DOCSLIB.ORG

The Oral Systemic Connection

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
The Oral Systemic Connection The Connection There is no doubt that oral health and general well-being are inextricably bound. Many conditions that plague the body are manifested in the mouth, a readily accessible vantage point from which to view the onset, progress, and management of numerous systemic diseases. What does this mean for traditional dental research? It means that perhaps this term is an anachronism, that it limits the field of inquiry to only the teeth and surrounding tissues, that the word "traditional" no longer applies. In fact, there is nothing traditional about the science of the oral, dental and craniofacial tissues. The teeth and gingiva (gums) are but one vital part of a remarkably dynamic system that touches on virtually every biomedical and behavioral discipline. Research in virology, immunology, genetics, biochemistry, developmental biology, and many other fields is carried out by men and women whose names end in PhD, DDS, and MD. They are laboratory researchers. They are patient-oriented clinical scientists. They see the beauty and order of a world at its molecular level. They engineer genes to correct nature's mistakes. Their educational backgrounds and training experiences are as diverse as the diseases and systems they study. What these scientists share in common, however, is the recognition that oral health is not an independent entity cut off from the rest of the body. Rather, it is woven deeply into the fabric of overall health. The Body's Silent Alarm One human mouth is home to more microorganisms than there are people on our planet earth. The wide array of habitat renders the mouth a microbial paradise, offering preferred accommodations on the cheek, or on the back of the tongue in an anaerobic crevice, or in the moist, oxygen-deprived area between the tooth surface and the adjacent periodontal tissues. The mouth's microbial ecology, however, is extremely sensitive to the challenges that confront its human host throughout the lifespan and, therefore, can often change precipitously. From fetal life through senescence, the mouth's continued exposure to opportunistic infectious pathogens is in balance with host immunity; the balance between these profoundly important processes often serves as a mirror for the detection of not only oral pathology, but also major systemic diseases. It is especially in the soft tissues that this relationship is played out. The lips, tongue, gums, salivary glands, and oral mucosa can all warn of trouble in our general health. Because of their exquisite positioning in the body, these tissues and their fluids form a protective barrier of mucosal immunity to the outside world that when breached, signal clinical disease. They tell of direct assaults by a broad range of systemic disorders such as diabetes, AIDS and Sjögren's syndrome, as well as complications of treatments like cancer chemotherapy and radiation. For some disorders, particularly AIDS and diabetes, oral tissues may reveal lesions or pathology that are the first signs of systemic disease. Oral Opportunistic Infections: Links to Systemic Diseases The periodontium, comprised of the gingiva, bone and other supporting tissues that anchor the teeth, plays a key role in the interplay between oral health and systemic disease. Infection in these tissues, primarily by gram-negative anaerobic bacteria, can initiate a series of inflammatory and immunologic changes leading to the destruction of connective tissue and bone. Long considered a localized infection, periodontal diseases are now linked to a variety of conditions with systemic implications. Chronic Degenerative Diseases Periodontitis, advanced infection of the periodontium that often causes tooth mobility and tooth loss, appears to share genetically determined risk factors with several other chronic degenerative diseases such as ulcerative colitis, juvenile arthritis, and systemic lupus erythematosus. Recent research points to specific genetic markers associated with increased production of the pro-inflammatory cytokines interleukin-1 and TNF as strong indicators of susceptibility to severe periodontitis. This recent finding could lead to early identification of people at most risk for severe periodontal disease and initiation of appropriate thera peutic interventions. Diabetes Mellitus The destructive inflammatory processes that define periodontal disease are closely intertwined with diabetes. Persons with noninsulin-dependent diabetes mellitus (NIDDM) are three times more likely to develop periodontal disease than nondiabetic individuals. Add smoking to the mix, and the chances of developing periodontitis with loss of tooth-supporting bone are 20 times higher. An increased risk for destructive periodontal disease also holds for persons with insulin-dependent diabetes mellitus (IDDM). Much of what is known about the periodontal complications of diabetes has been learned from the Pima Indians of Arizona, who have the highest reported rates of NIDDM in the world. NIDCR-supported research in the Pima community has shown that periodontal infection is more prevalent, more