Periodontal Health And Systemic Disorders Of Periodontium Question And Answers

Periodontal Medicine And Influence Of Systemic Disorders And Stress On The Periodontium

What is periodontal medicine. What is the impact of periodontal infection on systemic health?
Or
Write in brief about periodontal medicine.
Or
Write short answer on periodontal medicine.
Answer. Periodontal medicine is described as a new field of investigations based on scientific data which suggests that periodontal infections contribute to the morbidity and mortality of certain systemic conditions such as diabetes, atherosclerosis, chronic obstructive pulmonary disease (COPD), ischemic heart disease, stroke.

Read And Learn More: Periodontics Question And Answers

Impact of Periodontal Infection on Systemic Health

Impact of Periodontal Infection on Diabetics

• Systemic antibiotics may eliminate residual bacteria following scaling and root planning, further decreasing the bacterial challenge to the host.
• Tetracyclines are also known to suppress glycation of proteins and to decrease activity of tissue degrading enzymes, such as matrix metalloproteinases.
• Acute bacterial and viral infections have been shown to increase insulin resistance and aggravate glycemic control.
• Systemic infections increase tissue resistance to insulin, preventing glucose from entering target cells, causing elevated blood glucose levels.
• Periodontal treatment designed to decrease the bacterial insult and reduce inflammation might restore insulin sensitivity over time, resulting in improved metabolic control and in diabetic patients with periodontitis, periodontal therapy may have beneficial effects on glycemic control.

Periodontal Disease and Cardiovascular Disease

• Cardiovascular diseases consist of heart and vascular conditions, i.e. ischemia, atherosclerosis, peripheral artery disease, infective endocarditis and acute myocardial infarction and stroke. Periodontal disease and cardiovascular diseases are both related to lifestyle and share numerous risk factors, such as smoking, diabetes and low socioeconomic status.
• Biological basis for hypothetical association of cardiovascular disease and periodontal disease is presently unclear.
• Packet et al. specified four specific pathways have been proposed to explain the plausibility of link between cardiovascular disease and periodontal infections.

These Pathways Include the Following:

• Direct bacterial effects on platelets.
• Autoimmune responses.
• Invasion or uptake of bacteria in endothelial cells and macrophages.
• Endocrine-like effects of proinflammatory mediators.

 

Periodontal Disease and Pregnancy

• Low birth weight infants are those which are less than 2.5 kg weigh during birth.
• Primary cause of low birth weight infant delivery is preterm labor.
• Factors such as smoking, alcohol, low socioeconomic status, hypertension, high or low maternal age and genitourinary infections increase the risk of preterm low birth weight.
• Recently, periodontal infection has also been recognized to induce preterm low birth weight.

 

Periodontal Disease and Respiratory Disease

Periodontal Disease and Acute Respiratory Infections

Pneumonia is an infection of the lungs caused by bacteria, viruses, fungi or mycoplasma, and is broadly categorized as either community-acquired or nosocomial.

• Till today no association has been found between oral hygiene and periodontal disease, and risk for pneumonia in community-dwelling individuals.
• Hospital-acquired pneumonia is usually caused by aspiration of oropharyngeal contents that serve as a rich source for potential respiratory pathogens.
• Potential respiratory pathogens may also originate in oral cavity with dental plaque serving as a reservoir of these organisms.
• Potential respiratory pathogens are more commonly isolated from supragingival plaque and buccal mucosa of the patients in intensive care unit than in outdoor patients.

Periodontal Disease and Chronic Obstructive Pulmonary Disease (COPD)

• COPD shares similar pathogenic mechanism with periodontal disease.
• In both diseases, a host inflammatory response is mounted in response to chronic challenge by bacteria in periodontal disease and by factors, such as cigarette smoke in COPD.
• The resulting neutrophil influx leads to release of oxidative and hydrolytic enzymes that cause tissue destruction directly.
• Individuals with poor oral hygiene have been found to be at increased risk for chronic respiratory diseases such as bronchitis and emphysema; however, these associations remain to be confirmed by further research.

Periodontal Disease and Cancer

• Chronic infections such as periodontitis can play a direct or indirect role in carcinogenesis.
• Microorganisms and their products such as endotoxins, enzymes and metabolic by product are toxic to surrounding cells and may directly induce mutations in tumor suppressive genes and proto-oncogenes, or altered signaling pathways that affect cell proliferation.
• Microorganisms and their products activate host cells, such as neutrophils, macrophages, lymphocytes and fibroblasts to generate reactive oxygen species, which can induce DNA damage in epithelial cells.

Periodontal Disease and Arthritis

• Periodontitis has remarkably similar cytokine profile to rheumatoid arthritis, including IL-l beta, TNF-alpha, TGF-beta, and cytokines that suppress the immunoinflammatory response.
• The destruction of extracellular matrix in both diseases is determined by the balance of matrix metalloproteinases and their inhibitors.
• Bone destruction in periodontitis and rheumatoid arthritis is a result of uncoupling the normally coupled processes of bone resorption and bone formation, with PGE2, IL-l, TNF-alpha, and IL-6 as mediators of bone destruction.
• Periodontitis and rheumatoid arthritis have many pathological features in common, and hence the possibility exist that both conditions result from a common under-lying dysregulation of the host inflammatory response; however, the precise nature of which remains to be established.

Periodontal Disease and Renal Disease

Chronic renal disease can affect oral tissues and can greatly influence the dental management of renal patients, various studies also suggest that chronic periodontitis can contribute to overall systemic inflammatory burden, and may have consequences in the management of the end-stage renal disease patient on hemodialysis maintenance therapy.