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Periodontal Disease

Periodontal disease is the result of infection and inflammation of the gums and bone that surround and support the teeth. In its early stage, called gingivitis, the gums may become swollen and red, and bleed. In the more serious form, called periodontitis, the gums may pull away from the teeth, bone may be lost, and the teeth may loosen or fall out. In fact, periodontitis is the main cause of tooth loss in older people.

According to the Centers for Disease Control and Prevention (CDC), 47% of individuals ages 30 and older have some form of periodontal disease, and the prevalence climbs with age, to 70% of those 65 and older. Tooth loss due to untreated periodontal disease can start when someone is in their 40s.

Importantly, research shows connections between periodontal disease and systemic disease, meaning various diseases that affect the body. These include heart disease, several cancers, and rheumatoid arthritis. Furthermore, bacteria from the mouth have been found in plaques in the brains of Alzheimer’s patients. That’s because oral bacteria can travel from bleeding gums to the brain, causing both inflammation and plaque.

In addition, if you are pregnant, periodontal disease can increase the risk of pre-term birth and low birth weight.

Periodontal disease occurs when bacteria in the mouth infect the tissue around the teeth. When bacteria stay on the teeth long enough, they form a film called plaque. Plaque buildup irritates the gums, causing inflammation; over time, the gums pull away from the teeth, creating pockets that fill with more plaque. These pockets also become reservoirs for bacteria that can enter the bloodstream and cause infection elsewhere in the body.

Eventually, the plaque in deep pockets hardens into tartar. If tartar build-up spreads below the gum line, only a dental health professional can remove it and stop the periodontal disease process.

Periodontal Disease Symptoms

Common symptoms of periodontal disease include:

  • Tender, swollen and bleeding gums
  • Bad breath or bad taste that won’t go away
  • Painful chewing
  • Loose teeth
  • Change in your bite or in the fit of partial dentures

MicroGenDX Test Used to Diagnose Periodontal Disease

Periodontal disease is diagnosed by an examination of your mouth, X-rays to check for bone loss and measurement of the depth of the pockets between the gum and your tooth. A pocket depth deeper than 4 mm may indicate periodontal disease. These deeper pockets can become reservoirs for bacteria that can enter the bloodstream and contribute to systemic diseases.

Your dentist may take a sample of fluid from the pocket and it send to a lab to identify the bacteria and biofilms (groups of bacteria) that are contributing to your periodontal disease. However, standard cultures are limited and biofilms can further complicate identification. The MicroGenDX PerioDX test detects the DNA of all microbes (including those in biofilms) in your sample, along with how much of each is present, and uses that information to identify the causes of your infection and the drugs that can best treat it.

It is important to know that not all antibiotics work for all bacteria, and some even work differently in different areas of the body. Your doctor should consult the "antimicrobials for consideration" chart on your MicroGenDX PerioDX report to decide what antibiotic is right for you.

To get complete instructions, you can order the MicroGenDX PerioDX Kit.

Providing Samples for a MicroGenDX PerioDX Kit

The MicroGenDX PerioDX Kit comes with everything your provider needs to take a sample of a small amount of fluid from an infected pocket in your gums, as well as a saliva sample. Everything you need to know about how periodontal disease samples are taken is included with the test. It’s also available online on the product page. The instructions included with the test contain illustrations to help your provider collect a sample without contaminating it. It’s always important to obtain a proper sample by following the instructions for collecting the sample, as well as when packaging and shipping it. For example, you should not eat or drink anything for 30 minutes before a sample is taken.

Medical Specialties Treating Periodontal Disease

Periodontal disease is treated by a general dentist or a periodontist (a dentist that specializes in periodontal disease), often with help from a dental hygienist.

How Periodontal Disease is Treated

Proper treatment is the key to halting periodontal disease progression and helping to avoid gum inflammation, bleeding, tooth loss and potential worsening of systemic diseases.

Gingivitis, which is early-stage periodontal disease, can be treated and controlled with good oral hygiene and regular professional cleaning. If periodontal disease progresses to periodontitis, treatment may include deep cleaning of the root surfaces below the gums (scaling) and antibiotics to take by mouth or placed directly under the gums.

It is also important to treat risk factors, including smoking diabetes, and defective fillings, as well as oral appliances, such as bridges, that no longer fit properly.

In severe cases, surgery may be needed.

References

  1. Li X, Kolltveit KM, Tronstad L, Olsen I. Systemic diseases caused by oral infection. Clin Microbiol Rev. 2000;13(4):547-558. doi:10.1128/cmr.13.4.547-558.2000.
  2. Krishnan K, Chen T, Paster BJ. A practical guide to the oral microbiome and its relation to health and disease. Oral Dis. 2017 Apr;23(3):276-286. doi: 10.1111/odi.12509. Epub 2016 Jul 4. PMID: 27219464; PMCID: PMC5122475. |
  3. Matsushita K, Yamada-Furukawa M, Kurosawa M, Shikama Y. Periodontal Disease and Periodontal Disease-Related Bacteria Involved in the Pathogenesis of Alzheimer’s Disease. J Inflamm Res. 2020;13:275-283. Published 2020 Jun 30. doi:10.2147/JIR.S255309.
  4. https://www.merckmanuals.com/home/mouth-and-dental-disorders/periodontal-diseases/periodontitis
  5. https://www.cdc.gov/oralhealth/conditions/periodontal-disease.html#periodontal
  6. https://www.prweb.com/releases/microgendx_is_introducing_periodx_the_first_commercially_available_saliva_based_qpcr_ngs_test_for_oral_health/prweb17959867.htm

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