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David Richards, DDS, PhD
San Diego Periodontics
(619) 543-0905
4060 Fourth Avenue
Suite 303
San Diego, CA 92103

dwrichards@adamember.net

Interesting Information about Periodontal Disease: The topics below link to the web-site of either the American Dental Association, or the American Academy of Periodontology. Please use your browser's "Back" button to return to this page.


Gum Disease: �

Gum disease (also called periodontal disease) is an infection of the tissues surrounding and supporting the teeth. It is a major cause of tooth loss in adults. In fact, after age 35, about three out of four adults are affected by some form of gum disease. The adjacent cartoon shows the gradual progression of periodontal disease from mild gingivitis to tooth loss.


Cleaning Your Teeth and Gums: Brushing and flossing remove a thin sticky film of bacteria that grows on your teeth. This sticky film, called plaque, is the main cause of tooth decay and gum disease.


Link Between Gum Disease and Heart Disease: For a long time, we've known that bacteria may affect the heart. Now evidence is mounting that suggests people with periodontal disease, a bacterial infection, may be more at risk for heart disease, and have nearly twice the risk of having a fatal heart attack, than patients without periodontal disease.


Periodontal disease and pregnancy: There is now mounting evidence that suggests periodontal disease is a risk factor during pregnancy. Pregnant women who have periodontal disease may be seven times more likely to have a baby that is born too early and too small.


Periodontal disease and diabetes: People with diabetes are more likely to have periodontal disease than people without diabetes, probably because diabetics are more susceptible to contracting infections. In fact, periodontal disease is often considered the sixth complication of diabetes


Periodontal disease and osteoporosis: Researchers have suggested that a link between osteoporosis and bone loss in the jaw. Studies suggest that osteoporosis may lead to tooth loss because the density of the bone that supports the teeth may be decreased, which means the teeth no longer have a solid foundation.


Oral bacteria and respiratory diseases: Scientists have found that bacteria that grow in the oral cavity can be aspirated into the lung to cause respiratory diseases such as pneumonia, especially in people with periodontal disease. This discovery leads researchers to believe that these respiratory bacteria can travel from the oral cavity into the lungs to cause infection.


Genetic susceptibilty testing in periodontal therapy: Clinicians have recognized for years that some individuals get lots of plaque and calculus, but experience little loss of periodontal support. Other patients seem to have really clean mouths, but experience extensive bone loss. Their disease is not so much related to the presence of bacteria but to some other factor. Within the past two years, a genetic marker has been identified that can be correlated with the degree of tissue destruction that occurs in some periodontal patients with advanced disease.
Genetic testing for periodontal disease susceptibility hinges on measuring a gene which regulates the production of an inflammation mediator called Interleukin 1B. Interleukin 1B, which is produced in response to a bacterial challenge, is a strong stimulator of host cells which destroy bone and soft tissue in an attempt to limit the spread of infection. When gum tissue is invaded by bacteria the extent of the bone and soft tissue damage is related to the intensity of the host cell response rather than on the quantity of bacteria challenging the system. The intensity of the response is determined by individual genetic makeup which dictates the amount of interleukin 1B cells produce in response to a bacterial challenge. The more of the interleukin 1B that is produced the greater the bone and soft tissue damage. Currently, only smoking overrides this genetic risk marker as a determinant of periodontal disease.
The genetic test that has been developed to determine your risk for periodontal disease is called PST (for periodontal sensitivity testing). It is a simple saliva test which is processed by a commercial laboratory in Flagstaff, Arizona where the genetic makeup of the interleukin 1B gene site is determined.
What does a positive test mean in terms of care? If your PST test is positive we may recommend that you have supportive therapy (also known as periodontal maintenance therapy) at shortened intervals, at minimum four times/year. We would closely monitor your periodontal status and if deep pockets persist or worsen surgical therapy followed by a stringent maintenance regimen may be the most effective treatment because it will produce the greatest reduction in Interleukin 1B production.
Genetic susceptibility testing is a new screening tool which could prove to be highly beneficial in predicting disease potential. The use of this test will enable us, as periodontists, to better tailor treatment and preventive regimens to individual needs.
We look forward to any questions you might have regarding this advance in periodontal diagnosis