Focal Infection and Periodontitis: A Narrative Report and New Possible Approaches (original) (raw)

The impact of periodontal infections on systemic diseases. An update for medical practitioners.

Anil, S. and H. S. Al-Ghamdi (2006). "The impact of periodontal infections on systemic diseases. An update for medical practitioners." Saudi medical journal 27(6): 767-776. Oral health status is an integral component of a general health and well-being of an individual. Knowledge about the link between periodontal disease and systemic diseases are growing rapidly. Increasing evidence is available from many investigators to indicate periodontitis as a risk factor for cardiovascular diseases, diabetes mellitus, low birth weight infants and pulmonary diseases. Both epidemiologists and researchers in oral microbiology have contributed significantly to the new paradigm of periodontal disease. Although additional studies are needed to determine the mechanisms by which such associations exist; available research clearly demonstrates that oral diseases and conditions are not only markers for underlying health problems, but also important determinants influencing the development and management of adverse chronic health conditions. Physicians and dentists should be aware of this link and provide treatment that will greatly benefit the patients. A review of the relationship between periodontal infections and its possible impact on systemic diseases is discussed.

A literature review on periodontitis and systemic diseases

IP International Journal of Periodontology and Implantology

Periodontitis is found to be one of the most common infectious disease that is inflammatory in nature occurring in the oral cavity. A normal human being oral cavity contains variety of bacterias, that have the tendency to spread to different sites of the body that too particularly in the patients those are immunocompromised and ultimately results in the various systemic diseases. Maintenance of health of oral cavity is very much required and is a necessity as it is known as oral cavity is the mirror image of the systemic health of the individual.

The systemic implications of periodontitis: Dentist acquires a relevant role in general health

may enter into the systemic circulation and move to distant parts, initiating a distant disease [4]. Oral bacteria play a role in various systemic conditions including cardiovascular disease, rheumatoid arthritis, adverse effects on pregnancy, osteoporosis, diabetes mellitus, stroke, inflammatory bowel disease and colorectal cancer, pancreatic cancer, respiratory tract infections, meningitis or brain abscess, abscesses in the lung, liver and spleen, appendicitis, pneumonia, obesity and Alzheimer's disease [5-9]. In various body regions such as atheromatous plaques, placenta and amniotic sac, respiratory tract, pancreas, joints or joint replacement implants, several periodontal pathogens (Porphyromonas gingivalis, Treponema denticola, Fusobacterium nucleatum or Campylobacter rectus) have been isolated [5]. Periodontitis is an infectious disease that affects the tooth-supporting tissues and exhibits a wide range of clinical, microbiological, and immunological manifestations. It is associated with and probably caused by a multifaceted dynamic interaction among specific infectious agents, host immune responses, hazardous environmental exposure, and genetic propensity [10]. Bacteria are essential to initiate the disease, but not sufficient to determine all cases of periodontitis. According to one US survey, chronic periodontitis affects around 35% of the adult population, with an even higher prevalence among the elderly [11]. According to WHO, this prevalence refers to a cohort of young adults aged between 35 and 44 years, an early onset periodontitis that appears before the age of 30 years, along with other connotations, known as aggressive periodontitis. Periodontal pathogens can enter the bloodstream and produce focal infections in different organs or systems. These distant lesions can be developed through three possible mechanisms [12,13] • Distant lesions due to bacteremia: Generally, bacteremia is a short duration episode neutralized by the immune defensive cells. However, sometimes, microorganisms colonize different target organs, causing subclinical, acute or chronic infections. • Distant lesions due to periodontal microbial toxins which are transported through blood or lymphatic

