“Periodontal disease in children: etiology

and pathogenesis. Gingivitis,

periodontitis and periodontal syndrome

in children: prevalence, clinical

manifestations, diagnosis, differential

diagnosis, treatment and prevention”

Lecturer: Dr. Katrin Duda

Gums (also called gingiva). Gums consist of soft,

pink tissue, which covers the alveolar bone.

The gum line is where the tooth meets the gum.

Bone (alveolar bone). This is the bone in which

the roots of teeth are embedded.

Periodontal membrane or ligament. This

connects and attaches the root of the tooth to

the bone.

It is chronic inflammatory disease of the

gum and tissues that surround and support

the teeth. If left untreated, periodontal

disease can lead to tooth loss.

This disease divided into two types:

-Gingivitis

-Periodontitis

Gums that bleed during and after tooth brushing

Red, swollen, or tender gums

Persistent bad breath or bad taste in the mouth

Receding gums

Formation of deep pockets between teeth and gums

Loose or shifting teeth

Changes in the way teeth fit together upon biting down, or in

the fit of partial dentures.

“inflammation around the tooth" - it is a serious

gum infection that damages the soft tissue and

bone that supports the tooth. All periodontal

diseases, including periodontitis, are infections

which affect the periodontium. The periodontium

are the tissues around a tooth, tissues that

support the tooth. With periodontitis, the alveolar

bone around the teeth is slowly and progressively

lost. inflammation.

This is a

destructive infection that

can affect all the periodontal

tissues, that is, the gums,

the underlying bone and the

connecting tissues.

About 20% of adolescents

(14-17 years) develop adult

periodontitis, but the

disease is rare in young

children.

Hormonal changes in females 

Diabetes - patients who live with diabetes have a much higher incidence

of gum disease than other individuals of the same age

AIDS - people with AIDS have more gum diseases

Cancer - and some cancer treatments can make gum diseases more of a

problem

Some drugs - some medications that reduce saliva are linked to gum

disease risk.

Genetics - some people are more genetically susceptible to gum diseases

The possible role of systemic disorders and

systemic exposures in initiating or modifying

the progression of periodontal disease is a

very complex issue. It is however generally

agreed that several conditions may give rise

to an increase prevalence, incidence or

severity of gingivitis and periodontitis

Microbial plaque is the initiator of periodontal

disease but whether it affects a particular

subject, what form the disease takes, and how

it progresses, are all dependent on the host

defenses to this challenge. Systemic factors

modify all forms of periodontal disease

principally through their effects on the normal

immune and inflammatory defenses

Systemic factors most associated with the etiology

and or progression of peritonitis:

A. Diabetes Mellitus

B. Medications

C. Immunosuppressive disorders

D. Environmental Conditions or exposures

E. Hematological Disorders

F. Genetic Disorders.

1.    Chronic Periodontitis: a) localized b) generalized

2.    Aggressive Periodontitis: a) localized b) generalized

3.    Periodontitis Associated with Systemic Diseases

4.    Necrotizing Periodontal Diseases

5.    Abscesses of the Periodontium

6.    Periodontal Diseases associated with Endodontic Lesions

7.    Developmental or Acquired Deformities and Conditions

Most prevalent in adults, but can occur in children

and adolescents

Amount of destruction is consistent with presence of

local factors

Subgingival calculus is a frequent finding

Associated with a variable microbial pattern

Slow to moderate rate of progression but may have

periods of rapid progression

 Patients are otherwise clinically healthy

 Rapid attachment loss and bone destruction

 Familial aggregation and variable features

 Severity of destruction inconsistent with amount of

microbial deposts

 Elevated proportions of Actinobacillus

actinomycetemcomitans

and in some patients Porphyromonas gingivalis

 Hyper-responsive macrophage phenotype

 Progress of bone loss may be self arresting

A small percentage of children (approximately 1%)

develop this form of the disease.

It is a rapidly developing and very destructive form of

periodontitis.

It is associated with a blood cell (leucocyte) disorder.

The disease may be localized to a few teeth or it may be

generalized.

It is caused by specific bacteria, and is treated by a

combination of antibiotic and surgical therapy.

Dental plaque is the major cause of gingivitis and

periodontitis.

The bacteria in the plaque are the major offenders.

The effects of plaque can be even more damaging

if the patient is in poor health, or has a low

resistance to disease.

Periodontal disease is unlikely to be transmitted from

one person to another.

Qualified dentist should

find it fairly

straightforward to

diagnose periodontitis.

The dentist will ask the

patient questions

regarding symptoms and

carry out an examination

of his/her mouth.

Dental plaque is the major cause of gingivitis and

periodontitis.

The bacteria in the plaque are the major offenders.

The effects of plaque can be even more damaging

if the patient is in poor health, or has a low

resistance to disease.

Periodontal disease is unlikely to be transmitted from

one person to another.

pink or coral pink color firm, resilient tissues ”orange-peel” texture shape that follows the contour of the

teeth and forms scalloped edge no areas of redness, swelling or

inflammation no bleeding during daily plaque removal no discomfort

Gingivitis is inflammation of the gum tissue

The gums are irritated and swollen due to plaque or

calculus buildup along the gum line

The gums may be sore, bleed easily and appear puffy, soft

and swollen

Bleeding gum is one of the earliest and most common sings

of gingivitis

The good news about gingivitis is that it is preventable and

reversible through good brushing and flossing techniques/

Hormonal changes, such as those occurring during pregnancy, puberty,

menopause make gums more sensitive, which makes it easier for

gingivitis to develop.

Medications can affect oral health, because some lessen the flow of

saliva, which has a protective effect on teeth and gums.

Bad habits such as smoking make it harder for gum tissue to repair itself.

Poor oral hygiene habits such as not brushing and flossing

on a daily basis, make it easier for gingivitis to develop.

Family history of dental disease can be a contributing

factor for the development of gingivitis.