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Periodontal disease

Periodontal disease is the name for bacterial infections of the gums in the mouth. In most cases this disease is linked to poor oral hygiene. Some people however can have a genetic pre-disposition to the disease. The disease once initiated can progress more rapidly in people who have diabetes, especially if the diabetes is poorly controlled. Smoking is a strong risk factor for periodontal disease. more...

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Symptoms

  • occasional redness or bleeding of gums while brushing or using dental floss teeth or biting into hard food (e.g. apples)
  • occasional swellings that recur
  • halitosis or bad breath
  • persistent bad taste in the mouth
  • shaky teeth in later stages
  • recession of gums resulting in apparent lengthening of teeth (also caused by heavy handed brushing using a hard tooth brush)
  • pockets between the teeth and the gums (Pockets are sites where the jaw bone has been destroyed gradually or by repeated swellings. Teeth become loose or shaky when sufficient jaw bone has been destroyed. The unfortunate thing is that the bone destruction is largely painless.)
  • lack of pain when bleeding happens after cleaning is NOT a sign of health.

Treatment

  • regular brushing and flossing and using an interdental brush at least daily.
  • treatment by a Periodontist, which includes professional cleaning to remove calculus (tartar, tooth stone)and may include drugs (infrequently), and/or surgery occasionally.

Prevention

  • brushing properly on a regular basis (2 times a day)
  • flossing daily and using interdental brushes if there is sufficient space between teeth and behind the last tooth in each quarter.
  • regular dental checkups and professional teeth cleaning as required. This serves to monitor the person's oral hygiene methods and how the condition has responded to treatment. Professional tooth cleaning will not prevent or control the disease because the bacterial plaque (biofilm) returns on the tooth surfaces every 24 hours.

See also

  • Actinomyces naeslundii (a kind of bacteria)
  • dental plaque

Disease progression and predisposition

  • According to the Sri Lanka Tea Labourer study, on the absence of any oral hygiene activity, approximately 10% will suffer from severe periodontal disease with rapid loss of attachment(>2mm/yr). 80% will suffer from moderate loss (1-2 mm/year) and the remaining 10% will not suffer any loss.

Read more at Wikipedia.org


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Vitamin D deficiency and periodontal disease
From Nutrition Research Newsletter, 8/1/04

Periodontal disease, a chronic inflammatory disease, is the primary cause of tooth loss among adults. This widespread disease is characterized by the loss of periodontal attachment, that is, periodontal ligament and alveolar bone. Periodontal disease and potential tooth loss can greatly impact an individual's quality of life, dietary quality, and nutritional intake. Additionally, recent reports found associations between periodontal disease and increased risks of cardiovascular diseases. Scientists believe the mechanisms involved in these associations are decreased dietary quality and chronic inflammation. There are also positive associations between osteoporosis or low bone density and alveolar bone and tooth loss, which indicates poor bone quality may be a risk factor for periodontal disease.

Vitamin D status may impact periodontal disease both through an effect on bone mineral density (BMD) and through immunomodulatory effects. The active metabolite of 25-hydorxyvitamin D, 1,25-dihydroxyvitamin D, has been found to inhibit cytokine production and cell proliferation. Whether vitamin D, calcium, or both are beneficial in the prevention of periodontal disease is unclear. Furthermore, it is not clear whether the effect is mediated by the BMD or the BMD-independent effects of vitamin D.

A study was conducted to determine whether serum 25(OH)D3 concentrations are associated with periodontal disease in a large, representative sample of the US population [third National Health and Nutrition Examination Survey (NHANES III)] and, if so, whether this association is mediated by total hip BMD. NHANES III is a complex, multistage, stratified, clustered sample survey. Interviews were conducted at participants' homes. The examination included extensive dental examinations with periodontal assessments. Blood samples were taken and analyzed for serum 25(OH)D3 concentrations. Smoking status and diabetes mellitus were assessed during the household interview. The poverty income ratio was computed. Body mass index (BMI) was also calculated.

It was found that 25(OH)D3 concentrations were significantly and inversely associated with periodontal attachment loss (AL) in men and women aged >50 years. Compared with men in the highest 25(OH)D3 quintile, those in the lowest quintile had a mean AL that was 0.39 mm (95% CI: 0.17, 0.60 mm) higher; in women, the difference in AL between the lowest and highest quintiles was 0.26 mm (0.09, 0.43 mm). In men and women younger than 50 years, there was no significant association between 25(OH)D3 and AL. The BMD of the total femoral region was not associated with AL and did not mediate the association between 25(OH)D3 and AL.

It appears that low serum 25(OH)D3 concentrations may be associated with periodontal disease independently of BMD. Because of the high prevalence of both periodontal disease and vitamin D deficiency, the findings of this study may have influential public health consequences.

T. Dietrich, K. Joshipura, B. Dawson-Hughes, et al. Association between serum concentrations of 25-hydroxyvitamin D3 and periodontal disease in the US population. Am J Clin Nutr;80:108-113 (July, 2004). [Correspondence: T Dietrich, Department of Health Policy and Health Services Research, Goldman School of Dental Medicine, Boston University, 715 Albany Street, 560 3rd floor, Boston, MA 02118. E-mail: tdietric@bu.edu].

COPYRIGHT 2004 Frost & Sullivan
COPYRIGHT 2004 Gale Group

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