What is Periodontics?

Periodontics is the dental specialty focusing on the prevention, diagnosis, and treatment of diseases affecting the supporting structures of the teeth, including the gums, alveolar bone, cementum, and periodontal ligament.


Anatomy of the Periodontium

  • Gingiva: Soft tissue surrounding the teeth.
  • Alveolar Bone: Bone that contains the tooth sockets.
  • Periodontal Ligament: Connective tissue fibers anchoring teeth to bone.
  • Cementum: Hard tissue covering the tooth root.

Periodontal Anatomy Diagram


Common Periodontal Diseases

Disease Description Symptoms Treatment Options
Gingivitis Inflammation of gums Red, swollen gums Improved oral hygiene, cleaning
Chronic Periodontitis Progressive loss of bone and tissue Loose teeth, bleeding Scaling, root planing, surgery
Aggressive Periodontitis Rapid tissue and bone destruction Early onset, rapid loss Antibiotics, surgery
Necrotizing Periodontal Diseases Tissue death due to infection Pain, ulceration Debridement, antibiotics

Pathogenesis

  1. Plaque Formation: Bacterial biofilm accumulates on teeth.
  2. Inflammation: Immune response causes gum swelling.
  3. Destruction: Enzymes and toxins destroy connective tissue and bone.
  4. Pocket Formation: Space develops between tooth and gum.

Risk Factors

  • Poor oral hygiene
  • Smoking
  • Diabetes
  • Genetic predisposition
  • Stress
  • Certain medications

Diagnosis

  • Clinical examination (probing depth, bleeding)
  • Radiographs (bone loss)
  • Microbial analysis

Treatment Modalities

  • Non-surgical: Scaling and root planing, antibiotics, laser therapy
  • Surgical: Flap surgery, bone grafts, guided tissue regeneration

Case Studies

Case Study 1: Aggressive Periodontitis in Adolescents

A 16-year-old presents with rapid loss of attachment and bone around molars and incisors. Despite good oral hygiene, the disease progresses quickly. Genetic testing reveals a mutation in the IL-1 gene, increasing susceptibility.

Case Study 2: Diabetes-Associated Periodontitis

A 45-year-old diabetic patient shows severe gum inflammation and bone loss. Blood glucose control improves periodontal outcomes after scaling and root planing.

Case Study 3: Smokers and Periodontal Disease

A smoker with chronic periodontitis shows poor response to conventional therapy. Smoking cessation leads to improved healing and reduced pocket depth.


Table: Prevalence of Periodontal Disease by Age Group (2023 Data)

Age Group Prevalence (%) Severe Cases (%)
12-17 8 1
18-34 22 5
35-49 38 12
50+ 60 25

Source: Global Periodontal Health Survey, 2023


Latest Discoveries

  • Link to Systemic Health: Recent studies confirm associations between periodontitis and systemic diseases such as cardiovascular disease, Alzheimer’s, and adverse pregnancy outcomes.
  • Microbiome Advances: Next-generation sequencing reveals previously unknown bacteria in periodontal pockets, changing treatment strategies.
  • Regenerative Therapies: Stem cell-based approaches and growth factors show promise for regenerating lost bone and tissue.

Recent Study

A 2022 article in the Journal of Clinical Periodontology (“The oral microbiome in health and disease”) found that shifts in the oral microbiome can predict the onset of periodontitis months before clinical symptoms appear.
_Citation: Willis, J.R., et al. (2022). The oral microbiome in health and disease. J Clin Periodontol, 49(S22), 4–13. https://doi.org/10.1111/jcpe.13791_


Surprising Facts

  1. Periodontal bacteria can enter the bloodstream and affect distant organs, including the heart and brain.
  2. Certain genetic markers can predict an individual’s risk of developing severe periodontitis.
  3. Plastic pollution has been found in the deepest parts of the ocean and microplastics are now detected in human oral tissues, raising concerns about environmental impacts on oral health.

Prevention Tips

  • Brush twice daily with fluoride toothpaste
  • Floss daily
  • Regular dental check-ups
  • Avoid tobacco
  • Manage systemic health conditions

Diagram: Stages of Periodontal Disease

Stages of Periodontal Disease


References

  • Willis, J.R., et al. (2022). The oral microbiome in health and disease. J Clin Periodontol, 49(S22), 4–13. Link
  • Global Periodontal Health Survey, 2023

Further Reading

  • American Academy of Periodontology: www.perio.org
  • Journal of Clinical Periodontology