severe, and develops at an earlier age in this population than in nondiabetic persons. As diabetes increases in severity, the rate at which vital tooth-anchoring bone is lost accelerates. Pima Indians with NIDDM are 15 times more likely to be edentulous than those without diabetes. Now there is evidence that a history of chronic periodontal disease can disrupt diabetic control, suggesting that periodontal infections may have systemic repercussions. The exact nature of this complex relationship is not clear. It is likely, however, that increased genetic susceptibility to infection, impaired host response, and the excessive production of collagenase found in periodontal disease may all play important roles in NIDDM. Similarities in the etiology of periodontal and other complications of diabetes have also emerged. Studies have shown, for example, that hyperglycemia is the common basis for diabetic complications in the eyes, kidneys and nerves. Glucose in high concentrations attaches to other molecules, stimulating chemical reactions that produce advanced glycosylation end products. These large molecules accumulate in tissues, causing damage and disrupting normal function. Scientists suspect that these cellular reactions figure as well in the tissue destruction seen in periodontal disease. Investigators are also examining the interplay between periodontal infection and metabolic control. Acute viral and bacterial infections are known to induce insulin resistance, which disrupts blood glucose control. Factors including stress, fever, catabolism, and elevated levels of hormones antagonistic to insulin such as growth hormone, cortisol, and glucagon likely play a role in the development of insulin resistance during infection. It is possible, then, that chronic gram-negative infections with persistent production of bacterial toxins, like periodontal disease, could have the same deleterious effect. If so, would elimination or control of periodontal infection improve metabolic control of diabetes? To explore this hypothesis, researchers designed a treatment protocol specifically to manage diabetes- associated periodontitis in a group of Pima Indians with poorly controlled NIDDM. They found that debridement (deep cleaning to remove hardened plaque below the surface of the gingiva), combined with an antimicrobial solution and a 2-week regimen of the antibiotic doxycycline -- chosen for its anticollagenase activity -- resulted in significant short-term improvement in the concentration of hemoglobin A1c, a measure of average blood glucose levels over 3 months. A control group receiving only debridement did not share the gains in periodontal health, improved hemoglobin A1c levels, and reduced hyperglycemia that the treatment group experienced. These findings offer evidence that chronic infections such as periodontal disease worsen glycemic control and that eliminating these infections could enhance metabolic control in persons with diabetes. Additional large- scale studies are needed to further evaluate the effects of treating periodontitis on blood glucose levels. Future research should also examine, in other populations, the relationship between severe periodontal disease and poor glycemic control that has been evidenced in the Pima Indian community. While work proceeds on the oral complications of diabetes, other studies are exploring the molecular pathogenesis of the disease. NIDCR researchers have identified an important marker protein, IA-2ß, for insulin-dependent diabetes mellitus, an autoimmune disorder which affects close to one million people in the United States alone. Destructive autoantibodies, which attack the body's own insulin-producing beta cells, are the basis of the existing, labor intensive diagnostic test for IDDM. However, the recent identification of target proteins in the pancreas, such as IA-2ß, that react with these autoantibodies makes it possible to develop a rapid and effective test to screen large populations for IDDM. IA2ß, when used in combination with two other known marker proteins, IA-2 and GAD 65 , recognized autoantibodies in 90 percent of persons with IDDM. The presence of autoantibodies to the marker proteins in otherwise normal individuals was also highly predictive in identifying those at risk of developing the disease. In addition, these proteins are candidates for immune tolerance studies, which attempt to prevent the development of destructive autoantibodies and subsequent IDDM. The investigators
Load more

Recommended publications
  • Long-Term Uncontrolled Hereditary Gingival Fibromatosis: a Case Report
