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Periodontitis
Aka: Periodontitis, Pyorrhea
- Definition
- Loss of tooth supporting bone structure due to chronic Gingivitis
- Epidemiology
- Common cause of adult tooth loss (esp. men ages 30-50 years)
- Diabetes Mellitus is a common cause
- Pathophysiology
- Chronic Gingivitis results in inflammation of deeper tissues around teeth
- Crevices between gums and teeth enlarge
- Pockets develop in crevices with
- Debris
- Purulent materials
- Consequences
- Loss of tooth supporting bone structure
- Periodontal ligament detaches from tooth
- Types
- Localized Juvenile Periodontitis
- Onset as adolescent (ages 12 to 17 years old)
- Not related to Plaque
- Vertical alveolar bone loss
- Adult Periodontitis
- Onset after age 30 years
- Associated with subgingival dental Plaque
- Symptoms
- Halitosis
- Tooth Pain or sensitivity (esp. with eating)
- Signs
- Red, swollen gums
- Gum margins recede exposing roots of teeth (deep pockets may be present)
- Subgingival dental Plaque
- Friable gums that bleed easily when probed or with flossing or brushing
- Teeth may be loose
- Management
- Surgical Debridement of infected or necrotic tissue by dentist or periodontist
- Scaling and root planing removes Plaque and tartar
- Mouth rinses
- Chlorhexidine Gluconate 0.12% Rinse (Peridex)
- Hexetidine 0.1% Rinse (Oraldene)
- Systemic antibiotics in diffuse involvement
- Oral: Doxycycline or Metronidazole
- Topical: Minocycline
- Complications
- Periodontal Abscess
- References
- Albandar (1997) J Am Dent Assoc 128:1393-9 [PubMed]
- Nguyen (2008) Am Fam Physician 77:797-806 [PubMed]
- Stephens (2018) Am Fam Physician 98(11): 654-60 [PubMed]