Dog periodontal disease stages


Dog periodontal disease stages

The human periodontal disease continuum begins in the first trimester, continues through childhood, adolescence and young adulthood, and extends to senescence. Periodontal disease can be considered an inflammatory disease, which may progress to periodontitis, or the irreversible loss of periodontium and alveolar bone. The clinical manifestations of periodontitis are periodontal disease, dental caries, tooth loss and edentulism. It is generally accepted that the process is initiated by bacteria in the dental plaque, and advances along a continuum to loss of periodontium. The first stage of periodontitis is gingivitis.

Gingivitis

Gingivitis is the early stage of the disease. It is characterized by the presence of plaque and gingival inflammation. The gingiva, also known as the gum, is the soft tissue which lines the alveolar ridges of the teeth. The gingiva is divided into three zones, the free gingiva, attached gingiva, and the alveolar process. The free gingiva covers the free surface of the alveolar bone, the attached gingiva covers the alveolar ridge. The alveolar process is the part of the maxilla or mandible that attaches to the alveolar ridge and extends to the maxillary or mandibular process. Gingivitis may or may not involve the free gingiva, the attached gingiva or the alveolar process. A gingival area of more than 3mm in diameter is considered diseased.

Gingivitis occurs with periodontitis, a later disease stage, when the gingival tissues become inflamed due to plaque and inflammation from the surrounding periodontium.

Risk factors

Smoking

Smoking is the most common cause of periodontitis. Smoking is the leading known risk factor for both aggressive and chronic periodontitis. Cigarettes contain a complex mixture of chemicals that may promote inflammation of the periodontium. Tobacco's active component, nicotine, stimulates the release of the neurotransmitter acetylcholine from cholinergic neurons. Acetylcholine stimulates the release of inflammatory cytokines in addition to its stimulatory effect on neutrophils.

Tobacco also contains other potentially harmful chemical components, including arsenic, cadmium, lead, barium, formaldehyde, hydrogen cyanide and polycyclic aromatic hydrocarbons. These chemicals have the potential to alter the function of bone cells or damage the bone tissue.

Fluorides

Fluoride is found naturally in the enamel and dentin of teeth, in the saliva, and in water. The American Dental Association recommends that children receive fluoride supplements to maintain healthy teeth. Fluoride helps teeth become stronger, more resistant to decay, and protects them from disease.

The optimal daily intake of fluoride for prevention of dental caries is between 1.2 and 1.4 ,mg/kg. The average amount of fluoride found in the water supply in the U.S. is 0.4 ,mg/L. Although the amount is much lower, the U.S. Centers for Disease Control and Prevention (CDC) states that a person should receive fluoride supplements and that the best way to do this is through the public drinking water system.

There is some evidence that a high fluoride intake may be associated with increased risk of periodontitis, but the amount of evidence is low, and more research is needed.

Mastication

Smoking and poor mastication are associated with an increased risk of periodontitis. Both have the potential to alter the balance of oral microflora, which are responsible for the progression of periodontitis. Poor mastication is associated with an increase in plaque accumulation in the oral cavity.

Oral hygiene

Poor oral hygiene has been reported as one of the greatest causes of periodontitis. Periodontitis is more likely to be associated with a poor oral hygiene.

Lack of fluoride is also associated with periodontitis. The association is stronger in subjects with gingivitis.

Prevention

A review of the literature suggests that the incidence of gingivitis in patients with systemic diseases such as diabetes, hypertension, cardiovascular disease, and kidney disease is significantly higher than in healthy individuals. These patients are also more likely to be diagnosed with periodontitis. There are a number of studies, which have reported that systemic diseases may be risk factors for periodontitis, and may be used to identify individuals who are at risk for periodontitis.

In patients with diabetes, periodontitis may be treated by scaling and root planing. The use of antimicrobial mouthrinses may be beneficial as well, and in some studies, periodontal therapy was recommended to these patients. Diabetes is also a risk factor for periodontitis in non-human primates. It is important to note that periodontal therapy in diabetics is less likely to be effective in long-term treatment due to the presence of uncontrolled glucose levels.

Another important factor in the development of periodontitis in patients is the presence of bacteria in their gingival pockets. Patients with gingivitis, who are not yet diagnosed with periodontitis, are more likely to have high levels of a bacteria called Tannerella forsythensis. This bacteria has been associated with aggressive periodontitis, which is more common in patients with systemic diseases.

Diabetes patients are recommended to have their periodontal care, including scaling and root planing and antimicrobial mouthrinses, performed regularly. In patients with periodontitis, the risk of cardiovascular disease is increased. Patients with periodontitis may be encouraged to maintain a healthy lifestyle, and a healthy diet. Weight loss and smoking cessation are important, as well as regular dental care. There is also evidence that smoking cessation alone is associated with decreased plaque and gingival inflammation.

Dental caries

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