Presentation on theme: "Pediatric Dentistry “Periodontal disease in children: etiology and pathogenesis. Gingivitis, periodontitis and periodontal syndrome in children: prevalence,"— Presentation transcript:
1 Pediatric Dentistry“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
2 The periodontal tissues are: 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.
3 What is periodontal disease? 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:GingivitisPeriodontitis
4 What Are the Symptoms of Gum Disease? Gums that bleed during and after tooth brushingRed, swollen, or tender gumsPersistent bad breath or bad taste in the mouthReceding gumsFormation of deep pockets between teeth and gumsLoose or shifting teethChanges in the way teeth fit together upon biting down, or in the fit of partial dentures.
5 Periodontitis“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.
6 PeriodontitisThis 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.
7 What are the risk factors for periodontitis? Hormonal changes in females Diabetes - patients who live with diabetes have a much higher incidence of gum disease than other individuals of the same ageAIDS - people with AIDS have more gum diseasesCancer - and some cancer treatments can make gum diseases more of a problemSome drugs - some medications that reduce saliva are linked to gum disease risk.Genetics - some people are more genetically susceptible to gum diseases
8 Systemic Factors As Etiologic Agents 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
9 Systemic Factors As Etiologic Agents 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
10 Systemic Factors as Etiologic Agents 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.
11 Classification of Periodontitis 1. Chronic Periodontitis: a) localized b) generalized2. Aggressive Periodontitis: a) localized b) generalized3. Periodontitis Associated with Systemic Diseases4. Necrotizing Periodontal Diseases5. Abscesses of the Periodontium6. Periodontal Diseases associated with Endodontic Lesions7. Developmental or Acquired Deformities and Conditions
12 Characteristics of Chronic Periodontitis Most prevalent in adults, but can occur in children and adolescentsAmount of destruction is consistent with presence of local factorsSubgingival calculus is a frequent findingAssociated with a variable microbial patternSlow to moderate rate of progression but may have periods of rapid progression
14 Characteristics of Aggressive Periodontitis 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
15 Early onset periodontitis 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.
16 What causes periodontal disease? 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.
17 Diagnosing periodontitis 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.
18 Dental plaque, calculus and tartar 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.
19 Healthy Gum pink or coral pink color firm, resilient tissues ”orange-peel” textureshape that follows the contour of the teeth and forms scalloped edgeno areas of redness, swelling or inflammationno bleeding during daily plaque removalno discomfort
22 Gingivitis Gingivitis is inflammation of the gum tissue The gums are irritated and swollen due to plaque or calculus buildup along the gum lineThe gums may be sore, bleed easily and appear puffy, soft and swollenBleeding gum is one of the earliest and most common sings of gingivitisThe good news about gingivitis is that it is preventable and reversible through good brushing and flossing techniques/
26 What Causes Gum Disease? 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.