    Long-term Uncontrolled Hereditary Gingival Fibromatosis: A Case Report Abstract Hereditary gingival fibromatosis (HGF) is a rare condition characterized by varying degrees of gingival hyperplasia. Gingival fibromatosis usually occurs as an isolated disorder or can be associated with a variety of other syndromes. A 33-year-old male patient who had a generalized severe gingival overgrowth covering two thirds of almost all maxillary and mandibular teeth is reported. A mucoperiosteal flap was performed using interdental and crevicular incisions to remove excess gingival tissues and an internal bevel incision to reflect flaps. The patient was treated 15 years ago in the same clinical facility using the same treatment strategy. There was no recurrence one year following the most recent surgery. Keywords: Gingival hyperplasia, hereditary gingival hyperplasia, HGF, hereditary disease, therapy, mucoperiostal flap Citation: S¸engün D, Hatipog˘lu H, Hatipog˘lu MG. Long-term Uncontrolled Hereditary Gingival Fibromatosis: A Case Report. J Contemp Dent Pract 2007 January;(8)1:090-096. © Seer Publishing 1 The Journal of Contemporary Dental Practice, Volume 8, No. 1, January 1, 2007 Introduction Hereditary gingival fibromatosis (HGF), also Ankara, Turkey with a complaint of recurrent known as elephantiasis gingiva, hereditary generalized gingival overgrowth. The patient gingival hyperplasia, idiopathic fibromatosis, had presented himself for examination at the and hypertrophied gingival, is a rare condition same clinic with the same complaint 15 years (1:750000)1 which can present as an isolated ago. At that time, he was treated with full-mouth disorder or more rarely as a syndrome periodontal surgery after the diagnosis of HGF component.2,3 This condition is characterized by had been made following clinical and histological a slow and progressive enlargement of both the examination (Figures 1 A-B).
    [Show full text]
  • Oral Manifestations of Systemic Disease Their Clinical Practice
    ARTICLE Oral manifestations of systemic disease ©corbac40/iStock/Getty Plus Images S. R. Porter,1 V. Mercadente2 and S. Fedele3 provide a succinct review of oral mucosal and salivary gland disorders that may arise as a consequence of systemic disease. While the majority of disorders of the mouth are centred upon the focus of therapy; and/or 3) the dominant cause of a lessening of the direct action of plaque, the oral tissues can be subject to change affected person’s quality of life. The oral features that an oral healthcare or damage as a consequence of disease that predominantly affects provider may witness will often be dependent upon the nature of other body systems. Such oral manifestations of systemic disease their clinical practice. For example, specialists of paediatric dentistry can be highly variable in both frequency and presentation. As and orthodontics are likely to encounter the oral features of patients lifespan increases and medical care becomes ever more complex with congenital disease while those specialties allied to disease of and effective it is likely that the numbers of individuals with adulthood may see manifestations of infectious, immunologically- oral manifestations of systemic disease will continue to rise. mediated or malignant disease. The present article aims to provide This article provides a succinct review of oral manifestations a succinct review of the oral manifestations of systemic disease of of systemic disease. It focuses upon oral mucosal and salivary patients likely to attend oral medicine services. The review will focus gland disorders that may arise as a consequence of systemic upon disorders affecting the oral mucosa and salivary glands – as disease.
    [Show full text]
  • Dentinal Hypersensitivity: a Review
    Dentinal Hypersensitivity: A Review Abstract Dentinal hypersensitivity is generally reported by the patient after experiencing a sharp pain caused by one of several different stimuli. The pain response varies substantially from one person to another. The condition generally involves the facial surfaces of teeth near the cervical aspect and is very common in premolars and canines. The most widely accepted theory of how the pain occurs is Brannstrom’s hydrodynamic theory, fluid movement within the dentinal tubules. The dental professional, using a variety of diagnostic techniques, will discern the condition from other conditions that may cause sensitive teeth. Treatment of the condition can be invasive or non-invasive in nature. The most inexpensive and efficacious first line of treatment for most patients is a dentifrice containing a desensitizing active ingredient such as potassium nitrate and/or stannous fluoride. This review will address the prevalence, diagnosis, and treatment of dentinal hypersensitivity. In addition the home care recommendations will focus on desensitizing dentifrices. Keywords: Dentinal hypersensitivity, hydrodynamic theory, stannous fluoride, potassium nitrate Citation: Walters PA. Dentinal Hypersensitivity: A Review. J Contemp Dent Pract 2005 May;(6)2:107-117. © Seer Publishing 1 The Journal of Contemporary Dental Practice, Volume 6, No. 2, May 15, 2005 Introduction The prevalence of dentinal hypersensitivity Dentifrices and mouth rinses are routinely used has been reported over the years in a variety as a delivery system for therapeutic agents of ways: as greater than 40 million people such as antimicrobials and anti-sensitivity in the U.S. annually1, 14.3% of all dental agents. Therapeutic oral care products are patients2, between 8% and 57% of adult dentate available to assist the patient in the control of population3, and up to 30% of adults at some time dental caries, calculus formation, and dentinal during their lifetime.4 hypersensitivity to name a few.
