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Query: UMLS:C0031099 (periodontitis)
 12,489 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The situation of public dental insurance systems of several countries in Western Europe was examined in the light of the fact that caries and periodontitis may be prevented. Available epidemiological data were discussed as to their relevance. In Switzerland, dental insurance systems are of minor importance. In voluntary insurance plans for adults, prevention is scarcely included. On the other hand, the communities provide subsidies for dental care of schoolchildren, and prevention is an integral part of this system. In the German Federal Republic, dental insurance costs have quadrupled during the period 1970-1977. Preventive measures are not subsidized, and in recent years, more than half of the insurance payments were used for prosthetic dentistry. The few dental statistics available show that dental treatment of children is unsatisfactory. In Sweden, preventive measures are refunded at 75%. Since the introduction of the public insurance system in 1974 prosthetic dental work has increased at the expense of conservative treatment. In France, the social security system pays for about three quarters of conservative and simple prosthetic work. Prevention has so far not been included. Despite liberal refunding of restorative work markedly higher prevalence of tooth loss was found in lower social levels as compared to higher levels. In Great Britain, the National Health Service was introduced in 1948. As in France, tooth loss is most frequent in lower social levels. The findings are discussed with respect to cost developments and oral health prospects in Switzerland. Attention is focused upon the observation that the insurance systems were conceived at a time when realistic preventive programs were unavailable and their success had not yet been demonstrated in large groups.
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PMID:[Dental insurance systems in light of present-day prevention potentials]. 29 44

Gingivitis and periodontitis account for more than 95% of all inflammatory diseases of the tissues surrounding the teeth, comprising the principal cause of tooth loss in adults. Gingivitis is a relatively innocuous inflammation of the gums, with associated bleeding and exudation. Gingivitis may convert to periodontitis, a destructive aggressive disease with resorption of alveolar bone, destruction of collagen with fibrosis, and formation of deep pockets around the necks of the teeth. Gingivitis and periodontitis are caused by microorganisms populating the gingival sulcus and periodontal pocket. Treatment is directed toward arresting the progress of the disease through debridement and stabilization of the teeth. Toothbrushing and other measures by which the teeth are mechanically cleaned remain the most effective way to control plaque accumulation and periodontal disease.
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PMID:Chronic inflammatory gingival and periodontal disease. 67 30

Chronic periodontitis, a common disease of microbial origin, is the major cause of tooth loss in adult humans. The disease serves as a convenient experimental model for analysis of many aspects of chronic inflammation. A consideration of currently available data has permitted the formulation of a new concept of the pathogenesis of this disease. The gingival tissues respond within 2 to 4 days to a beginning accumlation of microbial plaque with a classic acute exudative vasculitis which we have termed the initial lesion. This response, which includes loss of perivascular collagen, is comparable to that elicited in most other tissues subjected to acute injury and may be a consequence of the elaboration and release of chemotactic and antigenic substances by microbial plaque. Within 4 to 10 days, the early lesion develops. It is characterized by a dense infiltrate of lymphocytes and other mononuclear cells, pathologic alteration of fibroblasts, and continuing loss of the connective tissue substance. The structural features of the early lesion are consistent with those expected in some form of cellular hypersensitivity, and a mechanism of this kind may be important in the pathogenesis. The early lesion is followed by the established lesion which develops within 2 to 3 weeks and is distinguished by a predominance of plasma cells in the absence of significant bone loss. The established lesion, which is extremely widespread in humans and in animals, may remain stable for years or decades, or it may become converted into a progressive destructive lesion. Factors causing this conversion are not understood. In the advanced lesion, plasma cells continue to predominate although loss of the alveolar bone and periodontal ligament, and disruption of the tissue architecture with fibrosis are also important characteristics. The initial, early, and established lesions are sequential stages in gingivitis and they, rather than the advanced lesion which is manifest clinically as periodontitis, make up the major portion of inflammatory gingival and periodontal disease in humans.
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PMID:Pathogenesis of inflammatory periodontal disease. A summary of current work. 76 22

