Periodontal Diseases - Essay Example

Periodontal Diseases Name Institution Course Date Contents Contents 2 Epidemiology of periodontal in Latin America 4 Prevalence of Periodontal diseases 5 Influence of risk factors 6 Age 6 Gender 6 Race/ethnicity 7 Genetics 7 Socioeconomic status 8 Tobacco smoking 9 Problems in measuring periodontal diseases 9 Periodontal and other diseases 10 Conclusion 12 References 13 Introduction Periodontal diseases such as gingivitis and periodontitis are some of the common chronic diseases. The phrase ‘periodontal’ stands for ‘around the tooth’ (Baelum et al., 2003). Therefore periodontal diseases are chronic bacterial infections affecting the gums and the bone that supports the teeth. This infection can affect one tooth or more than one tooth. Gingivitis also known as the inflammation of the gums takes place in response to bacteria that accumulates near the gum. It is mostly characterized by redness or bleeding of the gums and is a painless condition (Albandar and Rams, 2002). On the other hand, periodontitis is an inflammation of the tissue that surrounds the teeth and affects the gingiva, the bone and ligaments and also occurs in response to bacterial infection. Periodontitis is a painful condition and in tis severe form, it can cause loss of tooth bone leading to loose teeth or loss of tooth. Gingivitis and periodontitis occur as a result of bacteria that accumulate around the dental plaque (Baelum et al, 2003). When the bacteria accumulate as a result of infrequent oral hygiene, the risks of the occurrence of these oral diseases increases. Nevertheless, general health contributes significantly in the severity of the diseases and poor general health is a core determiner of the progression of gingivitis and periodontitis (Albander and Rams, 2002). An example of general health aspect is smoking as it plays a significant role in the growth of periodontitis. In additional, medical conditions such as cardiovascular diseases and diabetes also contribute to the development of periodontitis (Baelum et al., 2003). This essay aims at providing information regarding the prevalence of periodontal in the Latin America population. It will also detail out the epidemiology of the disease in Latin America and the challenges that come about in measuring the disease. In addition, it will highlight findings regarding the association of the periodontal disease and other health conditions such as diabetes. Epidemiology of periodontal in Latin America Epidemiology can be defined as the study of diseases in a particular population and the ways in which different social levels are affected by hereditary, individual behaviour, environmental, biological and socio-economic factors. Epidemiology is aimed at identifying the risk factors linked to a disease, quantifying the strengths of the relationship as determine whether the relationship is causal. Gingivitis is termed as the common periodontal disease found globally (Susin et al., 2005). The prevalence and severity of the disease are not much pronounced in the developed countries as in the less developed countries. In addition, periodontal disease is less prevalent in children and increases its occurrence with age. According to a recent study of the prevalent model for periodontal disease, not all sites with gingivitis can develop into periodontitis (Susin et al., 2005). However, long term gingivitis can increase attachment loss. Epidemiology assists in understanding the various aspects of interaction between periodontal healthy and diseased individuals (Borrell and Papapanou, 2005). New complex approaches with regard to the study of periodontal disease have shifted traditional clinical instruments of diagnosis explaining the significance of indicators like clinical attachment loss and offering new perspectives for other like periodontal probing. Moreover, recognising a number of these diagnostic instruments has been proposed all as a result of the study of epidemiology of periodontal diseases. The epidemiology of this disease also assists in recommending alternatives for treatment or prevention of the diseases (Borrell and Papapanou, 2005). The epidemiology of periodontal disease will there be analysed in terms of prevalence and influence of risk factors. Prevalence of Periodontal diseases Gingivitis is a common oral condition in the Latin America. According to survey conducted in Latin America, Brazil was noted to have a prevalence of as high as 90% among children between 7-14years (Susin et al., 2004). The gingival index was reported to be 1.24 irrespective of factors such as the socioeconomic background. In addition, the national survey conducted in Latin America showed that the severity and prevalence of gingivitis in Argentina increased with age. Only 2.7% of children below 7 years had gingivitis while 27.2% of age above 14 years had the disease. In addition, aggressive periodontics was found in 2.6% of the Latin population in the adolescence stage (Lopez et al., 2004). Also, 0.32% of adolescent