    [Show full text]
  • Periodontal Health, Gingival Diseases and Conditions 99 Section 1 Periodontal Health
    CHAPTER Periodontal Health, Gingival Diseases 6 and Conditions Section 1 Periodontal Health 99 Section 2 Dental Plaque-Induced Gingival Conditions 101 Classification of Plaque-Induced Gingivitis and Modifying Factors Plaque-Induced Gingivitis Modifying Factors of Plaque-Induced Gingivitis Drug-Influenced Gingival Enlargements Section 3 Non–Plaque-Induced Gingival Diseases 111 Description of Selected Disease Disorders Description of Selected Inflammatory and Immune Conditions and Lesions Section 4 Focus on Patients 117 Clinical Patient Care Ethical Dilemma Clinical Application. Examination of the gingiva is part of every patient visit. In this context, a thorough clinical and radiographic assessment of the patient’s gingival tissues provides the dental practitioner with invaluable diagnostic information that is critical to determining the health status of the gingiva. The dental hygienist is often the first member of the dental team to be able to detect the early signs of periodontal disease. In 2017, the American Academy of Periodontology (AAP) and the European Federation of Periodontology (EFP) developed a new worldwide classification scheme for periodontal and peri-implant diseases and conditions. Included in the new classification scheme is the category called “periodontal health, gingival diseases/conditions.” Therefore, this chapter will first review the parameters that define periodontal health. Appreciating what constitutes as periodontal health serves as the basis for the dental provider to have a stronger understanding of the different categories of gingival diseases and conditions that are commonly encountered in clinical practice. Learning Objectives • Define periodontal health and be able to describe the clinical features that are consistent with signs of periodontal health. • List the two major subdivisions of gingival disease as established by the American Academy of Periodontology and the European Federation of Periodontology.
    [Show full text]
  • Third Molar (Wisdom) Teeth
    Third molar (wisdom) teeth This information leaflet is for patients who may need to have their third molar (wisdom) teeth removed. It explains why they may need to be removed, what is involved and any risks or complications that there may be. Please take the opportunity to read this leaflet before seeing the surgeon for consultation. The surgeon will explain what treatment is required for you and how these issues may affect you. They will also answer any of your questions. What are wisdom teeth? Third molar (wisdom) teeth are the last teeth to erupt into the mouth. People will normally develop four wisdom teeth: two on each side of the mouth, one on the bottom jaw and one on the top jaw. These would normally erupt between the ages of 18-24 years. Some people can develop less than four wisdom teeth and, occasionally, others can develop more than four. A wisdom tooth can fail to erupt properly into the mouth and can become stuck, either under the gum, or as it pushes through the gum – this is referred to as an impacted wisdom tooth. Sometimes the wisdom tooth will not become impacted and will erupt and function normally. Both impacted and non-impacted wisdom teeth can cause problems for people. Some of these problems can cause symptoms such as pain & swelling, however other wisdom teeth may have no symptoms at all but will still cause problems in the mouth. People often develop problems soon after their wisdom teeth erupt but others may not cause problems until later on in life.
