Periodontal Disease - Prognosis


Plaque, also known as a biofilm, when examined under a microscope, is made of millions (10^6-8) of bacteria. There are many different types of microbes contained in the biofilm of those with periodontal disease. Two major bacteria implicated are "Porphyromonas gingivalis"and "Aggregatibacter actinomycetemcomitans" A. actinomycetemcomitans is associated with acquired resistance to normal treatments against periodontal disease. P. gingivalis can produce harmful enzymes which disrupt the host immune system and lead to massive tissue destruction. Since a microbe is a living organism, it maintains some of the same properties that we do to survive. Porphyromonas have a life cycle, they have a digestive system, and they reproduce. Bacteria have to eat to survive; they also have to eliminate wastes and are constantly reproducing. Naturally, bacteria are always present in the oral cavity. However, when plaque is not removed on a daily basis, trouble begins.

Bacteria around teeth cause the destruction and foul odors in a person with gum disease, specifically sulfur-containing compounds. Bone is considered to be the foundation and supporting structure of teeth. Bacteria will make themselves at home in the spaces between teeth and release or exhibit compounds that the body's immune response leads to inflammation resulting in bone loss. As bacteria proliferate, the immune response increases and teeth will eventually become loose and either fall out on their own, or are extracted by a dentist. This process is not something that happens overnight.

It is recommended that a dental prophylaxis and thorough examination of the mouth be done every six months, preventing plaque buildup on teeth. Plaque or bacteria, if left for a long period of time, eventually die off. Dead plaque hardens and calcifies and is then referred to as tartar, or calculus. Once the calculus builds up around the teeth, in between them, and the gums, it causes the gums to pull away from the teeth. When the gums pull away from the teeth, a pocket is created which allows food and debris to accumulate, harboring even more bacteria. This also allows bacteria to enter the bloodstream. Studies have shown that heart disease is almost twice as likely to occur in people with gum disease. Studies have also shown that the most common strain of bacteria found in dental plaque may cause blood clots. When blood clots escape into the bloodstream, there is a relation to increased risk of heart attacks, and other illnesses.

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