population in Chile was found to have periodontitis. In addition, in a more recent study, prevalence of 2.5% of adolescent population in Brazil was found to have periodontal. Generally, the research established that the prevalence of periodontal diseases in Brazil and Chile is higher than in other developing countries and developed countries. In addition, the prevalence of chronic periodontal disease varied between 40% and 80% in the general population. Such variation is attributed to regional differences and methodology and sampling differences (Cortelli et al., 2005). A study conducted recently by Susin et al revealed that the prevalence and severity was higher in the population of people above 30 years in Brazil compared to younger population. The prevalence of periodontitis in Porto Alegre is higher than reports of the disease in other countries (Lopez et al., 2004). In the Brazilian study, 92.2% of those with 34-44 years and 99.2% of those with 55-64 years are reported to showing a CAL ≥ 4 mm. Almost 80% of the Latin population has at least CAL of ≥2mm and with CAL of ≥ 6mm, the prevalence drops to 20% (Cortelli et al., 2005). Generally, Brazil is the Latin American country with the highest prevalence of periodontal diseases. In Latin American, highest prevalence of periodontal diseases is found among children and adolescent with gingivitis affecting 34.7% of young people with the highest prevalence found in Colombia and lowest prevalence in Mexico (Lopez et al., 2004). Higher prevalence of periodontal disease in Latin America is attributed to poor oral health, lower rates of dental visits and low socioeconomic status. The National Centre of Health Statistics has reported that, in Latin America, the milder form of periodontal are close to universal and the severe form of periodontal that result to tooth loss are less prevalent (Lopez et al., 2004). Influence of risk factors Age A good number of research studies in Latin America noted that the age is a fundamental factor owing to the prevalence and severity of the periodontal disease (Albander, 2000). In a study carried out by the Brazilian Government, periodontal prevalence and severity among Latin Americans jumped from 1.34% in young people to approximately 9.98% in the old population (Travilatto et al., 2002). However, it dropped to about 6.3% above 60 years of age. The drop of the prevalence and severity above 60 years of age can be explained by high rate of edentulous subjects among people in this age group. It is however unclear whether age increases the prevalence and severity of periodontal disease or this is due to the collective effect distinctive of the illness (Albander and Rams, 2002). Gender Among the Latin Americans population, there is an increased risk of developing periodontal diseases among males (Hugoson and Jordan, 2003). This can be attributed to the poor oral hygiene and smoking witnessed more often among men. Although gender-specific differences with regard to immune-inflammatory response to bacteria in periodontal have not been proven, it is believable that these differences exist (Hugoson and Jordan, 2003). Race/ethnicity In the United States, race or ethnicity is a major factor that is correlated to the development of periodontal diseases (Albandar, 2005). Among the Latin Americans, non-whites where associated to have higher risks of periodontitis that the whites. Certain ethnic groups especially subjects of Latin American background are associated with periodontal disease than any other groups in the United States. The association between the disease with race or ethnicity can be attenuated especially when certain aspects like cigarettes smoking and status level are accounted for (Albandar, 2005). For instance, Latin Americans often have lower socio-economic status compared to Caucasians. Therefore, the association of periodontal diseases among the Latin Americans can be attributed to socioeconomically factors, behavioural conditions among other disparities. To add to this, there is evidence also that such risks can be partly attributed to genetic disposition. Genetics Although periodontal diseases respond as a result of bacterial infection, studies have also indicated that susceptibility of periodontal diseases can partly be as a result of the host factors. In the Latin America, relatively isolated populations have shown to develop periodontal diseases that significantly differ from one group to another. It is estimated that almost 50% of periodontal incidents available in the Latin America population are explained through genetic determinants. A number of studies show that polymorphisms related to periodontal diseases among the Latin America population and they show inconsistent results. For instance, a case report presented by Trevilatto et al. (2002) where the relationship between polymorphism and periodontal development within lain America families was carried out. However, no correlation was found among the family members. In another instance, Quappe et al (2004) investigated