Outline of Presentation
What is periodontal disease?
What is inflammation? All about inflammation: the paradigm shift in
periodontology Inflammation, periodontal disease and cardiovascular disease Inflammation, periodontal disease and other disease states Risk factors for periodontal disease Treatment of periodontal inflammation Five Things to Remember Questions
2
care.
If left untreated, gingivitis may advance to periodontitis.
disease.
The tissues and bone that support the teeth are broken
down and destroyed, resulting in loosened teeth that may need to be removed There is an increased risk for other body problems. There are many treatment options available, including non-surgical and surgical therapies.
What is Inflammation?
Inflammation is the bodys first response to an injury. The first phase (acute inflammation) includes redness, swelling, heat,
inflammation. Acute inflammation often causes elevated C-reactive protein. Elevated CRP is a risk factor for several chronic inflammatory diseases.
diseases of aging.
These diseases include heart disease, arthritis, and periodontitis.
6
Examples of Inflammation
Sunburn
Infection
A cut on the skin
Inflammations Objective
Inflammation tries to contain the injury to the local
site.
The bodys reaction is immediate (called the innate
response).
Its ultimate purpose is to protect the body from further
damage.
8
conditions, uncontrolled inflammation, also called chronic inflammation, is harmful and causes tissue loss.
Chronic inflammation occurs when there is a sustained
Chronic Inflammation
Chronic inflammation can negatively affect all organs and tissues
of the body.
Chronic diseases of aging are connected through common
10
Periodontal Paradigm Shift: Because of this new focus on inflammation, there has been a shift in the way periodontists view periodontal disease and its relationship to other disease states.
11
inflammatory response.
Genetic and acquired risk factors lead to the hosts immuno-inflammatory
response.
A prolonged immuno-inflammatory response leads to destruction of
connective and bone tissues, which leads to the possible loss of teeth.
Chronic inflammatory diseases, such as periodontitis, arise over decades. Periodontal disease is a significant contributor to the total inflammatory
burden on your body and can adversely affect your systemic health.
12
thinking and brainstorming across many different fieldsusing inflammation as a common finding.
13
Workshop, cont.
The workshop was developed to expand and advance our
understanding of inflammation and the role it plays in diseases of aging. The experts from the diverse fields addressed topics of inflammation:
What is inflammation? What specific mechanisms constitute inflammation? What factors regulate inflammation? Why do individuals have different expression levels of inflammation? Is the inflammation in one disease common to the inflammation in
other diseases?
14
Workshop, cont.
The experts engaged in discussion of the future of
inflammation therapies and how they may change the future of periodontics. supplement to the Journal of Periodontology in August 2008.
(Available for free at: http://www.joponline.org/toc/jop/79/8s)
15
Workshop, cont.
What we learned: Periodontal disease is a bacterially-induced chronic inflammatory disease that does not resolve by itself. The inflammatory response is important. Environmental and genetic factors affect expression of inflammation in individuals . The initiation and resolution of inflammation are well controlled processes. Diabetes, CVD, and stroke all share common inflammatory processes similar to periodontal inflammation. Resolution of any inflammation in the body is helpful for overall health.
16
The Workshop helped highlight the relationship between various disease states, and suggested that inflammation may be the basis for these relationships.
17
Perio-Cardio Link: The relationship between periodontal disease and cardiovascular disease (CVD)
18
amount of inflammation in your body. Periodontitis and other sources of inflammation elevate CRP levels. Elevated CRP is a direct risk factor for CVD.
20
the August 2008 Journal of Periodontology supplement from the Workshop on Inflammation.
A consensus paper was developed in collaboration with the
21
22
23
Diabetes
Cancers
25
Arthritis
Arthritis (Rheumatoid arthritis
periodontal treatment. Patients assessment of pain also decreased following periodontal treatment.
*Pischon N, et al. J Periodontol. 2008 Jun;79(6):979-86. **Ortiz P, et al. J Periodontol. 2009 Apr;80(4):535-40.
26
Alzheimers Disease
Alzheimers disease is an inflammation of the brain. Antibodies and immune cells cross the blood brain barrier. Exposure to chronic periodontal
27
Diabetes
Hyperglycemia inhibits the resolution of inflammation. High CRP promotes insulin resistance. Patients with diabetes are three
Cancers
Pancreatic cancer Men with a history of gum disease are 54% more likely to develop pancreatic cancer than men with healthy gums.*
Head and neck cancers Chronic periodontitis is independently associated with the incidence of head and neck cancers.** Smoking increases this association.
*Michaud DS, et al. Lancet Oncol. 2008 Jun;9(6):550-8. Epub 2008 May 5.
29
Obesity
Patients with a higher body mass index (BMI) tend to have
30
31
32
33
Treatment of Periodontitis
Periodontists are experts in evaluating, diagnosing and treating
periodontal disease (a periodontist) if the inflammation is not resolved with regular teeth cleanings.
34
responded to non-surgical treatment may need additional procedures in order to become healthy.
Reducing one type of inflammation may reduce another: Patients with periodontitis and rheumatoid arthritis who received periodontal treatment:
The good news is that inflammation levels can be reduced. When chronic inflammation is controlled, the associated chronic inflammatory diseases may be controlled.
36
Chronic infections Periodontists can help reduce inflammation in the oral cavity.
Activate inflammation resolution systems: Add Omega-3 fatty acids to your diet. Take a daily low-dose aspirin. Have your teeth professionally examined and cleaned
regularly.
37
38
39
40
41
42
Thank you!
For more information visit www.perio.org To view supporting studies and references visit
www.joponline.org
Contact the American Academy of Periodontologys