What is Periodontitis?

Periodontitis:

If the gum disease is not treated early, the infection spreads to underlying bone and tooth supporting tissues. It is also caused by the same factors causing gin- givitis. Periodontitis is one of the most common chronic infections occurring in the body¹. Earlier studies conducted on Pakistani school children showed a 100% prevalence of the periodontitis². The following table summarizes the signs & symptoms, prevention and treatment of periodontitis.

Signs & symptoms, prevention and treatment of periodontitis.

Signs & symptoms

Bleeding gums (also in gingivitis). Sensitivity (also in gingivitis). Tooth mobility. Loss of attachment of gums from teeth. Gum overgrowth or recession (also in gingivitis) exposing the underlying portion of tooth. Red gums (also in gingivitis). Ulceration (also in gingivitis). Pus (also in gingivitis). Tilting of teeth. Spacing between teeth. Soreness. Itching pain (also in gingivitis). Bad breath (also in gingivitis) Bad taste (also in gingivitis).

Prevention

Maintaining good oral hygiene by proper tooth brushing and flossing. Calcium rich diet.

Treatment

Scaling and polishing of teeth. Root planning of teeth. Curettage. Antibiotics. Gum surgery. Bone or soft tissue grafts.

Complications of Periodontitis:

Periodontitis if not treated can lead to tooth loss. Periodontitis and tooth loss have been linked to many other diseases and disorders such as chronic kidney disease was observed to be more prevalent in people having no teeth in the mouth, periodontitis has been linked with heart disease, increased risk towards oral cancer and increased inflammatory chemicals in body, memory loss, movement disorders and raised blood pressure have been observed more frequently in people with no teeth in mouth.

Respiratory diseases have been observed in periodontitis patients. Risk of preterm babies increases with gingivitis and periodontitis possibly due to triggering of factors that induce labour. Porphyromonas gingivalis; a periodontal pathogen can increase the risk for diabetes mellitus, cardiovascular disorders, preterm birth,non alcoholic liver disease as well as autoimmune antibodies forma- tion in Rheumatoid arthritis patients.

The poor blood sugar control puts diabetic patients at 2.8 times higher risk of periodontitis and almost 4.2 times at risk of alveolar bone loss relating hyperglycemia with increased chances of periodontitis. On the other hand, improvement in oral hygiene is associated with a better control of blood sugar and a subsequent decline in the diabetes related complications such as retinopathy, neuropathy, proteinuria, cardiovascular system (CVS). complications and ketoacidosis.

Severe periodontal disease can increase mortality by diabetic nephropathy 8.5 times compared to people with mild to moderate peri- odontal disease. In Diabetes Mellitus (D.M.) patients, periodontitis is a predictor of mortality from ischemic heart disease. Periodontitis can also increase the resistance to insulin.Not only C.V.S. disease is a risk factor for periodontitis, the latter also increases the risk of thrombus and atherosclerosis as people who suffered from C.V.S. ischemia; non hemorrhagic stroke have always some form of periodontitis.

The degree of periodontitis is directly linked with severity of rheumatoid arthritis and improving oral health leads to reduction in severity of rheumatoid arthritis. C-reactive protein increases in patients with periodontitis.This increased syn- thesis can be due to local production of the inflammatory protein by the diseasedgingival tissue or by the liver enhancing thereby the risk of C.V.S. disorder due to atheroma formation.

Several periodontal bacteria have been isolated in patients with pyogenic liver abscess and improving the oral hygiene reduces liver in- jury and mortality in chronic liver disease patients.