Periodontitis: A dynamic pathology
Periodontitis manifests at both the microbial and clinical levels1,2
Periodontitis is a chronic bacterial infection caused by microbial plaque, also called dental biofilm, that colonizes on the tooth's surface and below the gingival margin.2
When dental biofilm irritates the gingiva, it breaks down the tissue and bone supporting the dentition.3 Left untreated, periodontitis can increase periodontal pocket depth (PD) and bleeding on probing (BOP), and may lead to the spread of active infection to healthy sites.1-3
This epithelial cell-associated biofilm lining the epithelial surface of the pocket contains primarily spirochetes and gram-negative bacterial species.2 Three of the most prominent species are P. gingivalis, T. denticola, and T. forsythia, comprising the class known as red complex bacteria (RCB).2
RCB multiply rapidly, and re-colonization is a persistent threat.2 Scaling and root planing (SRP) alone may not be enough to achieve and sustain a healthier balance of bacteria.4
SRP alone may not be enough4
Periodontitis, being an active bacterial infection, can pose a range of risks and potential oral health consequences to your patients if not controlled.
SRP alone may not be enough to achieve and sustain a healthier balance of bacteria.4
With treatment by mechanical procedures alone, baseline levels of bacteria may return in just a few days.2 Since periodontitis manifests at both the microbial and clinical levels, a treatment plan that addresses both may be appropriate.1,2
Antibiotics can help reduce the prevalence and severity of periodontal disease.5 Orally administered antibiotics, such as tetracyclines, which are concentrated in the gingival crevicular fluid of the periodontal pockets, have been particularly useful as adjuncts in the treatment of some types of periodontitis.5
REFERENCES: 1. Socransky SS, Haffajee AD, Cugini MA, Smith C, Kent RL. Microbial complexes in subgingival plaque. J Clin Periodontol. 1998;25:134-144. 2. Socransky SS, Haffajee AD. Dental biofilms: difficult therapeutic targets. Periodontol 2000. 2002;28:12-55. 3. Page RC. Periodontal diseases: a new paradigm. J Dent Educ. 1998;62(10):812-821. 4. Goodson JM, Gunsolley JC, Grossi SG, et al. Minocycline HCl microspheres reduce red-complex bacteria in periodontal disease therapy. J Periodontol. 2007;78(8):1568-1579. 5. Williams RC. Medical progress: periodontal disease. N Engl J Med. 1990;322(6):373-382.