periodontal disease; gum disease; gingival disease
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Introduction
Diseases of the gums & other structures around the teeth.
Etiology
- most commonly mixed bacterial infection
- Pseudomonas gingivalis is a common isolate
- Pseudomonas melaninogenica
- anaerobes
- other periodontal bacteria enriched in periodontal disease
- Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Prevotella spp, Porphyromonas endodontalis, Fretibacterium fastidiosum
- risk factors:
- oral fungal infections (esp Candica albicans) in patients with dentures[2]
Pathology
- proposed causative factors
- diminished neutrophil function
- abnormalities in collagen metabolism
- formation of advanced glycation end products[2] which adversely affect collagen & blood vessels
- xerostomia
- association with cardiovascular disease, not causal[3]
- proposed association with amyloid deposition in Alzheimer's disease[9]
Complications
- aspiration pneumonia*[2]
- atherosclerosis (association, no evidence causation)[3]
- postmenopausal women with periodontal disease have excess risk for breast cancer, lung cancer, esophageal cancer[8]*, gastric cancer[8], gallbladder cancer & melanoma[7],
- increased risk for colon cancer[10]
* bacteria originate from plaque on natural teeth & on dental prostheses (dentures)[2]
* oral microbiome may be implicated in esophageal cancer & gastric cancer (specifically adenocarcinoma)[8]
Management
- treatment of periodontal disease may improve outcomes & reduce costs in patients with diabetes mellitus type 2 &/or cardiovascular disease[4]
- treatment of periodontal disease may improve outcomes & reduce costs in pregnant patients[4]
More general terms
More specific terms
- genetic disease of the gums; hereditary periodontal disease
- giant cell epulis
- gingivitis
- periodontal abscess
- periodontitis
Additional terms
References
- ↑ Harrison's Principles of Internal Medicine, 13th ed. Isselbacher et al (eds), McGraw-Hill Inc. NY, 1994, pg 200
- ↑ 2.0 2.1 2.2 2.3 2.4 Geriatric Review Syllabus, 7th edition Parada JT et al (eds) American Geriatrics Society, 2010
Geriatric Review Syllabus, 9th edition (GRS9) Medinal-Walpole A, Pacala JT, Porter JF (eds) American Geriatrics Society, 2016 - ↑ 3.0 3.1 3.2 Friedewald VE, Kornman KS, Beck JD, The American Journal of Cardiology and Journal of Periodontology Editors' Consensus: periodontitis and atherosclerotic cardiovascular disease. Am J Cardiol. 2009 Jul 1;104(1):59-68. PMID: https://www.ncbi.nlm.nih.gov/pubmed/19576322
Lockhart PB et al AHA Scientific Statement Periodontal Disease and Atherosclerotic Vascular Disease: Does the Evidence Support an Independent Association? A Scientific Statement From the American Heart Association Circulation April 18, 2012 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22514251 <Internet> http://circ.ahajournals.org/content/early/2012/04/18/CIR.0b013e31825719f3 - ↑ 4.0 4.1 4.2 Jeffcoat MK, Jeffcoat RL, Gladowski PA et al Impact of periodontal therapy on general health: evidence from insurance data for five systemic conditions. Am J Prev Med 2014;47:166-174 PMID: https://www.ncbi.nlm.nih.gov/pubmed/24953519
- ↑ Vedin O, Hagstrom E, Gallup D Periodontal disease in patients with chronic coronary heart disease: Prevalence and association with cardiovascular risk factors. Eur J Prev Cardiol. 2015 Jun;22(6):771-8. PMID: https://www.ncbi.nlm.nih.gov/pubmed/24721691
- ↑ Yasui M, Ryu M, Sakurai K, Ishihara K. Colonisation of the oral cavity by periodontopathic bacteria in complete denture wearers. Gerodontology. 2012 Jun;29(2):e494-502. PMID: https://www.ncbi.nlm.nih.gov/pubmed/21929616
- ↑ 7.0 7.1 Nwizu NN, Marshall JR, Moysich K et al. Periodontal disease and incident cancer risk among postmenopausal women: Results from the Women's Health Initiative observational cohort. Cancer Epidemiol Biomarkers Prev 2017 Aug; 26:1255 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28765338 <Internet> http://cebp.aacrjournals.org/content/26/8/1255
- ↑ 8.0 8.1 8.2 8.3 Swift D Dysbiotic Oral Microbiome May Raise Cancer Risk
Periodontitis and tooth loss tied to two specific cancers MedPage Today. July 20, 2020 https://www.medpagetoday.com/gastroenterology/generalgastroenterology/87649
Lo CH, Kwon S, Wang L Periodontal disease, tooth loss, and risk of oesophageal and gastric adenocarcinoma: a prospective study. Gut (BMJ Jourrnal). 2020. July PMID: https://www.ncbi.nlm.nih.gov/pubmed/32690603 https://gut.bmj.com/content/early/2020/06/30/gutjnl-2020-321949 - ↑ 9.0 9.1 Kamer AR, Pushalkar S, Gulivindala D et al Periodontal dysbiosis associates with reduced CSF Abeta42 in cognitively normal elderly. Alzheimer's & Dementia: Diagnosis, Assessment, & Disease Monitoring 2021. April 12 PMID: https://www.ncbi.nlm.nih.gov/pubmed/33869725 PMCID: PMC8040436 https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/dad2.12172
- ↑ 10.0 10.1 Worcester S Gum Disease Linked to Colorectal Cancer: COLDENT Study. Medscape February 10, 2022 https://www.medscape.com/viewarticle/968247
Idrissi Janati A, Karp I, Latulippe JF et al Periodontal disease as a risk factor for sporadic colorectal cancer: results from COLDENT study. Cancer Causes Control. 2022. 33(3):463-472. Jan 26. PMID: https://www.ncbi.nlm.nih.gov/pubmed/35079924 https://link.springer.com/article/10.1007/s10552-021-01541-y - ↑ National Institute of Dental and Cransiofacial Research Periodontal (Gum) Disease https://www.nidcr.nih.gov/health-info/gum-disease/more-info