Systemic Effects of Periodontal Diseases

Dental Clinics of North America, 2005

The possibility that a localized oral condition such as periodontal disease (PD) may have systemic effects seems to be of interest to the average person. The notion that a condition that is often ignored (or dealt with only when causing pain) may have long-term systemic consequences gets people's attention. To some constituencies of the dental profession, this attention is a good thing; perhaps some of those who have ignored their oral health will now pay attention to their mouth and seek regular dental care. This notion has considerable public health significance because if it is true, then treatment of periodontal inflammation would contribute to reduction in the risk of many prevalent, often fatal chronic diseases. To what extent are the putative associations between PD and systemic conditions such as atherosclerosis, myocardial infarction, stroke, pneumonia, diabetes mellitus, and adverse pregnancy outcomes based on proven fact? To what extent can these potential associations be explained by a plausible pathogenic mechanism? Will provision of periodontal therapy reduce the risk of these systemic diseases? The goal of this article is to briefly review the history of this concept, describe the biologically plausible circumstances that may underlie these potential associations, and provide a summary of the published literature that supports or refutes them. History of the focal infection hypothesis The concept that oral infection may contribute to various systemic diseases is not new. Indeed, the possibility that a localized, or focal, infection such as PD could have systemic effects was a popular idea at the turn of the twentieth century [1,2]. A focal infection is a chronic, localized infection that can disseminate microorganisms or toxic microbial products to contiguous or

Periodontal diseases as bacterial infection

Avances en Periodoncia e Implantología Oral, 2005

The periodontal disease is conformed by a group of illnesses affecting the gums and dental support structures. They are caused by certain bacteria found in the bacterial plaque. These bacteria are essential to the onset of illness; however, there are predisposing factors in both the host and the microorganisms that will have an effect on the pathogenesis of the illness. Periodontopathogenic bacterial microbiota is needed, but by itself, it is not enough to cause the illness, requiring the presence of a susceptible host. These diseases have been classified as gingivitis, when limited to the gums, and periodontitis, when they spread to deeper tissues. Classification of periodontal disease has varied over the years. The one used in this work was approved at the International Workshop for a Classification of Periodontal Diseases and Conditions, held in 1999. This study is an overview of the different periodontal disease syndromes. Later, the systematic use of antibiotic treatment consisting of amoxicillin, amoxicillinclavulanic acid, and metronidazole as first line coadjuvant treatment of these illnesses will be reviewed.

Influence of periodontal disease on systemic disease: inversion of a paradigm: a review

Journal of medicine and life, 2013

Medicine and dentistry interface at many levels. For example, the focal infection theory, popular at the outset of the 1900s, suggested that systemic ailments could be traced to dental infections, which, in those days, were common, chronic, and often untreated. With the advent of modern dental and medical treatment, particularly antibiotics, this relationship was largely forgotten. Until recently, the discovery of relationships between periodontal disease and heart ailments, maternal oral health and prematurity of offspring, bidirectional interrelationships between diabetes and periodontal diseases, relationship of oral infections and chronic respiratory diseases and relationship between skeletal and oral bone mineral density, has brought a shift in the perspective. Research is now focused on the potential impact of periodontal diseases on systemic health. Thus, the impact of oral infection in systemic health defined a novel branch in Periodontology termed Periodontal medicine.

Periodontal diseases- A brief review

International Journal of Oral Health Dentistry, 2020

Periodontal diseases consists of a wide range of inflammatory conditions which causes degeneration of Periodontium and affects all supporting structures of teeth such as gingiva, periodontal ligament, cementum and alveolar bone etc. followed by teeth loss. WHO had reported about 10-15% of the world population is suffering from severe periodontal condition. It is complex infectious disease caused by aggressive microbial growth on teeth. The main aim of this study is to provide systemic update on periodontal disease regarding its stages, occurrence, pathophysiology, diagnosis, treatment and management. The pathophysiology of periodontal disease is associated with dental plaque, microbial biofilm formation and immunogenicity of the host cell. The severity of this disease depends upon risk factors and chronological stages. Prevention is attained by daily maintenance of oral hygiene. Various surgical and non-surgical treatments are available to control the formation of microbial biofilm. Daily maintenance and periodic management of this disease control worsening of condition and shows definite improvement in oral health.