“Typically, the patient affected by periodontitis is in the fifth decade of life and, in general, presents risk factors, one of which is certainly insufficient oral hygiene that has determined a condition that precedes that of periodontitis, which is gingivitis, that is, inflammation of the gums, from which then develops the physiopathological procession that determines the destruction of the tissue supporting the tooth. The habit of smoking certainly determines an acceleration in the destruction of periodontal tissues: the more the patient smokes, the greater the risk of this condition with a more rapid progression. Another fundamental risk factor is diabetes, in particular, uncontrolled diabetes”. Leonardo Trombelli, elected president of Sidp, Italian Society of Periodontology and Implantology, explains this to Adnkronos Salute on the occasion of National Periodontitis Day.
“When we are faced with a condition of severe periodontitis – adds Trombelli – it is always important to also evaluate glycemic metabolism, blood sugar and glycosylated hemoglobin, in order to ensure that there is no coexistence of undiagnosed diabetes. It is equally true, however, that periodontitis can exacerbate diabetes, in the sense that oral infection could cause metabolic decompensation in the diabetic patient”. In detail, “periodontitis is an infectious-inflammatory condition that is caused by dysbiosis, that is, an alteration of the oral flora, which causes an inflammatory condition. Furthermore – the specialist specifies – bacteria can continuously circulate by filtering from the gum margin and be introduced into the bloodstream, even simply during the chewing phases. The persistent inflammatory condition, on the other hand, can trigger complications also in different organs and body districts, such as the onset of lesions and atherosclerotic plaques that then predispose the patient to a cardiovascular disease”.
Technically, periodontitis “is a multifactorial disease, in which both genetic and environmental components come into play – the expert points out – From a genetic point of view it is polygenic, so there is a set of genes that seem to underlie the susceptibility to periodontitis, none of which however determine it. It therefore becomes particularly complex to identify markers, whether they are linked to the microbiome or to factors and mediators of inflammation, as well as genetic and epigenetic factors of the patient at risk. For this reason, early diagnosis is extremely important – concludes Trombelli – that is, intercepting the early forms of the disease, such as gingivitis, because the treatment of gingivitis is the best primary prevention for periodontitis”.
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