The two major forms of periodontal disease are gingivitis and periodontitis. Gingivitis, if not properly treated, in some individuals will develop into the more advanced and destructive periodontitis, which involves loss of gum and bone around the teeth. Both forms require immediate attention.
Scientific advances have improved understanding of the interrelationship between oral and overall systemic health and disease. Chronic inflammation in any part of the body has the potential to cause diseases in other parts of the body. For instance, chronic inflammation of the prostate gland will increase the risk of cardiovascular diseases in men. The same is true of inflammation of the gums in the oral cavity due to gingivitis and periodontitis; it can put the patient at risk for cardiovascular complications.
Physicians use risk assessment to develop prevention schemes for their patients. A good example is obese patients, who are at a higher risk of developing diabetes or heart disease: The prevention scheme would be weight loss and cholesterol-lowering drugs. In a similar manner, risk assessment is required to improve oral health and especially to reduce inflammation.
Risk Factor Identification
According to the American Academy of Periodontology, the risk factors of periodontal disease are numerous. Age is a factor; older patients require evaluation for disease and chronic inflammation. Gender also exercises some influence; males are at greater risk than females for advanced periodontitis. Genetic predisposition is also a major risk factor; there is no definitive genetic test available, but a family history of periodontal problems and tooth loss will give some indication whether an individual may be at risk. The next risk factors are smoking, diabetes, obesity, poor oral hygiene and having had previous experience with periodontal gum disease.
Very simple prevention methods can be applied. The patient's oral hygiene should be improved. The overall goal is to reduce gingival inflammation. Toothpaste with anti-inflammatory properties can be prescribed. A sonic toothbrush is clinically more effective for plaque removal than a generic manual toothbrush. The next and probably the most important part of prevention is regular cleanings and examinations at the dental office. Dental care every six months is very effective in controlling chronic inflammation from periodontal diseases. If examination reveals advancing periodontitis or difficulty in eliminating inflammation of the gingiva, then referral to a periodontist should be made.
Oral and Systemic Health
The patient should be made aware of the connection between periodontal diseases and increasing risks of other health issues. Pregnant patients should be made aware that uncontrolled periodontal disease has the potential to complicate the pregnancy. Other diseases that can be caused or exacerbated by untreated periodontal disease are heart disease, stroke, cancer, pulmonary disease and rheumatoid arthritis.
Periodontal diseases can, if not prevented or treated, put the patient at greater risk for complications from other chronic diseases. Risk assessment for periodontal and other diseases should be part of every dental examination.