Dental Products Report - February 2011 - (Page 86)
The relationship of oral health to overall human health is not a one-way street, with overall human health having a profound in⇑uence on periodontal diseases. Dental practitioners must understand how oral and periodontal lesions can be a ⇒rst indication of underlying systemic diseases so they can make the appropriate referrals.
The mouth-body connection
What you need to know about periodontal manifestations of systemic diseases and conditions.
by D R .
M A R K RY D E R
AT A GLANCE
THE SET-UP THE TEAM
Bringing together a variety of voices for the best advice and big ideas. TEAM MEMBERS
Dr. Peter Cabrera (Lead) Dr. Mark Ryder Dr. Richard Huot
“The connection between oral and systemic diseases has been well established. Dr. Mark Ryder provides an excellent overview of this extensive area. Of particular importance is the section on HIV where Dr. Ryder talks about the re-emergence of oral lesions in HIV positive patients”—DR. PETER CABRERA, TEAM LEAD
ABOUT THE AUTHOR Dr. Mark Ryder is a Professor and Chair of Periodontology and Director of the Postgraduate program in Periodontology at the University of California, San Francisco, where he has been a faculty member for 31 years. He received his dental and specialty training from the Harvard School of Dental Medicine. He is the author of more than 150 articles, abstracts and book chapters and has lectured extensively in continuing education courses on the diagnosis and treatment of periodontal diseases He has received awards both from the University of California and from national organizations for his entertaining and informative lectures, and for his contributions to dental education. The products that appear in conjunction with this article are for illustrative or informational purposes only. Their inclusion does not denote endorsement by the author of this article.
For an article from Dr. Mark Ryder on how tobacco use contributes to periodontal disease, go to dentalproductsreport.com.
Over the past 20 years, there has been a growing interest in the possible connections between oral health in general and periodontal diseases in particular on overall systemic health. Both the dental practitioner and the general public now are well aware of new research studies that implicate periodontal diseases as a possible risk for cardiovascular diseases, poor glycemic control, adverse pregnancy outcomes, pulmonary diseases and gastrointestinal diseases, just to name a few examples. The importance of this possible link is understandable when considering that periodontal diseases, taken as a whole, can be considered a “biofilm infection,” which of course is the bacterial plaque. If this plaque bioﬁlm is left untreated, there is an acute and chronic inﬂammatory reaction to that bioﬁlm. When considering periodontal diseases from this viewpoint, these diseases may be the most common bioﬁ lm and chronic inﬂammatory diseases one may encounter. While the inﬂuence of periodontal diseases on human diseases and human health has taken most of the scientiﬁc attention and public spotlight over the past 20 years, it is important
of GPs have noticed an increased awareness among patients about periodontal disease and treatment, or the oral-systemic link in the last three years.
Source: June 2010 DPR Periodontics Survey
to remember the relationship of oral health to overall human health is not a one-way street. Systemic conditions, medications and overall human health may have profound inf luences on the incidence, severity and clinical characteristics of periodontal diseases. More importantly, changes in the oral cavity in general and periodontal tissues in particular—which can be easily detected by direct observation, radiographs and clinical measures—may be the ﬁrst indication of underlying systemic problems. In this article, I will review some of the most important periodontal manifestations of systemic diseases and the dental practitioner’s role in monitoring these conditions.
FIGS. 1-3 Severe gingival
enlargement from a patient with Leukemia. As in patients with gingival enlargement from conditions such as other leukemias, lymphomas, immunosuppressive disorders, or patients on certain medications such as cyclosporin and dilantin, the clinical appearance of the periodontal tissues may appear similar. Special thanks to Dr. Sol Silverman (Fig. 1). Gingival enlargement from a patient who is taking cyclosporin, an immunosuppressive drug often used to prevent rejection of organ transplants. Special thanks to Dr. Caroline Shiboski (Fig. 2). An HIV positive patient with poor dental care. In particular, note the severe and broad band of inflammatory and cyanotic changes along the gingival margins. This is primarily because of a fungal infection (candida) that has invaded the surface of the gingiva (Fig. 3).
Photos courtesy of Dr. Sol Silverman (Fig. 1) and Dr. Caroline Shiboski (Fig. 2).
Table of Contents for the Digital Edition of Dental Products Report - February 2011
Dental Products Report - February 2011
Table of Contents
From the Editor
Clicks & Picks
DENTSPLY Caulk’s SureFil SDR Flow
Keep Your Data Secure
Ivoclar Vivadent’s Multilink Automix
DENTSPLY Caulk’s TPH3
The CAD/CAM Chorus
Reducing Contamination in Your DUWLs.
The Mouth-Body Connection
Use Sonic Instruments
Create Class V Restorations
Create a Stable Temporary Restoration
Focus on Improved Impressions
All New Scheduler for Softdent
Demi Plus LED Curing Light System
Seeing Is Believing
Your Loupe Options
Products in Practice
Image Is Everything
Quolis 5000 Chair
Byte by Byte
Dental Products Report - February 2011