Periodontal diseases and general diseases

 Periodontal diseases and general diseases

1. Introduction :

Inflammatory periodontal diseases are the consequence of local factors and/or aggravated by constitutional and general factors. The term general factors means general diseases or their treatment that play a role in the occurrence and development of periodontal disease.

2. Cases where general disease and periodontal disease always coexist: 
3. Palmoplantar hyperkeratosis or PAPILLON LE FEVRE syndrome:

It is a rare disease with a recessive genetic mode of transmission, characterized by keratotic thickening of the palms of the hands and soles of the feet, destruction of the periodontal structures of the deciduous and permanent teeth as soon as they erupt, the patient is totally edentulous at just 15 years of age. These patients have a defect in the phenomenon of chemotaxis of polymorphonuclear cells as well as a susceptibility to infections. It is a disease transmitted in an autosomal recessive manner and is linked to an almost total loss of cathepsin C which plays an important role in the functioning of lysosomes.

2. Hypophosphatasia or RICKETS: 

Metabolic disease characterized by a vitamin D deficiency which may be a deficiency of intake or absorption causing defects in mineralization and bone homeostasis, therefore destruction of supporting tissues and premature loss of teeth.

3. CHEDIAK-HIGACHI syndrome:

Disease with a recessive genetic mode of transmission described for the first time in 1943, is characterized by the frequency of infectious episodes, particularly respiratory. It combines partial albinism, organomegaly and repeated infections. It is observed that the phagocytic cells have anomalies on their lysosomes which are giant and abnormal as well as a dysfunction of the N (Natural) KILLER lymphocytes. At the periodontal level there is severe inflammation often associated with glossitis. Without treatment this disease causes death before the age of 10 years.

3. Cases where periodontal diseases and general diseases frequently coexist: 
4. Skin diseases:
5. PEMPHIGUS:

Bullous autoimmune disease (presence of IgG which damages the walls of the epithelial cells of the mucous membranes and skin), which can have an impact on the oral mucosa where the bubbles rupture leaving very painful ulcers. When the damage is gingival it is characterized by desquamation.

2. Erythema multiforme:

Causes stomatitis, conjunctivitis and skin lesions in the oral cavity. Affects mainly young adult males, the formation of crusty lesions and their extension are characteristic features of this disease.

3. LUPUS:

It is a collagenosis of unknown etiology. However, the presence of anti-DNA antibodies has been noted. The gingival lesion takes the form of soft and irregular erosion. At the level of the mucosa, the lesion appears as an erythematous disc surrounded by a keratotic area in the form of several discs and the whole is encircled by a formation of small blood vessels.

4. PSORIASIS:

Erythematosquamous dermatosis mainly with cutaneous manifestation is accompanied by oral lesions only rarely and when they exist it presents in the form of erythematous circles of silvery white color covered by scales that if detached leave bloody points. Some forms of psoriasis are characterized by what is called “geographic tongue”.

5. LICHEN PLANUS:

Adult dermatosis of unknown etiology but seems to be favored by emotional factors. At the level of the oral mucosa it gives lesions in the form of a pruritic eruption, on the gum we observe an alternation of white and erythematous areas.  

2. Diseases of the digestive system:
3. Idiopathic gingival fibromatosis:

Manifested by an excessive increase in gingival volume covering almost all of the teeth. This fibromatosis is generally associated with gastrointestinal or hepatobiliary digestive disorders.

2. Recurrent aphthous ulceration:

The etiology is unknown but researchers sometimes blame stress or emotional trauma.

3. Endocrine diseases:
4. Hypothyroidism:

It is the decrease in the secretion of thyroid hormones.

Parathyroid hormone or parathormone is responsible for regulating the level of calcium in the blood and stimulates the urinary elimination of phosphate. In the case of hypoparathyroidism, hypocalcemia is observed leading to tissue changes in the periodontium, causing bone lysis, mobility and tooth loss.

2. Diabetes:

Diabetes mellitus is a chronic disease related to carbohydrate metabolism disorder with insulin deficiency. Oral manifestations are:

– neck caries

– increased salivary viscosity

– dry mouth causing angular cheilitis at the corners of the lips

– a bright red tongue with no papillae

– pungent odor (acidotic)

– glossitis.

Periodontal manifestations:

– hard tartar

– erythematous gingivitis.

        d- Hematological disorders:

1. Cyclic neutropenia:

Characterized by the fall in the number of neutrophilic leukocytes cyclically every 3 weeks, after 5 to 8 days the number of these cells rises but never reaches the normal level. During leukopenic episodes the patient is febrile with alteration of the general condition and oral lesions manifest themselves in the form of acute or subacute gingivitis with ulceration resembling aphthae.

2. Leukemia:

Or blood cancer, manifests as hypertrophic or ulcerative gingivitis in the acute form of leukemia.

         e- periodontal diseases associated with HIV:

At the periodontal level, we find ulcero-necrotic gingivitis or ulcero-necrotic periodontitis. In addition to periodontal diseases, we note oral manifestations: herpes, papillomas, recurrent aphthous lesions, Kaposi’s sarcoma, etc.

IV- the notion of focal infection:

This involves the remote attack of an organ by microorganisms or their toxins from an infectious source; the route of transmission of the infection can be either the blood or lymphatic vascularization.

1- damage to the cardiovascular system:

A large percentage of Osler endocarditis is of dental origin, the occurrence of fever in patients with heart disease may lead us to think of a dental infectious focus.

2- dental infectious focus and pneumonia:

     Inhalation of periodontopathogenic germs can cause lung abscesses.

3- Periodontal infectious focus and nephropathies:

Dissemination of germs from dental or periodontal infection is sometimes responsible for glomerulonephritis.

4- periodontal focus and ocular manifestations:

Exceptionally, the development of uveitis or even conjunctivitis may be noted.

5- focal infection and dermatological diseases:

Patches of alopecia or partial alopecia may originate from infections in the oral cavity. 

6- neurological damage:

The onset of essential trigeminal neuralgia following bacterial dissemination of oral origin has rarely been observed.

7- premature births and periodontal diseases:

According to recent studies, a pregnant woman who has periodontitis during pregnancy has a 2.7 times higher risk of giving birth to

A premature baby compared to women with good oral health.

8- genetic influence and periodontal diseases:

There is a familial and hereditary character in patients with periodontitis , particularly those with aggressive periodontitis outside of periodontitis symptoms of syndromes.

Periodontal diseases and general diseases

  Early cavities in children need to be treated promptly.
Dental veneers cover imperfections such as stains or cracks.
Misaligned teeth can cause difficulty chewing.
Dental implants provide a stable solution to replace missing teeth.
Antiseptic mouthwashes reduce bacteria that cause bad breath.
Decayed baby teeth can affect the health of permanent teeth.
A soft-bristled toothbrush preserves enamel and gums.
 

Periodontal diseases and general diseases