 3 mm (0.12 in) below the gumline, the person is said to have a gingival pocket if no migration of the epithelial attachment has occurred or a periodontal pocket if apical migration has occurred. Therefore, in well managed diabetes there seems to be a small effect of diabetes on the risk for periodontitis. Periodontitis is an inflammation of periodontium. 2. STUDY. , Periodontal disease is generally due to bacteria in the mouth infecting the tissue around the teeth. The cornerstone of successful periodontal treatment starts with establishing excellent oral hygiene. Its occurrence decreases with a higher standard of living. A number of other products, functionally equivalent to hydrogen peroxide, are commercially available, but at substantially higher cost. Alkalosis – cause, types, symptoms, and management. , Like other conditions intimately related to access to hygiene and basic medical monitoring and care, periodontitis tends to be more common in economically disadvantaged populations or regions. Its prevalence in dogs increases with age, but decreases with increasing body weight; i.e., toy and miniature breeds are more severely affected. In the primary stage, the gum becomes swollen, red, and may bleed. Obviously, the more bone you lose around a tooth, the worse its prognosis for survival becomes. Future loss of periodontal support is unlikely. Nevertheless, it is extremely common in most adults. It causes the gums to become red, swollen, and bleed easily.  Periodontitis occurs more often in people from the lower end of the socioeconomic scale than people from the upper end of the socioeconomic scale.. , As dental plaque or biofilm accumulates on the teeth near and below the gums there is some dysbiosis of the normal oral microbiome. The seven categories are as follows: Moreover, terminology expressing both the extent and severity of periodontal diseases are appended to the terms above to denote the specific diagnosis of a particular person or group of people.  Furthermore, research has shown that in the Roman era in the UK, there was less periodontal disease than in modern times. Periodontal literature Most of the attempts to attach a classification for the prognosis of individual teeth come from the periodontal literature. , Treatment involves good oral hygiene and regular professional teeth cleaning. If nonsurgical therapy is found to have been unsuccessful in managing signs of disease activity, periodontal surgery may be needed to stop progressive bone loss and regenerate lost bone where possible.  So far, the mechanisms underlying the link are not fully understood, but it is known to involve aspects of inflammation, immune functioning, neutrophil activity, and cytokine biology. Symptoms may include; Bleeding of gums, or redness suddenly during brushing of teeth. Back to top Treatment. Doxycycline may be given alongside the primary therapy of scaling (see § initial therapy). As a review, the periodontal classifications were revised in 1999 and classified as chronic, aggressive (localized and generalized), necrotizing, and a manifestation of systemic disease. 3. Daily oral hygiene measures to prevent periodontal disease include: Typically, dental hygienists (or dentists) use special instruments to clean (debride) teeth below the gumline and disrupt any plaque growing below the gumline. Also hard to remove, and its bacteria produce more toxins that make gums causing them can bleed, tender, and inflamed. Recent research undertaken at the Waltham Centre for Pet Nutrition has established that the bacteria associated with gum disease in dogs are not the same as in humans. This is a standard treatment to prevent any further progress of established periodontitis. Generalized form – fair, poor or questionable prognosis due to generalized interproximal loss, poor antibody response and thus poor response to conventional periodontal therapy. If this periodontal condition is not identified and people remain unaware of the progressive nature of the disease, then years later, they may be surprised that some teeth will gradually become loose and may need to be extracted, sometimes due to a severe infection or even pain. About 80% will suffer from moderate loss (1–2 mm/year) and the remaining 10% will not suffer any loss..  It is arguably the most important environmental risk factor for periodontitis.  Overall, the increased risk of periodontitis in diabetics is estimated to be between two and three times higher. Subgingival microorganisms (those that exist under the gum line) colonize the periodontal pockets and cause further inflammation in the gum tissues and progressive bone loss. , Dentistry involving supporting structures of teeth (, Periodontitis as a manifestation of systemic disease, Necrotizing ulcerative gingivitis/periodontitis, Learn how and when to remove this template message, "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015", "Antibodies to periodontal pathogens and stroke risk", "Periodontal disease and coronary heart disease: a reappraisal of the exposure", "Periodontal disease and risk of cerebrovascular disease: the first national health and nutrition examination survey and its follow-up study", "Relationship of periodontal disease to carotid artery intima-media wall thickness: the atherosclerosis risk in communities (ARIC) study", "Periodontal disease and coronary heart disease incidence: a systematic review and meta-analysis", "Periodontitis is associated with cognitive impairment among older adults: analysis of NHANES-III", "Tooth loss and periodontal disease predict poor cognitive function in older men", "Periodontal disease might be associated even with impaired fasting glucose", "Prevalence of endodontic infection in patients with Crohn´s disease and ulcerative colitis", "European