Natalie+&+Bianca

http://moabdental.wordpress.com/   Periodontal Disease




 * TITLE:** Periodontal Disease: Teeth's Worse Nightmare
 * AUTHOR:** Natalie Ventimiglia
 * DATE:** December 7, 2010
 * ABSTRACT:** Periodontal Disease comes in the form of three progressive stages caused by bacteria and inflammation. The gum and bone in the mouth are destroyed by dental plaque that has accumulated throughout a period of time. Researchers are still searching to find the exact causes of Periodontal Disease. Through laboratory tests, biologists receive techniques and knowledge of the bacteria present in this disease. The role of chemicals will be discussed, which allows this disease to stay active.
 * INTRODUCTION:** Choosing this topic was easy for me. I plan on become a dental hygienist. Learning about the infectious bacteria that can form in one’s mouth is not only something that I need to know it is also a subject that interests me. Researching what happens in one’s mouth, due to lack of dental hygiene, I was able to see reasons why gum disease occurs. Without dental hygiene plaque forms to one’s teeth creating a series of events to happen, and with out removal of this plaque one can eventually lose their teeth.
 * DISCUSSION:** Throughout Periodontal Disease the bacteria plays the main role in causing the mouth to slowly decay over time. During this disease the gum and bone that support the teeth are being destroyed because of a large build up of bacteria. This build up of bacteria is in forms of biofilms, attached to the gingival crevice regions of the teeth. These biofilms are considered to be dental plaque. Plaque in the mouth consisted of bacteria and dextran (Tortora et al, 709). These both play a role creating acid, and begin to destroy one’s gum (Page, 232). During the first stage, gingivitis, gum will begin to bleed when one brushes their teeth, due to gum sensitivity. The gum is sensitive because the plaque is beginning to break down the gum tissue. This occurs due to the lack of one’s dental hygiene. When one does not brush their teeth for one to two weeks a large amount of plaque forms. Untreated, more plaque forms causing more bacteria to release molecules that induce infection. The next stage in this disease will occur once periodontal pockets are formed. These are formed because the gum is being broken down, causing the teeth to separate from the gum, forming pockets of pus. The inflammation and the pocket will increase (Tortora et al., 709). There are many reasons why inflammation occurs. The dental plaque is responsible for triggering the certain molecules that pass through the cell walls of the gingival, causing inflammation (Page, 232). These molecules will then be responsible for controlling and mediating inflammation (Page, 235). Periodontitis, the final stage, occurs due to the previous implications. During this stage the disease becomes chronic and the bone begins break away. The plaque will continuously eat away the gum and bone causing the teeth to become loose. This can eventually result into loss of teeth (Tortora et al., 709). During a sectional study scientists were able to prove a direct relationship between bone loss and dental hygiene ( Socransky, 204)

 http://www.diabetesmonitor.com/learning-center/detection-and-prevention-of-periodontal-disease.htm

Bacteria that is mostly found in patients with periodontal disease is gram negative. The body’s immune system will react to this and, in the later stages of periodontal disease, will begin to fight off the chemicals by forming antigens and antibodies (Kenane, 289-290). The main species found in the mouth is //Porphyromona// s (Tortora et al., 709). Since gingivitis and periodontalitis is an infection, the body’s lymphatic system will respond by providing T-cells and B-cells. During gingivitis, T-cells are present. As the infection increases the amount of B-cells and plasma cells also increases (Gemmel, 388). Scientist, in the lab, test microorganisms responsible for periodontal disease. During their tests there are many different variables that will come into play. During the processing of sampling and identifying bacteria, in periodontal disease, many different problems may occur. While sampling bacteria from an infected mouth there is a concern of receiving a mixture of normal bacteria and periodontal bacteria. Scientist are attempting to extract the bacteria that is causing the gum disease. However, it is hard to identify the bacteria due to many different complications in the laboratory. If a culture if left unexamined and becomes old a test that would normally be gram positive may turn out to be gram negative. These test have to be done numerous times to make sure the results are accurate. The two scientists Stutman and Gordan where able to prove that obligated anaerobes where living in the gums of patients. They did this by exercising the Hungate technique. By excluding the atmosphere oxygen from their cultures, the amount of gingival bacteria increased by 67%. With the end results being, 50% obligated anaerobes, this shows that these bacteria are able to live and function without oxygen (Socransky, 207). These results show why infections last and only progress. Since the bacteria are able to live without oxygen they can stay strong and go deep into the gum tissue of the mouth. The importance of dental hygiene was determined through a study where 480 patients were taken, some in a control group and some in an experimental group, and tested the effect of dental care. Through this three year process scientists were able to find that people that were seen every two months for the first two years and once every three months the last year come out with little to no gum or bone damage in the mouth. This was their experimental group. They were able to teach good hygiene to these patients and keep a steady eye on the care they needed throughout the years. Their control group were patients that were seen once a year, an average persons dental care. These patients were given their regular dental care. However, these patient's results were different. They showed to have gingivitis and loss of periodontal tissue (Axelsson, 133-138).

When imagining the cleanliness of one’s mouth, the average person does not think about the biofilm and plaque that are forming within the hours after they had brushed their teeth. Bacteria form rapidly and with out the hygiene required to keep a healthy mouth one will eventually begin to lose their supporting structures around their teeth. Even though the lymphatic system is creating an immune response the gum will be eaten away, if uncared. Through dental therapy and possibly, surgery, the state of ones mouth can be fixed. Brushing and flossing one’s teeth will help prevent periodontal disease from occurring by removing the plaque on a regular basis. Axelsson, P., and J. Lindhe. "Effect of control of oral hygiene procedures on caries and periodontal disease." journal of clinical periodontology 5.2 (2005): 133-151. Web. 6 Dec 2010. .
 * LITERATURE CITED:**

Gemmell, E., CL. Carter, DNJ Hart, KE Drysdale, and DH Seymour. "Oral Microbiology Immunology." Antigen presenting cells in human periodontal disease tissue 17.6 (2002): 388-393. Web. 6 Dec 2010. .

Kenane, Denis F., John Mooney, and Jeffery L. Ebersole. "Humoral Immune Response to Actinobacillus actinomycetemmcomitans and Porphyromonas gingivalis." Periodontology 2000 20.1 (2007): 289-340. Web. 6 Dec 2010. .

Page, Roy C. "The role of inflammatory mediators in the pathogenesis of periodontal disease." Journal of Periodontal Research 26.3 (2006): 230-242. Web. 5 Dec 2010. Socransky, Sigmund S. "Relationship of Bacteria to the Etiology of Periodontal Disease" JDENTRES February 1970 49: 203-222, doi:10.1177/00220345700490020401

Tortora, Gerard J., Funke Berdell R., and Case L. Christine. Microbiology an Introduction. 10th ed. San Francisco: Pearson Education Inc, 2010. 1-812.