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. The prognosis can be classified in two ways. More advanced cases of gum disease are not common in children. 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. Periodontitis is an inflammation of the periodontium, i.e., the tissues that support the teeth. 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. ... Periodontal disease – symptoms, causes, and types. 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. 49. The purpose of this study was to identify and better understand dental hygienists' perceived barriers and experiences during the process of diagnosing periodontal disease in clinical practice. If your gums are red, swollen, bleed easily, or sore, you … Gingivitis is quite common, with many people having it to different strengths. 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). 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. However, such treatments do not address calculus formations, and so are short-lived, as anaerobic microbial colonies quickly regenerate in and around calculus. Probing should be avoided then, and an analysis by gingival index should determine the presence or absence of inflammation. 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. Periodontal literature Most of the attempts to attach a classification for the prognosis of individual teeth come from the periodontal literature. 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. Symptoms may include; Bleeding of gums, or redness suddenly during brushing of teeth. [6] Globally 538 million people were estimated to be affected in 2015. The different types of diseases have distinct symptoms and characteristics. If people have 7-mm or deeper pockets around their teeth, then they would likely risk eventual tooth loss over the years. Hereditary benign intraepithelial dyskeratosis, Neuralgia-inducing cavitational osteonecrosis, https://en.wikipedia.org/w/index.php?title=Periodontal_disease&oldid=997542888, Articles containing Ancient Greek (to 1453)-language text, Articles needing additional references from November 2018, All articles needing additional references, Articles with unsourced statements from May 2018, Articles with unsourced statements from June 2016, Articles with unsourced statements from December 2011, Articles with unsourced statements from April 2020, Wikipedia medicine articles ready to translate, Creative Commons Attribution-ShareAlike License. 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. A number of other products, functionally equivalent to hydrogen peroxide, are commercially available, but at substantially higher cost. [4] In the United States nearly half of those over the age of 30 are affected to some degree, and about 70% of those over 65 have the condition. Therefore if the brushing techniques are not modified, a periodontal recurrence is probable. Examine your mouth to look for plaque and tartar buildup and check for easy bleeding. According to the 1999 classification, the severity of chronic periodontitis is graded as follows:[51]. Refer you to a periodontist. The goal of periodontal surgery is access for definitive calculus removal and surgical management of bony irregularities which have resulted from the disease process to reduce pockets as much as possible. Periodontitis can cause teeth to loosen or lead to tooth loss.Periodontitis is common but largely preventable. In 2017, a new classification system for Periodontal diseases was released. Save my name, email, and website in this browser for the next time I comment. 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. 0. 2. This is especially true in molar tooth sites where furcations (areas between the roots) have been exposed. [3] In its early stage, called gingivitis, the gums become swollen, red, and may bleed. About 80% will suffer from moderate loss (1–2 mm/year) and the remaining 10% will not suffer any loss.[65][66]. The "extent" of disease refers to the proportion of the dentition affected by the disease in terms of percentage of sites. [76] Systemic disease may develop because the gums are very vascular (have a good blood supply). Diabetes also can occur during periodontitis in the advanced stages, such as; Type-I and ii diabetes. Pocket depths of greater than 5–6 mm (0.20–0.24 in) which remain after initial therapy, with bleeding upon probing, indicate continued active disease and will very likely lead to further bone loss over time. 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. [64] To avoid killing beneficial oral microbes, only small doses of doxycycline (20 mg) are used.[64]. [1] Diagnosis is by inspecting the gum tissue around the teeth both visually and with a probe and X-rays looking for bone loss around the teeth. Its prevalence in dogs increases with age, but decreases with increasing body weight; i.e., toy and miniature breeds are more severely affected. TYPES OF PROGNOSIS
- No bone loss, excellent gingival condition, good patient cooperation, no systemic environmental factors. Nonsurgical scaling and root planing are usually successful if the periodontal pockets are shallower than 4–5 mm (0.16–0.20 in). 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. Obviously, the more bone you lose around a tooth, the worse its prognosis for survival becomes. We will discuss the management of periodontal diseases. This thin "measuring stick" is gently placed into the space between the gums and the teeth, and slipped below the gumline. [1], Periodontal disease is generally due to bacteria in the mouth infecting the tissue around the teeth. Research has shown that smokers have more bone loss, attachment loss and tooth loss compared to non-smokers. [69] Periodontitis is frequently reported to be socially patterned, i.e. When the pocket depths reach 6 to 7 mm (0.24 to 0.28 in) in depth, the hand instruments and ultrasonic scalers used by the dental professionals may not reach deeply enough into the pocket to clean out the microbial plaque that causes gingival inflammation. This includes twice-daily brushing with daily flossing. ... 33, proposed an evidence-based periodontal prognosis model. PERIODONTITIS AS A MANIFESTATION OF SYSTEMIC DISEASES It can be divided into two categories: - periodontitis associated with hematologic disorders such as leukemia and acquired neutropenia. This process in turn activates osteoclasts which begin to destroy bone, and it activates matrix metalloproteinases that destroy ligaments. According to The Merriam-Webster Dictionary, “Prognosis” is defined as “the prospect of recovery as anticipated from the usual course of disease or peculiarities of the case.” In medicine, however, the term is commonly defined by the mortality rate. Genetics – It appears to play a role in regulating the risk of periodontitis. Periodontal disease, also known as gum disease, destroys the bone and soft tissue that supports the teeth. The Otzi Iceman was shown to have had severe gum disease. 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. [49] Research in 2004 indicated three gram negative anaerobic species: Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Bacteroides forsythus and Eikenella corrodens. STUDY. It causes the gums to become red, swollen, and bleed easily. 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