    [Show full text]
  • BIMJ April 2013
    Original Article Brunei Int Med J. 2013; 9 (5): 290-301 Yellow lesions of the oral cavity: diagnostic appraisal and management strategies Faraz MOHAMMED 1, Arishiya THAPASUM 2, Shamaz MOHAMED 3, Halima SHAMAZ 4, Ramesh KUMARASAN 5 1 Department of Oral & Maxillofacial Pathology, Dr Syamala Reddy Dental College Hospital & Research Centre, Bangalore, India 2 Department of Oral Medicine & Radiology, Dr Syamala Reddy Dental College Hospital & Research Centre, Bangalore, India 3 Department of Community & Public Health Dentistry, Faculty of Dentistry, Amrita University, Cochin, India 4 Amrita center of Nanosciences, Amrita University, Cochin, India 5 Oral and Maxillofacial Surgery, Faculty of Dentistry, AIMST University, Kedah, Malaysia ABSTRACT Yellow lesions of the oral cavity constitute a rather common group of lesions that are encountered during routine clinical dental practice. The process of clinical diagnosis and treatment planning is of great concern to the patient as it determines the nature of future follow up care. There is a strong need for a rational and functional classification which will enable better understanding of the basic disease process, as well as in formulating a differential diagnosis. Clinical diagnostic skills and good judgment forms the key to successful management of yellow lesions of the oral cavity. Keywords: Yellow lesions, oral cavity, diagnosis, management INTRODUCTION INTRODUCTI Changes in colour have been traditionally low lesions have a varied prognostic spec- used to register and classify mucosal and soft trum. The yellowish colouration may be tissue pathology of the oral cavity. Thus, the- caused by lipofuscin (the pigment of fat). It se lesions have been categorised as white, may also be the result of other causes such red, white and red, blue and/or purple, as accumulation of pus, aggregation of lym- brown, grey and/or black and yellow.
    [Show full text]
  • Hairy Leukoplakia James E
    Marquette University e-Publications@Marquette School of Dentistry Faculty Research and Dentistry, School of Publications 5-5-2017 Hairy Leukoplakia James E. Cade Meharry Medical College School of Dentistry Richard P. Vinson Paul L Foster School of Medicine Jeff urB gess University of Washington School of Dental Medicine Sanjiv S. Agarwala Temple University Shool of Medicine Denis P. Lynch Marquette University, [email protected] See next page for additional authors Published version. Medscape Drugs & Diseases (May 5, 2017). Publisher link. © 2017 by WebMD LLC. Used with permission. Authors James E. Cade, Richard P. Vinson, Jeff urB gess, Sanjiv S. Agarwala, Denis P. Lynch, and Gary L. Stafford This blog post/website is available at e-Publications@Marquette: https://epublications.marquette.edu/dentistry_fac/252 Overview Background Oral hairy leukoplakia (OHL) is a disease of the mucosa first described in 1984. This pathology is associated with Epstein-Barr virus (EBV) and occurs mostly in people with HIV infection, both immunocompromised and immunocompetent, and can affect patients who are HIV negative.{ref1}{ref2} The first case in an HIV-negative patient was reported in 1999 in a 56-year-old patient with acute lymphocytic leukemia. Later, many cases were reported in heart, kidney, and bone marrow transplant recipients and patients with hematological malignancies.{ref3}{ref4} Pathophysiology The Epstein-Barr virus (EBV), a ubiquitous herpesvirus estimated to infect 90% of the world's population, is linked to a growing number of diseases, especially in immunocompromised hosts. Like all herpesviruses, EBV establishes a life-long, persistent infection of its host. The pathogenesis of hairy leukoplakia is clearly complex, potentially requiring a convergence of factors including EBV co-infection, productive EBV replication, EBV genetic evolution, expression of specific EBV "latent" genes, and immune escape.
    [Show full text]
  • Pathogenic Viruses Commonly Present in the Oral Cavity and Relevant Antiviral Compounds Derived from Natural Products
    medicines Review Pathogenic Viruses Commonly Present in the Oral Cavity and Relevant Antiviral Compounds Derived from Natural Products Daisuke Asai and Hideki Nakashima * Department of Microbiology, St. Marianna University School of Medicine, Kawasaki 216-8511, Japan * Correspondence: [email protected]; Tel.: +81-44-977-8111 Received: 24 October 2018; Accepted: 7 November 2018; Published: 12 November 2018 Abstract: Many viruses, such as human herpesviruses, may be present in the human oral cavity, but most are usually asymptomatic. However, if individuals become immunocompromised by age, illness, or as a side effect of therapy, these dormant viruses can be activated and produce a variety of pathological changes in the oral mucosa. Unfortunately, available treatments for viral infectious diseases are limited, because (1) there are diseases for which no treatment is available; (2) drug-resistant strains of virus may appear; (3) incomplete eradication of virus may lead to recurrence. Rational design strategies are widely used to optimize the potency and selectivity of drug candidates, but discovery of leads for new antiviral agents, especially leads with novel structures, still relies mostly on large-scale screening programs, and many hits are found among natural products, such as extracts of marine sponges, sea algae, plants, and arthropods. Here, we review representative viruses found in the human oral cavity and their effects, together with relevant antiviral compounds derived from natural products. We also highlight some recent emerging pharmaceutical technologies with potential to deliver antivirals more effectively for disease prevention and therapy. Keywords: anti-human immunodeficiency virus (HIV); antiviral; natural product; human virus 1. Introduction The human oral cavity is home to a rich microbial flora, including bacteria, fungi, and viruses.
