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| about periodontal disease |
| In this column, we will reply to questions about periodontal disease, monthly. We hope you can learn correctly what periodontal disease in connection with your health is, and refer to it for your life. |
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| The 3rd time basic knowledge
of gum disease |
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Q1:How
periodontal disease progresses?
A1:
Periodontal disease is mainly caused by
bacterial infection. In general, 300-500
kinds of bacteria exist in the mouth of
human, and when the mouth is left unclean,
these bacteria nest in gingival sulcus,
forming a cluster, called plaque. Since
periodontal bacteria dislike oxygen, they
move toward the inner part of the periodontal
tissue, where oxygen partial pressure
is low, to prepare a comfortable environment
for themselves. As they get in, they generate
endotoxins and enzymes that destroy surrounding
tissues.
Meanwhile, the defensive cells in periodontal
tissues defend themselves by incorporating
their immune system to eliminate plaque
bacteria from gingival margins. First,
neutrophils fight in the forefront and
then the dead cells are discharged as
pus. When further defense is required,
host defense system sends out macrophages
and lymphocytes, and these cells generate
the substances such as proinflammatory
cytokines: IL-1, TNF-α, IL-6. These
substances are produced to protect the
body but their overproduction works against
periodontal tissues and causes periodontitis
to be advanced. Furthermore, many researchers
are paying attention to these substances
because they travel throughout the body
through the blood stream and may lead
to serious health situation such as diabetes,
cardiovascular diseases, low-birth weight,
adverse pregnancy out comes, respiratory
disease, etc.
Development and progress of periodontal
disease are as follows:
Initial stage
1) The gingival margins are intricate
and food particles are easy to be cumulated
in the structure.
[Detailed
illustration]
2) The antibodies and neutrophils of the
local area counteract the bacteria and
the gums are inflamed (gingivitis).
[Detailed
illustration]
3) As inflammation advances, the area
runs short of oxygen and anaerobic bacteria
proliferate. These periodontal bacteria
generate endotoxins and other harmful
substances into gingival pockets and destroy
epithelial cells that adjoin teeth and
gums.
[Detailed
illustration]
Early stage
4) When epithelial cells that adjoin teeth
and gums are destroyed, macrophage, lymphocytes
and fibroblasts of the periodontal tissues
begin their defense reaction (gingivitis).
[Detailed
illustration]
5) Macrophages, lymphocytes and fibroblasts
generate cytokine and proteolytic enzymes
and destroy periodontal fibers and teeth
supporting bones.
[Detailed
illustration]
Established stage
6) Teeth become loose while gums are swollen
and be predisposed to bleeding and draining
pus. Cytokines, enzymes and other substances
with proteolytic activity generated at
this stage may be carried throughout the
body by capillary vessels leading to serious
health situation.
*What is cytokine?:
It is a protein bonding sugar, mainly
function as a signal transduction element
which enables communication among cells.
It directly and indirectly engages in
host immune response, biological defense
reactions, inflammation and allergy.
Illustration offer: Okayama University
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