Detection of high‐risk groups and individuals for periodontal diseases

Abstract

The evidence for systemic predisposition to periodontal diseases is reviewed in relation to cellular and humoral immunity, drug therapy, diet and nutrition and stress. It is concluded that, apart from defects of polymorphonuclear leukocytes (PMN) and Ehlers-Danlos Syndrome, little firm evidence exists for other diseases, though insulin-dependent diabetes and acquired immune deficiency syndrome (AIDS) may accelerate and/or potentiate the damage of existing disease. The precise rôle of drugs, diet and nutrition and stress remain to be elucidated, but recent advances in these areas offer the prospect of assessing risk using carefully controlled studies.

Oral diseases and socio-economic status (SES)

“…Above and beyond these well known and accepted aetiological factors and in the context of the present paper, it is interesting to note that since Goldhaber and Giddon 35 reported their findings in the 1960s concerning acute necrotizing ulcerative gingivitis (ANUG), the role of psychosocial stress has also been a recurring theme in the search for the aetiological factors of destructive periodontitis. 36,37 The model outlined by Clarke and Hirsch 38 for example, has received considerable support from a number of more recent studies. [39][40][41][42] Thus the evidence supporting psychosocial stress as an aetiological factor in periodontitis is growing.…”

Defining and classifying periodontitis: need for a paradigm shift?

“…This statement is founded on a belief that the number of sufficient causes will be limited and fully identifiable. However, to date, all indications have been that the causal web for periodontitis is so complex and involves so many factors in so many different constellations (27) that a classification of periodontitis based on etiology is effectively precluded.…”

Chediak-Higashi Syndrome and Premature Exfoliation of Primary Teeth

“…Alterations in the humoral immune system, fundamentally affecting the immunoglobulins, generate periodontal disease when the humoral disorder in turn affects other systems such as cellular immunity or the metabolic system. Therefore, the alteration of these two systems is the principal mechanism underlying periodontal disease mediated by immunoglobulins (3).…”