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__NOTOC__
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{{Periodontitis}}
'''For patient information click [[{{PAGENAME}} (patient information)|here]]'''
{{CMG}}
 
{{Infobox_Disease |
{{Infobox_Disease |
   Name          = Periodontal disease |
   Name          = Periodontal disease |
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   Caption        = This x-ray shows significant bone loss between the two roots of a tooth. The spongy bone has receded due to infection under tooth, reducing the bony support for the tooth. |
   Caption        = This x-ray shows significant bone loss between the two roots of a tooth. The spongy bone has receded due to infection under tooth, reducing the bony support for the tooth. |
}}
}}
{{Periodontitis}}
{{CMG}}
{{SK}} Pyorrhea alveolaris
==[[Periodontitis overview|Overview]]==


==[[Periodontitis pathophysiology|Pathophysiology]]==


== Assessment and prognosis ==
==[[Periodontitis causes|Causes]]==
Dentists or dental hygienists "measure" periodontal disease using a device called a [[periodontal probe]].  This is a thin "measuring stick" that is gently placed into the space between the gums and the teeth, and slipped below the gum-line.  If the probe can slip more than 3 millimetres length below the gum-line, the patient is said to have a "gingival pocket" around that tooth.  This is somewhat of a misnomer, as any depth is in essence a pocket, which in turn is defined by its depth, i.e., a 2 mm pocket or a 6 mm pocket.  However, it is generally accepted that pockets are self-cleansable (at home, by the patient, with a toothbrush) if they are 3 mm or less in depth.  This is important because if there is a pocket which is deeper than 3 mm around the tooth, at-home care will not be sufficient to cleanse the pocket, and professional care should be sought.  When the pocket depths reach 5, 6 and 7 mm in depth, even the hand instruments and cavitrons used by the dental professionals cannot reach deeply enough into the pocket to clean out the bacterial plaque that cause gingival inflammation. In such a situation the pocket or the gums around that tooth will always have inflammation which will likely result in bone loss around that tooth.  The only way to stop the inflammation would be for the patient to undergo some form of gingival surgery to access the depths of the pockets and perhaps even change the pocket depths so that they become 3 or less mm in depth and can once again be properly cleaned by the patient at home with his or her toothbrush.


If a patient has 5 mm or deeper pockets around their teeth, then they would risk eventual tooth loss over the years.  If this periodontal condition is not identified and the patient remains 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.
==[[Periodontitis differential diagnosis|Differentiating Periodontitis from other Diseases]]==


According to the Sri Lankan Tea Labourer 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). 80% will suffer from moderate loss (1-2 mm/year) and the remaining 10% will not suffer any loss.<!--
==[[Periodontitis epidemiology and demographics|Epidemiology and Demographics]]==
  --><ref name="JclinPeriodontol1995-Preus">{{cite journal | author=Preus HR, Anerud A, Boysen H, Dunford RG, Zambon JJ, Loe H | title=The natural history of periodontal disease. The correlation of selected microbiological parameters with disease severity in Sri Lankan tea workers | journal=J Clin Periodontol | year=1995 | pages=674-8 | volume=22 | issue=9 | id=PMID 7593696}}</ref><!--
 
  --><ref name="ComDentOralEpidemiol1984-Ekanayaka">{{cite journal | author=Ekanayaka A | title=Tooth mortality in plantation workers and residents in Sri Lanka | journal=Community Dent Oral Epidemiol | year=1984 | pages=128-35 | volume=12 | issue=2 | id=PMID 6584263}}</ref>
==[[Periodontitis risk factors|Risk Factors]]==
 
==[[Periodontitis natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
 
==Diagnosis==
[[Periodontitis history and symptoms|History and Symptoms]] | [[Periodontitis physical examination|Physical Examination]] | [[Periodontitis laboratory findings|Laboratory Findings]] | [[Periodontitis x ray|X Ray]] | [[Periodontitis other imaging findings|Other Imaging Findings]] | [[Periodontitis other diagnostic studies|Other Diagnostic Studies]]
 
==Treatment==
[[Periodontitis medical therapy|Medical Therapy]] | [[Periodontitis surgery|Surgery]] | [[Periodontitis primary prevention|Primary Prevention]] | [[Periodontitis secondary prevention|Secondary Prevention]] | [[Periodontitis cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Periodontitis future or investigational therapies|Future or Investigational Therapies]]
 
==Case Studies==
[[Periodontitis case study one|Case #1]]


==Related Chapters==
==Related Chapters==
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* [[Head and neck anatomy]]
* [[Head and neck anatomy]]
* [[Osteoimmunology]]
* [[Osteoimmunology]]
== Further reading ==
* {{cite journal|last=Pihlstrom|first= BL|coauthors=Michalowicz BS, Johnson NW|year=2005|title=Periodontal diseases|url=|journal=Lancet|issn=0140-6736|volume=366|issue=9499|pages=1809-20|pmid=16298220}}


{{Periodontology}}
{{Periodontology}}
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[[pt:Doença periodontal]]
[[pt:Doença periodontal]]


[[Category:Disease]]
[[Category:Oral pathology]]
[[Category:Oral pathology]]
[[Category:Infectious disease]]
 
[[Category:Periodontology]]
[[Category:Periodontology]]
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Latest revision as of 18:40, 18 September 2017

For patient information click here

Periodontal disease
This x-ray shows significant bone loss between the two roots of a tooth. The spongy bone has receded due to infection under tooth, reducing the bony support for the tooth.

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X Ray

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Synonyms and keywords: Pyorrhea alveolaris

Overview

Pathophysiology

Causes

Differentiating Periodontitis from other Diseases

Epidemiology and Demographics

Risk Factors

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | X Ray | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

Related Chapters

Template:Periodontology Template:Oral pathology
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