June 2014

Over Half of UK Adults are Affected by Periodontitis

Periodontitis is an inflammatory condition affecting the supporting tissues of the tooth. Destructive periodontitis - where the damage is essentially irreversible - is generally classified as either chronic or aggressive. The aggressive form is associated with early onset and a rapid progression rate that leads to more severe tissue destruction.

In the UK, more teeth are lost through periodontitis than as a result of caries. A recent national Adult Dental Health Survey found that 54% of adults aged over 16 had moderate signs of periodontal disease in one or more teeth (pocket depth > 3.5mm). More severe periodontal disease (pocket depth > 5.5mm) was found in 5% of the population, the majority of whom were over 65 years.

As periodontitis is usually progressive and develops slowly in most people, it is much less common in children. Management of gingivitis in childhood therefore needs to incorporate effective oral hygiene practices that can be carried on into early adulthood and beyond.

New Classification for Periodontal Disease? New Research Looks at the Possibility

Biofilm is the main contributing factor in most cases of periodontitis. But the progression of the disease can be caused by a number of things such as poor nutrition, smoking, stress and underlying medical conditions such as diabetes. Social, behavioural, genetic factors and microbiologic ones may also need consideration - this has been a line of thinking for a while.¹

Recent research² looked into this theory further to investigate the pathophysiology of both chronic and aggressive periodontitis. The researchers had recognised the fact that at the moment, accepted classifications lack an unequivocal pathobiology-based foundation. Therefore, they wanted to discover if gingival tissue transcriptonomes could serve as a basis for yet another type of this condition. Data from 241 gingival tissue biopsies was obtained from 120 healthy non-smokers with periodontitis. The data generated two distinct clusters of patients that did not align with the current classification of chronic and aggressive periodontitis. The patients in the two clusters did not differ in respect to age, but presented with distinct phenotypes. Therefore, the findings suggest that the distinct gene expression signatures in pathological gingival tissues translate into phenotypic differences and provide a basis for a totally new classification of periodontitis.

  1. Complement-targeted Theraputics in Periodontitis, George Hajishengallis and John D. Lambris, accessed 22 April 2014
  2. Gingival Tissue Transcriptomes Identify Distinct Distinct Periodontitis Phenotypes, M. Kebschull et al, J DENT RES published online 19 March 2014.

Ultra Water Flosser WP-120 What This Means For You

A pathophysiological clarification for periodontitis may soon affect how you treat it. As treatment costs rise at the NHS every year, new and effective options to account for a new classification of the condition are very important. Treatment currently starts with instructing the patient how to practise the basics of good oral hygiene. Non-surgical scaling or root planing may also be needed. More research is required about these complement pathways, so that treatment can be targeted to defend against specific forms of periodontitis developing or worsening. Complement-targeted drugs may therefore prove effective as adjunctive treatments for periodontitis in the near future, in addition of course to good oral hygiene routines.

The Water Flosser has been shown to modulate the inflammatory process and host response to biofilm. Consider it for all patients but especially for individuals who are genetically predisposed to more aggressive forms of periodontal disease.

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