the relationship between interleukin-1 gene polymorphisms and periodontitis. The results indicated a positive correlation between periodontitis and polymorphism. Most of the studies showed appositive correlation between genetic polymorphism and periodontal status of people. Socioeconomic status Various research studies conducted in Latin America have addressed the issues revolving around socioeconomic status as common risk factors for the periodontal diseases. It is understandable that many of the studies have shown correlation between socioeconomic status and periodontal disease (Albander, 2005). Periodontal diseases carry a social determinant underestimated through statistic corrections. A recent research noted many studies showing a positive correlation between socioeconomic factor and periodontal status. Many studies have concluded that socioeconomic factors associated with the development of periodontal diseases among the Latin Americans appear less important than smoking. Nevertheless, as stated by Nicolau (2005), there is a strong gradient associated with periodontal diseases as they are socially patterned with effects of low socio-economic factors in the course of the development of the diseases. According to Nicolau, as SMS increases, the proportion of the population having periodontal diseases significantly diseases. In effect a study conducted by Brazilian National Survey in Latin-American, a tendency of higher prevalence and severity of periodontal diseases among population with lower socioeconomic status was observed compared to population of higher socioeconomic status (Trevilatto et al., 2002). Also, people living in country-side villages were observed to have higher prevalence compared to people living in the cities. Tobacco smoking Research studies have attempted to address the correlation between tobacco smoking and periodontal diseases status (Tomar and Asma, 2000). Among the Latin American, compared to non-smokers, smokers were two times likely to have CAL. In the ages between 14 and 29, smokers were 2 times likely to develop localised recession of approximately 1mm than non-smokers. Among individuals with 30 years and above, smokers were more likely to develop localised recession of approximately 3mm (Susin, Oppermann and Haugejorden, 2004). generally, it can be confirmed from the studies that cigarette smoking increases the prevalence and severity of periodontal disease with heavy-smokers as high-risk individuals. Problems in measuring periodontal diseases Diseases severity ranges along a wide range of slight to severe or localised to generalised attributed to the amount, locality and maybe rate of attachment loss (Savage, 2007). Periodontal diseases especially periodontitis is known to affect different regions in the mount to differing degrees. This is usually progressive as it is characterised by systemic disease progression which is then followed by periods where the illness is more quiescent. If chronic periodontitis is left untreated, an individual may experience tooth loss as a result of the progressive nature that it has (Borrell and Papapanou, 2005). Therefore, the main goal needed to preserve and retail oral health with a number of therapies and techniques. The measurement criteria form measuring periodontal health may include maintenance of clinical attachment levels, infection and bleeding on probing. Measurement of periodontal just like any other diseases is measured using indices. An index is a way of converting a particular clinical diagnosis into a clear comparable statistics (Borrell and Papapanou, 2005). Examples of indices used for dental measurement include Oral Hygiene Index, Plaque Index, Periodontal Index to name a few. For periodontal diseases Community periodontal index, gingival index and oral hygiene index can be used. For instance, Community Periodontal Index of Treatment Needs is an international acknowledged method of measurement of periodontal condition. For this method, there indicators used for assessment include periodontal pockets, gingival calculus and presence of gingival bleeding (Savage, 2007). The disadvantages of measuring periodontal disease using CPINT is that the probe measures several parameters such as bleeding and periodontal pocket utilising the same index, recession and mobility is excluded, it does not exactly measure the effectiveness of a particular treatment and measures the available treatment needs and not the diseases (Savage, 2007). In general periodontal the methods of measuring periodontal diseases such as CPINT and partial mouth assessment have the potential of underestimating the prevalence and overestimate severity of the diseases based on cumulative attachment loss. In addition, measurement this diseases can encounter the problem of ‘clustering of data’ since many scores are obtained in one subject causing a severe analytical consequences (Allen, 2009). Therefore, the confidence intervals for these techniques are narrower, which often result to increase in risk for