Periodontal Disease

Aka: Periodontal Disease, Gingival Disorder

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II. Pathophysiology

  1. Bacteria and other pathogens infect subgingival dental Plaque
  2. Pathogens invade and inflame Gingival epithelium

III. Risk Factors

  1. Dental Caries
  2. Poor Dental Hygiene
  3. Older patients with comorbid illness
  4. Tobacco Abuse
  5. Immunosuppression
    1. Human Immunodeficiency Virus
    2. Diabetes Mellitus
  6. Exposure to Saliva of a patient with Periodontal Disease
    1. Asikainen (1997) J Am Dent Assoc 128: 1263-71 [PubMed]

IV. Types

  1. Gingivitis
    1. Inflammation of gums (swelling, erythema) that bleed more easily
    2. Periodontal Disease typically starts with Gingivitis
  2. Periodontitis
    1. Inflammation spreads to the periodontal ligament and alveolar bone
  3. Pericoronitis
    1. Localized infection within Gingival flap as tooth erupts (e.g. impacted wisdom tooth)

V. Complications

  1. Fever of Unknown Origin
    1. Siminoski (1993) Clin Infect Dis 16: 550-4 [PubMed]
  2. Bacterial Endocarditis
    1. Ito (2006) J Med Invest 53:189-98 [PubMed]
  3. May be related to pathogenesis of atherosclerosis and other vascular disease
    1. Beck (2005) J Periodontol 76:2089-2100 [PubMed]
    2. Caplan(2006) J Dent Res 85: 996-1000 [PubMed]

VI. Prevention

  1. See Gingivitis

VII. References

  1. Stephens (2018) Am Fam Physician 98(11): 654-60 [PubMed]

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