Periodontosis is an idiopathic degeneration of the periodontium which results in migration and loss of teeth. The disease begins in the regions of the incisors and first molars. Late in the disease, other areas of the dental arches may be involved. The gingivae are not initially inflamed, and there are no associated systemic abnormalities. Local irritants cannot account for the marked alveolar destruction which leads to the tooth loss. Several heritable syndromes and periodontitis also may be associated with alveolar bone destruction. Periodontosis can be differentiated each of these on the basis of negative laboratory tests, lack of associated anomalies, distinctive pattern of bone loss and timing of onset of gingival inflammation. A family in which periodontosis was present in three of six sibs and in which ichthyosis was segregating independently of periodontosis is reported.
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PMID:Periodontosis in sibs. 105 38

Clinical and epidemiological studies have shown that: 1. Bacterial plaque which accumulates around the teeth is responsible for chronic periodontal inflammation. From adolescence on, this inflammation is almost universal. 2. Gingivitis prepares the periodontitis, which is characterized by a migration of the epithelial attachment, pocket formation and progressive bone loss. 3. Calculus is formed by plaque calcification. Its rough surface allows bacterial retention and proliferation in contact with the epithelial covering. 4. The mechanisms of host resistance to parasitic plaque are mostly unknown. This resistance is variable and seems to decrease with age. 5. Periodontal disease in children and adolescents is a real problem in preventive medicine, because of its immediate or remote consequences on tooth loss. Thanks to fluoride, the prevention of dental caries is quite effective; the prevention of periodontal disease is on the contrary much more difficult. Mechanical removal of plaque is tedious and must be done again and again; however, it is not logical to separate prevention of caries from that of periodontal disease. Information of the public at large on oral health is of utmost importance, as well as a good cooperation of the teachers in preventive programs for schoolchildren. Every health department or service should try to apply the following measures: -Permanent employments for "school dental nurses" should be created, on a part-time or full-time basis. They should take care of the organisation and supervision of oral health programs. -In each school dental service, a dentist should be responsible for teaching the theoretical and practical aspects of periodontal prevention. -Caries reduction obtained by fluorides is no excuse to reduce the "treatment staff". This staff should be devoted to prevention at large and to refreshing courses. In a young population with regular supervision, prevention of periodontal disease can meet with considerable success. Initial periodontal disease is reversible: it is possible to avoid the degradation of gingivitis in progressive periodontitis, and this helps maintaining dental and periodontal health throughout life.
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PMID:[Periodontal disease and prevention in children and adolescents]. 122 36

In this study, an attempt has been made to examine and analyse the ancient mandibles of people who have died several hundreds of years ago during the second and first millenium B.C. These mandibles have been recovered from the burial mounds in Bahrain (Arabian Gulf) and preserved in the National Museum and the Department of Antiquities in Bahrain. The dental conditions recorded are e.g. attrition, caries, fluorosis, periodontitis or antemortem tooth loss. The results indicate the age, sex, diet, occupation and environmental conditions that existed and even the culture of the people. A comparative study of the ancient mandibles and those of the present generation has been carried out.
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PMID:The mandible--an analysis. 144 84

The aging of the American population will have enormous social ramifications, among which will be a greater focus on the elderly patient. Traditionally, the dental status of this group has been extracted teeth and full dentures, but that is now steadily changing. There were 41.1% of Americans aged 65 or older who were edentulous in 1985 to 1986, but a good proportion of them have been edentulous for many years. The prevalence of total tooth loss will continue to decline with time. The growth of a dentate elderly population, however, leaves more of that group at risk of caries. Caries, once seen as a disease of childhood, is now clearly a lifelong disease. Elderly persons are particularly at risk of root caries, which follows as a consequence of periodontitis. Total tooth loss and severe caries are both associated with lower socioeconomic status. Although cross-sectional survey data invariably show, on average, a greater extent of periodontitis among older than among younger persons, periodontitis is not considered a disease of aging. The age difference in surveys is not because of greater susceptibility among the elderly but represents disease accumulated over time. Limited longitudinal data suggest that rapid loss of periodontal attachment, serious enough to threaten the dentition, is found in 7% to 15% of any population. But this group exhibits the disease when young. Those who have retained a more-or-less intact dentition into old age rarely exhibit a sudden onset of periodontitis. If such a change is seen it could be indicative of broader changes in the immune system.
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PMID:Epidemiology of dental diseases in the elderly. 150 37

