“Periodontal disease in children: etiology and pathogenesis. Gingivitis, periodontitis and periodontal syndrome in children: prevalence, clinical manifestations, diagnosis, differential diagnosis, treatment
Dec 18, 2015
“Periodontal disease in children: etiology
and pathogenesis. Gingivitis,
periodontitis and periodontal syndrome
in children: prevalence, clinical
manifestations, diagnosis, differential
diagnosis, treatment and prevention”
Lecturer: Dr. Katrin Duda
Gums (also called gingiva). Gums consist of soft,
pink tissue, which covers the alveolar bone.
The gum line is where the tooth meets the gum.
Bone (alveolar bone). This is the bone in which
the roots of teeth are embedded.
Periodontal membrane or ligament. This
connects and attaches the root of the tooth to
the bone.
It is chronic inflammatory disease of the
gum and tissues that surround and support
the teeth. If left untreated, periodontal
disease can lead to tooth loss.
This disease divided into two types:
-Gingivitis
-Periodontitis
Gums that bleed during and after tooth brushing
Red, swollen, or tender gums
Persistent bad breath or bad taste in the mouth
Receding gums
Formation of deep pockets between teeth and gums
Loose or shifting teeth
Changes in the way teeth fit together upon biting down, or in
the fit of partial dentures.
“inflammation around the tooth" - it is a serious
gum infection that damages the soft tissue and
bone that supports the tooth. All periodontal
diseases, including periodontitis, are infections
which affect the periodontium. The periodontium
are the tissues around a tooth, tissues that
support the tooth. With periodontitis, the alveolar
bone around the teeth is slowly and progressively
lost. inflammation.
This is a
destructive infection that
can affect all the periodontal
tissues, that is, the gums,
the underlying bone and the
connecting tissues.
About 20% of adolescents
(14-17 years) develop adult
periodontitis, but the
disease is rare in young
children.
Hormonal changes in females
Diabetes - patients who live with diabetes have a much higher incidence
of gum disease than other individuals of the same age
AIDS - people with AIDS have more gum diseases
Cancer - and some cancer treatments can make gum diseases more of a
problem
Some drugs - some medications that reduce saliva are linked to gum
disease risk.
Genetics - some people are more genetically susceptible to gum diseases
The possible role of systemic disorders and
systemic exposures in initiating or modifying
the progression of periodontal disease is a
very complex issue. It is however generally
agreed that several conditions may give rise
to an increase prevalence, incidence or
severity of gingivitis and periodontitis
Microbial plaque is the initiator of periodontal
disease but whether it affects a particular
subject, what form the disease takes, and how
it progresses, are all dependent on the host
defenses to this challenge. Systemic factors
modify all forms of periodontal disease
principally through their effects on the normal
immune and inflammatory defenses
Systemic factors most associated with the etiology
and or progression of peritonitis:
A. Diabetes Mellitus
B. Medications
C. Immunosuppressive disorders
D. Environmental Conditions or exposures
E. Hematological Disorders
F. Genetic Disorders.
1. Chronic Periodontitis: a) localized b) generalized
2. Aggressive Periodontitis: a) localized b) generalized
3. Periodontitis Associated with Systemic Diseases
4. Necrotizing Periodontal Diseases
5. Abscesses of the Periodontium
6. Periodontal Diseases associated with Endodontic Lesions
7. Developmental or Acquired Deformities and Conditions
Most prevalent in adults, but can occur in children
and adolescents
Amount of destruction is consistent with presence of
local factors
Subgingival calculus is a frequent finding
Associated with a variable microbial pattern
Slow to moderate rate of progression but may have
periods of rapid progression
Patients are otherwise clinically healthy
Rapid attachment loss and bone destruction
Familial aggregation and variable features
Severity of destruction inconsistent with amount of
microbial deposts
Elevated proportions of Actinobacillus
actinomycetemcomitans
and in some patients Porphyromonas gingivalis
Hyper-responsive macrophage phenotype
Progress of bone loss may be self arresting
A small percentage of children (approximately 1%)
develop this form of the disease.
It is a rapidly developing and very destructive form of
periodontitis.
It is associated with a blood cell (leucocyte) disorder.
The disease may be localized to a few teeth or it may be
generalized.
It is caused by specific bacteria, and is treated by a
combination of antibiotic and surgical therapy.
Dental plaque is the major cause of gingivitis and
periodontitis.
The bacteria in the plaque are the major offenders.
The effects of plaque can be even more damaging
if the patient is in poor health, or has a low
resistance to disease.
Periodontal disease is unlikely to be transmitted from
one person to another.
Qualified dentist should
find it fairly
straightforward to
diagnose periodontitis.
The dentist will ask the
patient questions
regarding symptoms and
carry out an examination
of his/her mouth.
Dental plaque is the major cause of gingivitis and
periodontitis.
The bacteria in the plaque are the major offenders.
The effects of plaque can be even more damaging
if the patient is in poor health, or has a low
resistance to disease.
Periodontal disease is unlikely to be transmitted from
one person to another.
pink or coral pink color firm, resilient tissues ”orange-peel” texture shape that follows the contour of the
teeth and forms scalloped edge no areas of redness, swelling or
inflammation no bleeding during daily plaque removal no discomfort
Gingivitis is inflammation of the gum tissue
The gums are irritated and swollen due to plaque or
calculus buildup along the gum line
The gums may be sore, bleed easily and appear puffy, soft
and swollen
Bleeding gum is one of the earliest and most common sings
of gingivitis
The good news about gingivitis is that it is preventable and
reversible through good brushing and flossing techniques/
Hormonal changes, such as those occurring during pregnancy, puberty,
menopause make gums more sensitive, which makes it easier for
gingivitis to develop.
Medications can affect oral health, because some lessen the flow of
saliva, which has a protective effect on teeth and gums.
Bad habits such as smoking make it harder for gum tissue to repair itself.
Poor oral hygiene habits such as not brushing and flossing
on a daily basis, make it easier for gingivitis to develop.
Family history of dental disease can be a contributing
factor for the development of gingivitis.