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Periodontal Disease Affects

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Introduction

Periodontal disease affects the tissues around the tooth. If untreated results to progressive and steady loss of the bone around the bone the eventuality of which is complete loss of teeth. It can manifest itself in various forms but the severe forms of the disease are less common but generally the disease is common in most populations. The disease is caused by bacteria that attach to the tooth around the gum where they grow and multiply. Factors that affect the severity of the disease leading to the manifestation of the disease in various forms include smoking, inherited genetic susceptibility, and diabetes. Signs and symptoms of the disease include redness of the gum during brushing accompanied by bleeding or during biting of tough foods for example sugarcane, secondly, there maybe recurrent swelling of the gums accompanied with unpleasant breath and the presence of a persistent metallic taste a condition known as halitosis.

There is also destruction of the attachment sites between teeth and the gum as result of collagenases, the patient may at times suffer from gingival recession of which the eventuality is lengthening of the tooth, and these effects can eventually lead to complete loss of teeth. Some symptoms may be example bone destruction are painless and should not be assumed by patients. Periodontal disease is characterized by a change in the normal oral flora consisting mainly of aerobic gram-positive bacteria mainly the genus Lactobacillus, Peptostreptococcus and the Streptococcus to a gram-negative aerobic bacteria dominated environment with the most common species reported including: Bacteroides forsythus, Porphyromonas gingivalis and Trepenoma dentinema.

Debridement entails the removal of excessive amounts of plaque from the teeth especially for people with heavy plaque arising from lack of seeking medical check-up.

The risk associated with Debridement is associated with bleeding experienced in inflammated gums. In some case the gums may become too sensitive to heat and cold after the process. Consequently in rare occasions one can get an infection in the process.

Effects of Periodontal Disease

  1. On the Cementum

This is the outer layer of the roots of teeth and covers a third to half portion of the tooth. It contains plenty of calcium and it’s mainly produced or secreted by cementoblasts which are specialized within the root of the tooth. The cementum is generally thickest at the tip if the tooth. The principal function of the cementum is to offer maximum stability to the bone by functioning as the main medium through which the periodontal ligaments can adhere to the tooth. The cementum contains fewer minerals compared to enamel hence its not as tough as enamel itself and has a yellow coloring. It borders the enamel on the on the lower part of the tooth, and the periodontal ligaments at its bottom.

  1. Dental Alveolus 

Can be described in simple terms as sockets in the jaw where the root of the tooth is firmly attached to with the periodontal ligament.

Periodontal debridement causes the swelling of the dental alveoli leading to a condition called alveolitis that can result to massive pain and discomfort of the mouth. Infection of an individual with periodontal disease results to loss of alveolus bone due to the action of proteolytic enzymes that split the bone. The enzymes are produced by neutrophils which are some of the numerous white blood cells.

  1. periodontal ligaments (PDLs) 

This is a group of specialized connective tissue whose main function is to attach the tooth to the alveolar bone. It is this fibres that make the bone stable during vigorous process that include chewing. These fibres also act as a form of sensory through which the brain can detect the amount force that has placed on the tooth by the help of pressure sensitive receptors within the fibres. During infection there is activation of metalloproteinases that occurs as a result of inflammation causing production of reactive oxygen species in the forms of free radicals, oxygen ions and peroxidases. The periodontal ligaments are destroyed as a result of this action resulting to the weakening of the tooth characterized by shaking teeth consequently leading to the deepening of the gingival sulcus. It has been found out that periodontal disease results to permanent loss of periodontal ligaments. However, with effective further destruction of the ligaments can be controlled.

  1. attachment ligaments

Include the connective tissue including blood, cartilage and the bone all of which contain collagen. The collagenase produced during infection adversely affects the collagen leading to loose attachment of the tooth to the jaw bone.

Treatment

The involves not only the growth and multiplication of bacteria but also the change of flora from gram-positive to gram-negative as a result treatment strategies involve the use of both systemic and topical antimicrobial agents. The advantage of topical antibiotics is that the antibiotic is delivered directly to where it is needed. In some instances mechanical treatment is also used. The effectiveness of systemic antibiotics lies on the fact that they reach the gingival pocket through the gingival crevice fluid therefore when used with topical they form an effective treatment for the infection.

Prevention strategies

The prevention of periodontal disease is a simple daily basis procedure involving properly brushing the teeth on regular interval basis preferably in the morning and evening after meals. This will prevent the proliferation of the microorganisms that cause the disease. If there are large spaces between the teeth then one can opt to do flossing or using interdental brushes. During tooth brushing one can also use mouthwash. In addition regular check ups can to watch the condition of one’s dental hygiene and identify the presence of the disease at an early stage.

Conclusion

Periodontal disease can be a worrying infection if the teeth are not well cared for, however the prevention strategies are very simple to carry out and not expensive. Physicians can’t explain the high number of infection of the disease despite its simple management procedures it is more importantly for physicians to advice their patients to avoid high sugar concentration sweets, brush their teeth regularly after meals and if possible to use the oral rinse. 

References

Bennet J.E., (2003). Principles and practice of infectious disease. 5th edition.

Dolin R., (2000) infections of the oral cavity, head and neck. Churchill. Philadelphia

Hockberg R. S. (1999). Emergency medicine: concepts of clinical practice. St. Louis Amsterdam

Kumar V., (2004) pathological basis of disease. 7th edt. Elsevier. Philadelphia.

Reding M.E., (1992). The relationship between diabetes infection and control. 63:843-848

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