Periodontal disease is a generic term encompassing a variety of inflammatory conditions affecting the supporting tissues of the teeth. Periodontitis is inflammation associated with net resorption of supporting alveolar bone and periodontal ligament. Gingivitis is inflammation limited to the covering gingival tissues and does not directly lead to tooth mobility or loss. Periodontal diseases are very prevalent. Because the bone and ligament resorption are essentially irreversible, accumulated tissue damage of periodontitis is reflected in a prevalence and severity that increase with age. Periodontitis is not caused by aging per se but by a complex host-parasite relationship in which specific pathogens among the subgingival microbiota not only injure tissues directly but stimulate a cascade of inflammatory mediators to damage host tissues. Analytic epidemiology has identified several risk indicators for advanced periodontitis in older adults. These are microbiologic (prevalence of certain anaerobes in the microbiota), behavioral (tobacco smoking and infrequent professional dental care), medical (older age, preexisting and generalized periodontitis, gingival bleeding), and social (financial worries). Periodontitis in older adults is treated by reducing the impact of these risk indicators. The infections are controlled by combinations of debridement, antimicrobial agents, and surgical procedures as indicated. Medically well older adults can be treated similarly to younger adults. Management of periodontal conditions can be complicated for patients who are medically compromised. Communication between physicians and dental personnel is often required to ascertain the medical history and list of medications taken by older patients. Many of the medications prescribed for medical problems associated with aging impact on treatment choices for managing periodontitis. Moreover, periodontists frequently prescribe analgesics, antibiotics, and anti-inflammatory agents that might interact with others among the numerous drugs taken by older patients. Older adults with cognitive or physical disabilities have special needs for individualized hygiene instruction and implements. Periodontal health promotion and improving access to periodontal care for the elderly are challenges, because dental services are most often in the private sector and dental insurance does not often apply after retirement. Because they grew up in an era in which tooth loss due to "gum" diseases was considered inevitable, their current motivation toward regular preventive care must be improved by removing barriers and impediments to care. In addition to life-threatening medical conditions, frail individuals institutionalized in collective living centers face compounded problems concerning the provision of adequate, not even optimal, dental care. Their periodontal health often deteriorates rapidly after institutionalization, and in some instances it can possibly predispose to aspiration pneumonia or other disseminated infections.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Considerations for physicians caring for older adults with periodontal disease. 150 48

Chronic adult periodontitis (CAP) is a common disease of the supporting tissues of teeth, and is a major cause of tooth loss. This disease is distinguished from more rare rapidly progressing forms of periodontitis, in which a variety of neutrophilic polymorphonuclear leukocyte (PMN) defects have been identified. PMN dysfunctions have, however, not been observed in CAP. In CAP, destructive episodes of the disease occur sporadically and independently in different parts of the mouth. In this paper, it is proposed that CAP is due to highly localized defects in PMN function. Impaired PMN function is suggested as resulting in the formation of a virulent bacterial plaque, which is capable of initiating periodontal pocket formation. A previously reported perivascular hyaline material may account for localized PMN defects, by reducing the number of PMNs entering affected sites. The proposed model may explain both the presence of CAP in otherwise normal patients, and the sporadic pattern of tissue destruction seen in this disease.
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PMID:Chronic adult periodontitis and burst progression may reflect local neutrophil defects due to perivascular hyaline deposits. 172 80

Periodontal disease is one of the most widespread diseases known. It can begin in childhood and progress through adolescence into adult life, eventually resulting in tooth loss. This article identifies the features of periodontal health, gingivitis and periodontitis in children and adolescents. Periodontal assessment, diagnosis and management in younger patients are also described.
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PMID:Periodontal disease in children and adolescents. 181 Jul 73


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