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Fast Facts: Perio Edition - Periodontitis as a Manifestation of Systemic Disease - Familial & Cyclic Neutropenia
Fast Facts: Perio Edition Episode 59
[Andrew Johnston, RDH]
Welcome back everyone! You are listening to another episode of Fast Facts- Perio Edition brought to you by A Tale of Two Hygienists in partnership with DentistRX. And now, please welcome your host, Katrina Sanders.
[Katrina Sanders, RDH]
Hello, and welcome to Fast Facts: Perio Edition. This week, we are continuing the conversation that we started last week in discussing periodontitis as a manifestation of systemic disease. Now, as we unpacked these diseases, we understand that these, although relatively rare, diseases, are diseases that will have a dramatic impact on the periodontium, and this week we begin the conversation in talking about familial and cyclic neutropenias. Now neutropenia, I want to be very clear, is a disease of our patients’ neutrophils. These are individuals who experienced episodes of abnormally low white blood cells. And we know how important these white blood cells are throughout the body. These neutrophils are important. They are integral in fighting off infection, particularly infection that is causative by surrounding bacteria that can destroy and subsequently enter the body. Does that sound like periodontal disease? In addition, when we talk about patients that have a deficiency of these neutrophils and not just talking about bodily or systemic disease, these are patients who now do not have the immune defense to fight off the bacteria associated with periodontal disease.
So these patients can present with familial, that would be congenital neutropenias. And these would be patients who would likely report that a family member, a mom, a dad, has neutropenia, has a deficiency within their immune system. Or these could be patients that present with cyclic neutropenias. And again, this is a relatively rare disease. But when patients experience cyclic neutropenias, cyclic means that this individual is experiencing relatively recurring severity of disease. In these patients, episodes of neutropenia will recur about every 21 days, and the severity of this neutropenia will last anywhere between three to six days.
During this period, this individual is experiencing constant and consistent episodic challenges. They're experiencing abnormal blood levels, anemias, they're experiencing changes in their platelet or clotting time. They're also experiencing regular changes in the concentration of their white blood cells. These individuals will experience systemic observations. So these will be patients that may experience fever, a general ill feeling like malaise, inflammation. In addition, they may also present with oral observations in their mucosal membranes, things like aphthous or stomatitis ulcers. They may experience pharyngitis or inflammation of the throat.
And of course, alongside this, we see the sequelae of periodontal disease. This is where, of course, the disease process is likely due to the fact that the body is now susceptible to allowing bacterial infection through our mucosal membranes. These bacterial infections, of course, will vary in severity. But we do understand that this hereditary disease does provide an opportunity, does prime the oral cavity to allow for the patient to experience this disease process. Cyclic neutropenias can be called anything from cyclic neutropenia to periodic neutropenia, human cyclic neutropenia, or even cyclic hemopoiesis.
It's important for us to understand that when patients present to our chairs, there is a possibility that these individuals may not know that they have this disease process. If we are observing a patient who is constantly experiencing episodic bouts of periodontitis without resolution, it's important for us as patient advocates to, of course, encourage this patient to consider seeing a primary care physician or to have additional blood work done to evaluate for potential systemic disease that may provide a contributory factor. Thank you for joining us today.
Join us next week as we continue the conversation around patients presenting with periodontitis as a manifestation of systemic disease.
This has been another episode of Fast Facts - Perio Edition with Katrina Sanders, RDH. Please feel free to reach me on Instagram @thedentalwinegenist or on my website www.KatrinaSanders.com Cheers.
[Andrew Johnston, RDH]
Thank you for listening to another episode of Fast Facts - Perio Edition, brought to you in part by DentistRX makers of the InteliSonic line of power brushes. Find out more by visiting their website at www.dentistrx.com. We'll see you next week for another Fast Fact!