Posts tagged: periodontitis

Understanding the Different Stages of Gum Disease

Did you know that gum disease affects more than half of all people over the age of 30? As prevalent as this disease is, many people still remain undiagnosed. Typical symptoms of patients with gum disease include red, swollen, and puffy gums that feel tender to the touch. If left untreated, the disease can progress and result in loss of connective tissue, gum recession, and even tooth loss. Pus can also develop in the pockets between the teeth and gums as the body attempts to fight the infection. Not surprisingly, this creates a permanent bad taste in the mouth, and sufferers will also have bad breath. Not only does gum disease wreak havoc in your mouth, studies have also shown that is linked to serious conditions such as heart disease, diabetes, and even impotence.

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Mice Help Explain the Mystery of Bacterium’s Role in Periodontitis

Up until recently it has been a bit of a mystery as to how common oral bacteria such as P. gingivalis, A. actinomycetemcomitans, and T. fosythia, were able to wreak such havoc in the mouth. Scientists have pondered for years how exactly they were able to trigger periodontitis, despite being present in relatively low numbers in the sub gingival crevice. Now researchers have discovered that the common oral bacteria P. gingivalis is able to reprogram the immune cells that normally protect the sub gingival crevice, into creating conditions it finds more favourable.

The reprogrammed immune cells effectively persuade more immune cells to follow their lead, prompting the usually benign bacterial residents of the sub gingival crevice to rise up and defend their realm, which in turn leads to inflammation of the supportive structures of the tooth. Prior to this research it had often been thought that P. gingivalis was directly responsible for the infection, but it now seems likely that it just sits back to watch the destruction unfold, waiting to feed off the nutrients generated by the inflammation.

George Hajishengallis, D.D.S., Ph.D., a researcher at the University of Louisville School of Dentistry was a co-lead author on the study which was supported by the National Institute of Dental and Craniofacial Research, and has commented that this research is important as it is the first documented case of a keystone species being discovered in microbiology. The term keystone species was first invented in the late 1960s and is a species which is present in low numbers but which is able to exert a disproportionate influence on its environment. P. gingivalis, a common oral bacteria, would seem to be a perfect example as it is able to change the microbial environment creating conditions favourable for periodontitis to develop.

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Periowave™ Case Study #3 – Unsuccessful Prior Periodontal Therapy

Case Report
This is the case of a 52-year-old East Indian female who was on regular four-month maintenance following previous periodontal therapy. The patient had been treated three years prior for generalized severe periodontitis. The treatment at that time consisted of scaling and root planing, home care instructions, occlusal equilibration, and osseous surgery. The patient was in generally good health apart from high blood pressure, which was stable on lisinopril (Prinivil®) once a day. The dental examination showed a 6 mm inflamed bleeding pocket that was evident between 43 and 42 the rest of the mouth was healthy.

Periowave™ Treatment and Results

Scaling and root planing with local anesthesia was used to treat 43 and 42, with adjunctive treatment with Periowave following the scaling. The patient was out of the country after treatment for several months, but did return for a 12-week follow-up visit, at which time the pocket probing depth was reduced to 3 mm with no signs of inflammation

Left: Pre-treatment gingival inflammation near the pocket, Right: Post-treatment resolution of gingival inflammation

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