Thesis on Periodontal health in the elderly population (60 years and over)

The aim of this study was to identify the risk factors for periodontal disease progression by individual characteristics at baseline among elderly people over a 6 months period. Subjects were selected from 200 people aged 60 years over at Preventive and Children Dentistry Department hospital of Bangabandhu Sheik Mujib Medical University (BSMMU) in Bangladesh who were in good general health and who did not require special care for their daily activities.

Gender, smoking, food habit,knowledge of teeth cleaning method and material and alcohol drinking habits were obtained using a questionnaire. For the assessment of periodontal disease progression, additional attachment loss was used if one or more sites had a 3-mm or more increase in probing attachment level over a 6 months period. In all, 200 subjects (135 males and 65 females) were surveyed. Significant associations were found between additional attachment loss and smoking, and attachment level of 6 mm or more at baseline respectively. Smoking habit and baseline attachment level of 6 mm or more may be considered risk factors for further attachment loss among healthy elderly people.
Periodontal diseases range from simple gum inflammation to serious disease those result in major damage to the soft tissue and bone that support the teeth. In the worst cases, teeth are lost. Whether the gum disease is stopped, slowed, or gets worse depends a great deal on how well the persons care for their teeth and gums every day.

In 1999, classification system for periodontal diseases and conditions were listed as seven major categories of periodontal diseases, of which the last six were termed as destructive periodontal disease because they are essentially irreversible. The seven categories are as follows:

1. Gingivitis
2. Chronic periodontitis
3. Aggressive periodontitis
4. Periodontitis as a manifestation of systemic disease
5. Necrotizing ulcerative gingivitis/periodontitis
6. Abscesses of the periodontium
7. Combined periodontic-endodontic lesions
Mouth is full of bacteria. These bacteria, along with mucus and other particles, constantly form a sticky, colorless pellicle on teeth. Regular tooth brushing and flossing can help to get rid from this pellicle. Otherwise it becomes hard to form Dental Plaque. Dental Plaque cannot be removed so easily. If left undisturbed, microbic plaque calcifies to form calculus, which is commonly called tartar. Calculus above and below the gum line must be removed completely by the dental hygienist or dentist to treat gingivitis and periodontitis. Although the primary cause of both gingivitis and periodontitis is the microbic plaque that adheres to the tooth surface, there are many other modifying factors. A very strong risk factor is one's genetic susceptibility. Several conditions and diseases, including Down syndrome, diabetes, and other diseases that affect one's resistance to infection such as periodontitis.

The longer the plaque and tartar present on teeth, the more harmful they become. The bacteria cause inflammation of the gums that is called "gingivitis." In gingivitis, the gums become red, swollen and can bleed easily. Gingivitis can usually be reversed with daily brushing and flossing, and regular cleaning by a dentist or dental hygienist. This form of gum disease does not include any loss of bone and tissue that hold teeth in place.

When gingivitis is not treated, it can advance to "periodontitis" (which means "inflammation around the tooth."). In periodontitis, gums pull away from the teeth and form spaces (called "pockets") that become infected. The body's immune system fights with the bacteria as the plaque spreads and grows below the gum line. Despite the body's natural response to infection bacterial toxins starts to break down the bone and connective tissue that hold teeth in place. So the condition is not treated, the bones, gums, and tissue that support the teeth are destroyed. The teeth may eventually become loose and have to be removed.
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