PERIODONTOLOGY

DENT 1306

Periodontology is an essential course, as it discusses common conditions that a variety of clients will present with in practice. This content of the course was straight forward; however, the course was challenging due to the amount of information that needed to be retained. There is a lot of information to know regarding periodontology, including the associated conditions and complications that may occur systemically as a result or cause of the oral implications. It is important to be aware of the periodontitis that may occur as a result of systemic disease, due to the fact that a variety of clients, specifically the older generations, will present with many co-morbidities that could lead to the development of periodontitis. By drawing this connection from a client's medical history and assessing the associated periodontal risk, a more effective and client-centred appointment plan can be developed, resulting in better client care.

Periodontitis as a Result of Systemic Disease

Hemorrhagic Periodontitis Associated with Blood Disorder

This may be due to an abnormality in the structure or function of blood and blood-forming tissues, including red cells, white cells, platelets, and clotting factors.

Periodontitis Associated with PMN Deficiency

This form of periodontitis may result in the exfoliation of permanent dentition upon eruption.

Periodontitis Associated with Leukemia

In clients with Leukemia, their bodies have abnormal white blood cells that do not function properly.

Periodontitis Associated with HIV Infection

One of the most common HIV-associated periodontal conditions is linear gingival erythema (LGE). This is a gingival manifestation of immunosuppression, and appears as a distinct linear red band on the free gingiva. It does not respond to improved home care routines or periodontal instrumentation.

Necrotizing Periodontal Diseases

Necrotizing Ulcerative Gingivitis (NUG)

In clients with NUG, tissue necrosis is limited to the gingival tissues, primarily the interdental and marginal gingiva. This is very painful for the client. It is characterized by partial loss of interdental papillae, gingival bleeding, and pain. Systemically, the client may be experiencing fever, malaise, and swollen lymph nodes. It may also be an early stage of necrotizing ulcerative periodontitis (NUP).

Necrotizing Ulcerative Periodontitis (NUP)

In clients with NUP, there is necrosis not only of gingival tissues, but there is also a loss of the periodontal ligament and alveolar bone levels. This is a painful infection that can produce attachment loss within days. Like NUG, it also results in systemic symptoms, including fever, malaise, and swollen lymph nodes. Characteristics of NUP also include rapid gingival recession, rapid irregular bone loss, delayed healing, and a spread of infection to the surrounding oral mucosa.

Predisposing Factors for Necrotizing Periodontal Diseases (NPD)

NPD reflects a diminished systemic resistance to bacterial infection. The following are factors that may contribute to the development or progression of NUG or NUP:

Systemic diseases that lead to immunosuppression
Poor oral home care routine
Emotional stress
Inadequate sleep
Alcohol use
Cigarette smoking
Caucasian background
Poor eating habits
Poor nutrition, particularly a lack of protein intake

Sokransky Microbial Complexes

Socransky complexes are groups of microorganisms that are organized based on their association with health or disease.

Yellow and green complexes are early colonizing bacteria that are compatible with gingival health.

Orange and red complexes are major etiologic agents of periodontal disease.

Study Notes Review

This study session reminded me to always look at a client as a whole, not only taking into consideration home care routine, or oral habits, but also looking into the systemic conditions present. By going over this material, I am able to better identify links better a client's systemic condition and their oral health status. By drawing this link between a client's oral health and overall health, I will be able to modify my care in order to make it more client-centred. Many systemic conditions cause the oral cavity to be more sensitive, which means that dental hygiene care should accommodate this. Also, when developing a treatment plan, additional aids may be recommended, based on the knowledge that symptoms may arise due to the present systemic condition. By reviewing these periodontology chapters, I was able to enhance my knowledge on the subject, which will result in better client care.