Guidelines on cardiovascular disease prevention in clinical practice (version 2012): The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts) Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR)", "Microbiota, Oral Microbiome, and Pancreatic Cancer", "Periodontal aspects of the juvenile form of paracoccidioidomycosis", "Current Concepts in Periodontal Pathogenesis", "Periodontitis as a possible early sign of diabetes mellitus", "Diabetes and periodontal disease: a two-way relationship", "A review of the evidence for pathogenic mechanisms that may link periodontitis and diabetes", "Development of a classification system for periodontal diseases and conditions", "The Periodontal Disease Classification System of the American Academy of Periodontology – An Update", "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", "Peri-implant diseases and conditions: Consensus report of workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions", "A new classification scheme for periodontal and peri-implant diseases and conditions – Introduction and key changes from the 1999 classification", "Effect of local drug delivery in chronic periodontitis patients: A meta-analysis", "Tetracycline as local drug delivery in treatment of chronic periodontitis: A systematic review and meta-analysis", "Mortality and Burden of Disease Estimates for WHO Member States in 2002", "Years lived with disability (YLDs) for 1160 sequelae of 289 diseases and injuries 1990–2010: a systematic analysis for the Global Burden of Disease Study 2010", "Roman-Britons had less gum disease than modern Britons". This is due to several effects of smoking on the immune response including; decreased wound healing, refreshing antibody production, and reduction of phagocytosis by neutrophils.  Records from China and the Middle East, along with archaeological studies, show that mankind has suffered from Periodontal disease for at least many thousands of years. However, they all require prompt attention and treatment. Bone grafting is a surgical procedure that promotes the growth of bone in an area where bone has been destroyed by periodontal disease. It is important to note that RSI is different to scaling and root planing: RSI only removes the calculus, while scaling and root planing removes the calculus as well as underlying softened dentine, which leaves behind a smooth and glassy surface, which is not a requisite for periodontal healing. In Israeli population, individuals of Yemenite, North-African, South Asian, or Mediterranean origin have higher prevalence of periodontal disease than individuals from European descent. In 2017, a new classification system for Periodontal diseases was released. The disease is generally occurred by bacteria in the mouth infecting the tissues around the teeth. In Europe and the Middle East archaeological research looking at ancient plaque DNA, shows that in the ancient hunter-gatherer lifestyle there was less gum disease, but that it became more common when more cereals were eaten.  Bad breath may also occur. B: moderate progression; <2 mm of bone loss last 5 years. Refer you to a periodontist. What are the symptoms of periodontal disease in a child?  Individuals with impaired fasting glucose and diabetes mellitus have higher degrees of periodontal inflammation, and often have difficulties with balancing their blood glucose level owing to the constant systemic inflammatory state, caused by the periodontal inflammation.  Males are affected more often than females.. For smaller spaces, products such as narrow picks with soft rubber bristles provide excellent manual cleaning. The 1999 classification system for periodontal diseases and conditions listed seven major categories of periodontal diseases, of which 2–6 are termed destructive periodontal disease, because the damage is essentially irreversible. Sites are defined as the positions at which probing measurements are taken around each tooth and, generally, six probing sites around each tooth are recorded, as follows: If up to 30% of sites in the mouth are affected, the manifestation is classified as "localized"; for more than 30%, the term "generalized" is used. Periodontal disease, also known as gum disease, destroys the bone and soft tissue that supports the teeth. Additional diseases that may result from periodontitis include chronic bronchitis and pulmonary fibrosis. It results from bacteria that accumulate in the mouth and form plaque, a sticky membrane that forms over the teeth ( x ). Perio - Prognosis. Other contributors are poor nutrition and underlying medical issues such as diabetes. The diagnosis of periodontal disease involves elinical observation and the use of a probe; the roentgenogram is essential for planning treatment and for determining prognosis. It's usually the result of poor oral hygiene. Most patients have short stature and orofacial characteristics such as micrognathia, gingival hyperplasia with varying degrees of hyperkeratosis, and agenesis or microdontia of multiple teeth, accompanied sometimes by increased sensitivity to infection. Oral hygiene – Poor oral hygiene is the main cause of periodontal diseases in addition to indigestion and hyperacidity. The first step in the treatment of periodontitis involves nonsurgical cleaning below the gum line with a procedure called "root surface instrumentation" or "RSI", this causes a mechanical disturbance to the bacterial biofilm below the gumline. 49. According to the 2017 classification, periodontits is divided into four stages; after considering a few factors such as: According to the 2017 classification, the grading system for periodontitis consists of three grades:, Risk factors affecting which grade a person is classified into include:. 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