type 1 error and rejection of null hypothesis. Periodontal and other diseases Recently, literatures have begun highlighting the possible connections between periodontal and other systemic diseases (Paquette, 2002). A chronic oral infection like the periodontitis is a potential source of infection. Chronic periodontal diseases have been considered a risk factor for other diseases such as cardiovascular diseases, peripheral arterial diseases, among others. In addition, it has been considered a risk factor for increases mortality for diabetes, obesity and complications of pregnancy (Tsai, Hayes and Taylor, 2002). In fact, some of the mentioned conditions may increase the prevalence and severity of periodontal diseases by means of modifying the immune system response to periodontal bacteria. According to research, periodontal diseases and systemic diseases have bi-directional relationships. The potential mechanisms that link periodontal diseases to the secondary systemic diseases may include the metastatic spread of infection as a result of transient bacteraemia, injury as a result of circulation of oral microbial toxins, and inflammation resulting from immunological injury caused by oral micro-organisms (Sheihan and Netuveli, 2002). Heart diseases have been discovering to be the diseases most commonly witnessed in many individuals with periodontitis. Individuals with periodontitis have a 25% increased risk for developing a coronary heart diseases compared to individuals free from periodontitis (Paquette, 2002). In male population with ages below 50 years with periodontitis, they are 70% likely to develop heat diseases compared to man within the age group free from periodontal diseases (Paquette, 2002). In addition, periodontal diseases have the potential to induce low-level bacteraemia, reduce white blood cell count and expose the host to endotoxins that destroys endothelial integrity, platelet function and the metabolism of lipoproteins. Moreover, periodontal diseases can be a risk factor contributing to pre-term low birth weights. For instance, a research study conducted by Bosnjak et al, (2002) determined the relationship between periodontal diseases and pregnancy complications. He stated that the ratio for pre-term low birth weight among women with periodontitis was approximately 7.5. A complementary risk analysis concluded that 18% of pre-term low birth weight case was attributed to periodontitis infections (Paquette, 2002). With regard to the association between periodontal diseases and secondary respiratory diseases, it is evident that pneumonia is positively correlated with oral health and good oral health can reduce the progression respiratory diseases especially among the elderlies. Lung function decreases with occurrence of periodontitis (Paquette, 2002). The oral cavity is a potential residence for respiratory pathogens. Thus the mechanisms linking periodontal diseases with respiratory complications could be due to the ability of oral bacteria to cause pneumonia in the lungs and colonization of respiratory pathogens (Paquette, 2002). Conclusion Periodontal diseases are very common chronic diseases found globally. They are chronic bacterial infection affecting the gum and bone of the teeth. Prevalence of the disease in the Latin America is high with Brazil having the highest prevalence among other countries. In the country, the prevalence of periodontal diseases is higher in male than in female. In addition, factors such as socioeconomic status, age and dental check-ups impact the prevalence and severity of the disease. In Latin America, the risk factors associated with periodontal diseases include race or ethnicity, age, socioeconomic status, genetic factors, gender among other factors. Also, research has provided evidence that there is a connection between periodontal condition and various systemic diseases such as respiratory diseases, cardiovascular diseases, diabetes etc. This means that periodontal diseases and secondary systemic diseases have bi-directional relationship. Measurement of periodontal diseases is faced with many challenges including occurrence of type 1 error, underestimation of prevalence of the diseases and unreliability of the methods. References Albandar JM, Rams TE. (2002). Global epidemiology of periodontal diseases: an overview. Periodontal, 29, 7-10. Albandar, JM. & Rams, TE. (2002). Risk factors for periodontitis in children and young persons. Periodontology 2000, Vol.29, pp. 207-222, ISSN 0906-6713 Albandar, JM. (2000). Global risk factors and risk indicators for periodontal diseases. Periodontology 2000, Vol. 29, pp. 177-206, ISSN 0906-6713 Albandar, JM. (2005). Epidemiology and risk factors of periodontal disease. Dental Clinics of North America, Vol.49, pp. 517-532, ISSN 0011-8532 Allen F. & Steele J. (2009). Data Validity and Quality. In Statistical and Methodological Aspects of Oral Health Research 1st edition. Edited by Lesaffre E, Feine J, Leroux BG, Declerck D. 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