    [Show full text]
  • Desquamative Gingivitis Desquamative Gingivitis
    DOI: 10.5772/intechopen.69268 Provisional chapter Chapter 1 Desquamative Gingivitis Desquamative Gingivitis Hiroyasu Endo, Terry D. Rees, Hideo Niwa, HiroyasuKayo Kuyama, Endo, Morio Terry D.Iijima, Rees, Ryuuichi Hideo Niwa, KayoImamura, Kuyama, Takao Morio Kato, Iijima, Kenji Doi,Ryuuichi Hirotsugu Imamura, TakaoYamamoto Kato, and Kenji Takanori Doi, Hirotsugu Ito Yamamoto and TakanoriAdditional information Ito is available at the end of the chapter Additional information is available at the end of the chapter http://dx.doi.org/10.5772/intechopen.69268 Abstract Desquamative gingivitis (DG) is characterized by erythematous, epithelial desquama‐ tion, erosion of the gingival epithelium, and blister formation on the gingiva. DG is a clinical feature of a variety of diseases or disorders. Most cases of DG are associated with mucocutaneous diseases, the most common ones being lichen planus, mucous membrane pemphigoid, and pemphigus vulgaris. Proper diagnosis of the underlying cause is important because the prognosis varies, depending on the disease. This chapter presents the underlying etiology that is most commonly associated with DG. The current literature on the diagnostic and management modalities of patients with DG is reviewed. Keywords: gingival diseases/pemphigus/pemphigoid, benign mucous membrane/lichen planus, oral/hypersensitivity/autoimmune diseases 1. Introduction Manifestations of desquamative gingivitis (DG) include erythematous gingiva, epithelial des‐ quamation, and erosion of the gingival epithelium, as well as blister formation on the gingiva [1, 2] (Figure 1). The DG lesions may be localized or generalized and may extend into the alveolar mucosa. Similar lesions are often found on the buccal mucosa, tongue, and palate in the oral cavity. The signs of DG are clearly different from those of dental plaque‐induced gingivitis.
    [Show full text]
  • Clinical Features and Histological Description of Tongue Lesions in a Large Northern Italian Population
    Med Oral Patol Oral Cir Bucal. 2015 Sep 1;20 (5):e560-5. Retrospective study on tongue lesions Journal section: Oral Medicine and Pathology doi:10.4317/medoral.20556 Publication Types: Research http://dx.doi.org/doi:10.4317/medoral.20556 Clinical features and histological description of tongue lesions in a large Northern Italian population Alessio Gambino 1, Mario Carbone 1, Paolo-Giacomo Arduino 1, Marco Carrozzo 2, Davide Conrotto 1, Carlotta Tanteri 1, Lucio Carbone 3, Alessandra Elia 1, Zaira Maragon 3, Roberto Broccoletti 1 1 Department of Surgical Sciences, Oral Medicine Section, CIR - Dental School, University of Turin, Turin, Italy 2 Oral Medicine Department, Centre for Oral Health Research, Newcastle University, Newcastle upon Tyne, UK 3 Private practice, Turin Correspondence: Oral Medicine Section University of Turin CIR – Dental School Gambino A, Carbone M, Arduino PG, Carrozzo M, Conrotto D, Tanteri Via Nizza 230, 10126 C, Carbone L, Elia A, Maragon Z, Broccoletti R. Clinical features and Turin, Italy histological description of tongue lesions in a lar�������������������������ge Northern Italian popu- [email protected] lation. Med Oral Patol Oral Cir Bucal. 2015 Sep 1;20 (5):e560-5. http://www.medicinaoral.com/medoralfree01/v20i5/medoralv20i5p560.pdf Article Number: 20556 http://www.medicinaoral.com/ Received: 21/12/2014 © Medicina Oral S. L. C.I.F. B 96689336 - pISSN 1698-4447 - eISSN: 1698-6946 Accepted: 25/04/2015 eMail: [email protected] Indexed in: Science Citation Index Expanded Journal Citation Reports Index Medicus, MEDLINE, PubMed Scopus, Embase and Emcare Indice Médico Español Abstract Background: Only few studies on tongue lesions considered sizable populations, and contemporary literature does not provide a valid report regarding the epidemiology of tongue lesions within the Italian population.
