Tuesday, July 18, 2017

The potential lifespan impact of gingivitis and periodontitis in children

Department of Pediatric Dentistry
Lutheran Medical Center
Resident’s Name: Brian Darling                                                                                             Date: 7/19/2017
Article Title: The potential lifespan impact of gingivitis and periodontitis in children
Author(s): Bimstein E, Huja PE, Ebersole JL
Journal: The Journal of Clinical Pediatric Dentistry
Date: Vol 38 No 2; 2013 pg 95-99
Major Topic: Periodontal Disease in children and its lifelong implications
Type of Article: Topic overview
Main Purpose: This article aimed to describe information regarding periodontal disease in children and speculate about the lifetime impact of it adults
Key Points: (2 lines Max): Periodontal pathogens may be acquired early in life and contribute to increase susceptibility to periodontal disease in the future, even if no detectable in childhood. Gingival inflammation in childhood may contribute to periodontal and systemic implications in adulthood.
·      Periodontitis is the primary reason of tooth loss in adulthood
·      Plaque-induce gingivitis has low prevalence in early childhood but peaks during puberty
·      Severity and prevalene of gingivitis will progressively intensify from primary through permanent dentition
·      Incidence and severity of gingivitis increase from childhood to adolescence
·      Initial stages of gingivitis in primary dentition are not detectable because the inflammatory infiltrate is masked by the overlying gingival tissues.
·      Self-administered plaque control programs alone, without periodic professional reinforcement, are inconsistent in providing long-term inhibition of gingivitis
·      For every human cell in our body there are 10 bacterial cells
·      Innate Immunity of Periodontium
o   Intact gingival sulcular and junctional epithelium act as a barrier against bacterial products
o   Saliva and GCF provide continuous flushing and deliver antimicrobial products
o   Normal commensal microbiota inhibits colonization/growth/emergence of pathogenic microbes
o   Phagocytic cells migrate into gingival tissues
·      Periodontal pathogens that contribute to periodontitis in adults are likely not acquired later in life (likely acquired in childhood)
·      Once an individual establishes their oral microbiota, it is difficult for extrinsic bacteria to acquire a foothold for permanent colonization
·      Infants and small children exhibit reduced clinical signs of gingival inflammation even in the presence of a substantive microbial burden, so an increased susceptibility to gingival and periodontal diseases later in life should be suspected
·      There may be a link between obesity and periodontitis, so obese or even overweight children may have an increased long-term risk for periodontal disease. Also, chronic oral infectiosn in children coupled with obesity could produce substantial cumulative effects on risk of cardiovascular disease, diabetes, and other chronic inflammatory diseases.
·      Red complex = T. denticola; P. gingivalis; T. forsythus
Assessment of Article:  Level of Evidence/Comments: III

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