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Protecting All Children's Teeth (PACT): A Pediatric Oral Health Training Program
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Periodontal Disease
Periodontitis is usually accompanied by gingivitis but is a distinct disease process that involves irreversible destruction of the supporting tissues surrounding the tooth, including the alveolar bone.
Periodontitis: Inflammation of the periodontium and especially the periodontal membrane .
Gingivitis: Inflammation or infection of the gums.

Plaque and tartar accumulate at the gum line and the resultant inflammation leads to formation of a “periodontal� pocket between the gums and the teeth.

The infection and inflammation spread from the gingiva to the periodontal ligament and alveolar bone that support the teeth. The destruction of support causes the teeth to become mobile and, if left untreated, can lead to tooth loss.

Signs and Symptoms of Periodontal Disease

  • Gums that are swollen, bright red, and tender to touch
  • Gums that bleed easily
  • Gingival recession
  • Tooth Loss
  • Loose/mobile permanent teeth
  • Both hormonal changes and external factors can affect the periodontal tissues of the adolescent

Localized Aggressive Periodontitis

  • Usually begins at onset of puberty
  • Alveolar bone loss usually affects incisors and 1st molars
  • Destruction of supporting tissues = high risk for tooth loss
  • Signs can include tooth mobility and migration (increased spacing
    between teeth)
  • Can occur without obvious inflammation (gingivitis) or other
  • Disease typically progresses very quickly
  • Clinical and radiographic exam by a dental team is very important
  • Intra-oral condition is not necessarily linked to any systemic
  • Genetic predisposition (family dental history should be
    evaluated; siblings should be examined)
  • Destruction can either arrest or progress and affect more teeth
    and become “Generalized Aggressive Periodontitis� (can affect
    the entire dentition)
  • A specific group of bacteria have been associated with this
    disease, so dental treatment typically includes antimicrobial

Fast Facts
Periodontal disease is very common among adolescents.
Periodontitis is the number one cause of tooth loss in adults.
Pubertal hormonal changes, hormonal contraceptives, and pregnancy all increase the risk of developing periodontitis.
Tobacco use significantly increases the risk for development of periodontal disease.
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