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“Periodontal disease in children: etiology and
pathogenesis. Gingivitis, periodontitis and
periodontal syndrome in children: prevalence,
clinical manifestations, diagnosis, differential
diagnosis, treatment and prevention”
Lecturer: Dr. Katrin Duda

Gums (also called gingiva). Gums consist of soft, pink
tissue, which covers the alveolar bone.

The gum line is where the tooth meets the gum.

Bone (alveolar bone). This is the bone in which the
roots of teeth are embedded.

Periodontal membrane or ligament. This connects and
attaches the root of the tooth to the bone.
It is chronic inflammatory disease of the gum and
tissues that surround and support the teeth. If left
untreated, periodontal disease can lead to tooth
loss.
This disease divided into two types:
-
Gingivitis
-
Periodontitis

Gums that bleed during and after tooth brushing

Red, swollen, or tender gums
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Persistent bad breath or bad taste in the mouth
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Receding gums
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Formation of deep pockets between teeth and gums
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Loose or shifting teeth

Changes in the way teeth fit together upon biting down, or in
the fit of partial dentures.

“inflammation around the tooth" - it is a serious gum
infection that damages the soft tissue and bone that
supports the tooth. All periodontal diseases, including
periodontitis, are infections which affect
the periodontium. The periodontium are the tissues
around a tooth, tissues that support the tooth. With
periodontitis, the alveolar bone around the teeth is
slowly and progressively lost. inflammation.

This is a
destructive infection that can
affect all the periodontal
tissues, that is, the gums, the
underlying bone and the
connecting tissues.

About 20% of adolescents (1417 years) develop adult
periodontitis, but the disease is
rare in young children.

Hormonal changes in females

Diabetes - patients who live with diabetes have a much higher incidence
of gum disease than other individuals of the same age

AIDS - people with AIDS have more gum diseases

Cancer - and some cancer treatments can make gum diseases more of a
problem

Some drugs - some medications that reduce saliva are linked to gum
disease risk.

Genetics - some people are more genetically susceptible to gum diseases

The possible role of systemic disorders and
systemic exposures in initiating or modifying
the progression of periodontal disease is a very
complex issue. It is however generally agreed
that several conditions may give rise to an
increase prevalence, incidence or severity of
gingivitis and periodontitis

Microbial plaque is the initiator of periodontal
disease but whether it affects a particular
subject, what form the disease takes, and how
it progresses, are all dependent on the host
defenses to this challenge. Systemic factors
modify all forms of periodontal disease
principally through their effects on the normal
immune and inflammatory defenses
Systemic factors most associated with the etiology
and or progression of peritonitis:
A. Diabetes Mellitus
B. Medications
C. Immunosuppressive disorders
D. Environmental Conditions or exposures
E. Hematological Disorders
F. Genetic Disorders.
1.
Chronic Periodontitis: a) localized b) generalized
2. Aggressive Periodontitis: a) localized b) generalized
3.
Periodontitis Associated with Systemic Diseases
4.
Necrotizing Periodontal Diseases
5. Abscesses of the Periodontium
6.
Periodontal Diseases associated with Endodontic Lesions
7.
Developmental or Acquired Deformities and Conditions

Most prevalent in adults, but can occur in children and
adolescents

Amount of destruction is consistent with presence of local
factors

Subgingival calculus is a frequent finding

Associated with a variable microbial pattern

Slow to moderate rate of progression but may have periods
of rapid progression

Patients are otherwise clinically healthy

Rapid attachment loss and bone destruction
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Familial aggregation and variable features

Severity of destruction inconsistent with amount of microbial
deposts

Elevated proportions of Actinobacillus actinomycetemcomitans
and in some patients Porphyromonas gingivalis

Hyper-responsive macrophage phenotype

Progress of bone loss may be self arresting

A small percentage of children (approximately 1%) develop this
form of the disease.

It is a rapidly developing and very destructive form of
periodontitis.

It is associated with a blood cell (leucocyte) disorder.

The disease may be localized to a few teeth or it may be
generalized.

It is caused by specific bacteria, and is treated by a combination of
antibiotic and surgical therapy.

Dental plaque is the major cause of gingivitis and
periodontitis.

The bacteria in the plaque are the major offenders.

The effects of plaque can be even more damaging if the
patient is in poor health, or has a low resistance to
disease.

Periodontal disease is unlikely to be transmitted from one
person to another.

Qualified dentist should find
it fairly straightforward to
diagnose periodontitis. The
dentist will ask the patient
questions regarding
symptoms and carry out an
examination of his/her
mouth.

Dental plaque is the major cause of gingivitis and
periodontitis.

The bacteria in the plaque are the major offenders.

The effects of plaque can be even more damaging if the
patient is in poor health, or has a low resistance to
disease.

Periodontal disease is unlikely to be transmitted from one
person to another.






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pink or coral pink color
firm, resilient tissues
”orange-peel” texture
shape that follows the contour of the teeth and
forms scalloped edge
no areas of redness, swelling or inflammation
no bleeding during daily plaque removal
no discomfort

Gingivitis is inflammation of the gum tissue

The gums are irritated and swollen due to plaque or calculus
buildup along the gum line

The gums may be sore, bleed easily and appear puffy, soft and
swollen

Bleeding gum is one of the earliest and most common sings of
gingivitis

The good news about gingivitis is that it is preventable and
reversible through good brushing and flossing techniques/

Hormonal changes, such as those occurring during pregnancy, puberty,
menopause make gums more sensitive, which makes it easier for
gingivitis to develop.

Medications can affect oral health, because some lessen the flow of
saliva, which has a protective effect on teeth and gums.

Bad habits such as smoking make it harder for gum tissue to repair itself.

Poor oral hygiene habits such as not brushing and flossing on a
daily basis, make it easier for gingivitis to develop.

Family history of dental disease can be a contributing factor for
the development of gingivitis.