Diagnosing periodontal disease: new tools to solve an old problem

Article Abstract:

A review is presented of newly developed approaches to the treatment of periodontal disease (disease of the gums and other structures that support the teeth). If untreated, periodontitis (inflammation of the gums and other structures around the teeth) can lead to loss of bone, teeth, and jaw mobility, as well as to the formation of abscesses. Older methods of evaluating periodontal health include probing and radiography, but these provide only limited information about the ongoing nature of disease. Radiographs (X-rays), for instance, cannot tell when visible damage occurred, and probing only reveals damage when it has progressed considerably. Newer methods allow testing for bacteria in the mouth that are believed to cause periodontal disease. Formerly, bacteria had to be grown under laboratory conditions to allow their identification, a process impossible for many mouth bacteria, which die on exposure to air. Now, DNA probe technology can compare the DNA of sampled bacteria with known patterns, regardless of whether the bacteria are dead or alive. Progress has also been made in knowledge regarding the bacterial strains that cause periodontal disease: at least 15 such strains are believed to be pathogens in adults. Immunological tests to evaluate host (patient) response to pathogens are under development, as are tests that evaluate the activity of periodontal disease. Some of these simply involve the insertion of strips into the area near the tooth to test for concentrations of enzymes associated with tissue damage or destruction. Bone scans can help gauge the extent of bone disease, and radiographic techniques have been improved so that very small changes can be detected. Electronic probes can reduce the errors and variability inherent in manual probing. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Diagnosing periodontal diseases

Article Abstract:

Dentists have long known that the leading cause of tooth loss is periodontal disease, and the public is beginning to understand this as well. Periodontal disease affects the bone and gums that support the teeth; eventually teeth loosen and fall out or must be pulled. Early diagnosis can prevent tooth loss, and make it possible for the patient to keep his or her own teeth for life. Every time a patient sees a dentist, the periodontium should be examined for signs of early deterioration. As many as 80 percent of the people in the United States have some degree of periodontal disease; even children and adolescents can develop this condition, but it is most common as a chronic disorder in adults. Healthy gums are pale pink, firm, and not easily moved away from the teeth. When probed gently with a dental instrument, healthy gums do not bleed. But in the early stages of periodontal disease (also called gingivitis), the gums are inflamed, bleed easily, and show changes in color and texture. The main cause of the inflammation is bacterial plaque, which forms continuously on teeth and needs to be removed by measures such as brushing and flossing. As the condition progresses, the bone tissue that supports the teeth (surrounding the roots) begins to break down, and the dentist can insert a probe into the spaces around and between teeth. Eventually pockets form around teeth and they become loose, leading to tooth loss. The examination for diagnosing periodontal disease includes visual inspection of teeth and gums, probing with a dental instrument, and X-rays (to observe underlying bone structures). (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Teeth, Preventive dentistry

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