    [Show full text]
  • Periodontal Disease)
    Patient Fact Sheet Gum Disease (Periodontal Disease) It can often go unnoticed – until it’s too late. While you may not think periodontal (gum) disease affects you, 75 percent of adults over the age of 35 show signs and symptoms. In fact, periodontal disease is the leading cause of tooth loss in adults. Why? Because it occurs at an age when cavities are usually a thing of the past and the initial symptoms often go unnoticed. Recent studies have also shown a possible link between periodontal disease and heart disease. One theory in support of this is that the bacteria that cause periodontal disease enter the bloodstream and promote blood clots and narrowing of the arteries that cause heart attacks. It has also been shown that if a woman develops severe periodontal disease during pregnancy, she is more likely to give birth to a low birth weight infant. Research also shows periodontal disease is linked to many other health problems, as well. What is gum (periodontal) If I have no symptoms, how do I How can I prevent periodontal disease? What causes it? know if I have gum disease? disease? Periodontal disease, or gum disease, is a bacterial Periodontal disease can be easily detected by your • Brush your teeth twice a day with a soft-bristled infection of the gums, ligaments and bone that support general dentist or a periodontist (a specialist in toothbrush. Hold the brush at a 45-degree angle to the teeth and anchor them in the jaw. The bacteria, periodontal diseases) during regular dental the gum line and gently clean where the gums meet which act mainly on certain carbohydrates in our diets, examinations.Therefore, regular checkups, ideally every your teeth.
    [Show full text]
  • Hereditary Gingival Fibromatosis, Inherited Disease, Gingivectomy
    Clinical Practice 2014, 3(1): 7-10 DOI: 10.5923/j.cp.20140301.03 Hereditary Gingival Fibromatosis - A Case Report Anand Kishore1,*, Vivek Srivastava2, Ajeeta Meenawat2, Ambrish Kaushal3 1King George Medical College, Lucknow 2BBD College of dental sciences 3Chandra Dental College & Hospital Abstract Hereditary gingival fibromatosis is characterized by a slow benign enlargement of gingival tissue. It causes teeth being partially or totally covered by enlarged gingiva, causing esthetic and functional problems. It is usually transmitted both as autosomal dominant trait and autosomal recessive inheritance although sporadic cases are commonly reported. This paper reports three cases of gingival fibromatosis out of which one was in a 15 year old girl treated with convectional gingivectomy. Keywords Hereditary gingival fibromatosis, Inherited disease, Gingivectomy having the gingival enlargement before the patient’s birth 1. Introduction and she got operated in the village government hospital. No further relevant medical history was present. Hereditary gingival fibromatosis (HGF) or Idiopathic gingival fibromatosis is a rare, benign, asymptomatic, non-hemorrhagic and non-exudative proliferative fibrous lesion of gingival tissue occurring equally among men and women, in both arches with varying intensity in individuals within the same family [1]. It occurs as an autosomal dominant condition although recessive form also does occur. Consanguinity seems to increase the risk of autosomal dominant inheritance. It affects the marginal gingival, attached gingival and interdental papilla presenting as pink, non-hemorrhagic and have a firm, fibrotic consistency [2]. It also shows a generalized firm nodular enlargement with smooth to stippled surfaces and minimal tendency to bleed. Figure 1. Gingival enlargement However, in some cases the enlargement can be so firm and dense that it feels like bone on palpation [3].
    [Show full text]