Periodontal Diseases
Chapter 14Introduction
Periodontal disease is an infectious disease process that involves inflammation. Periodontal diseases involve the structures of the periodontium. Periodontal disease can cause a breakdown of the periodontium resulting in loss of tissue attachment and destruction of the alveolar bone.Prevalence of Periodontal Disease
Periodontal diseases are the leading cause of tooth loss in adults. Almost 75% of American adults have some form of periodontal disease, and most are unaware of the condition. Almost all adults and many children have calculus on their teeth. Fortunately, with the early detection and treatment of periodontal disease, most people can keep their teeth for life.Systemic Conditions: Links to Periodontal Disease
Certain systemic conditions increase the patient’s susceptibility to periodontal disease, and periodontal disease may actually increase a patient’s susceptibility to certain systemic conditions.Cardiovascular diseasePreterm low birthweightRespiratory disease
Fig. 14-1 Structures of the periodontium: junctional epithelium, gingival sulcus, periodontal ligaments, and cementum
Periodontal Diseases
Infectious diseases that are the leading cause of tooth loss in adults. Nearly 75% of American adults suffer from various forms of periodontal disease and most are unaware of it. Almost all adults have calculus on their teeth. With the early detection and treatment of periodontal disease, it is possible for most people to keep their teeth for a lifetime.Causes of Periodontal Diseases
Dental plaque is the major factor in causing periodontal disease. Dental calculus provides a surface for plaque to attach. Subgingival calculus Supragingival calculusFig. 14-2 Buildup of bacterial plaque on the teeth affects the gingival tissues
Fig. 14-3 Periodontal disease (Courtesy Dr. Edward J. Taggart, San Francisco, CA.)
Types of Periodontal DiseasesPeriodontal disease is an inclusive term describing any disease of the periodontium. Gingival diseases and periodontitis are the two basic forms of periodontal disease, and each has a variety of forms.
Gingival Diseases
Gingivitis is inflammation of the gingival tissue. Gingivitis is characterized by areas of redness and swelling, and there is a tendency for the gingiva to bleed easily. Gingivitis is limited to the epithelium and gingival connective tissues. It is important to note that there is no tissue recession or loss of connective tissue or bone.Fig. 14-4 Marginal gingivitis
Other Types of GingivitisOther types of gingivitis are associated with: Puberty Pregnancy Use of birth control medications Gingivitis is painless and often unrecognized until a dental professional emphasizes its importance. Improved daily oral hygiene practices will reverse gingivitis.
Fig. 14-5 Medication-induced gingivitis (From Perry D, Beemsterboer P, Taggart E: Periodontology for the dental hygienist, Philadelphia, 2001, Saunders.)
Fig. 14-6 Pregnancy gingivitis (From Perry D, Beemsterboer P, Taggart E: Periodontology for the dental hygienist, Philadelphia, 2001, Saunders.)
Periodontitis
Periodontitis means inflammation of the supporting tissues of the teeth. Periodontitis is the extension of the inflammatory process from the gingiva into the connective tissue and alveolar bone that supports the teeth. The progression of periodontitis involves the destruction of connective tissue attachment at the most apical portion of a periodontal pocket.Risk Factors for Periodontal Disease
Smoking Diabetes Poor Oral Hygiene Osteoporosis HIV/AIDS Medications StressFig. 14-7 Cross section of a tooth and associated anatomic structures. A, Illustrates the depth of a normal gingival sulcus. B, Illustrates a periodontal pocket.
Fig. 14-8 The arrows indicate varying amounts of bone loss due to periodontal disease (From Miles DA et al: Radiographic imaging for dental auxiliaries, ed 3, Philadelphia, 1999, Saunders.)
Fig. 14-9 Generalized juvenile periodontitis (From Perry D, Beemsterboer P, Taggart E: Periodontology for the dental hygienist, Philadelphia, 2001, Saunders.)