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Fast Facts: Perio Edition – Periodontitis as a Manifestation of Systemic Disease – Glycogen Storage Disease

Fast Facts: Perio Edition Episode 64
[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 our conversation in discussing various types of systemic diseases that will contribute to Periodontitis as a Manifestation of Systemic Disease. This week, we are talking all things Glycogen Storage Disease, and I know what you’re thinking “glycogen storage disease is something similar to, for example, my patients who have diabetes or various types of diabetic complications?” And my answer to you would be sort of. You see, we remember back to hygiene school when we learned that glycogen is the stored form of glucose. So when we have excess glucose in our bloodstream, our body can actually convert that glucose into glycogen. It gets stored in our liver and sometimes in our muscle cells. And when our blood glucose starts to dip a little bit, when the body needs energy, particularly for the central nervous system, this is when certain types of enzymes will come along and break down that glycogen into glucose, which, of course, then gets sent out into the body.
Well, here’s the challenge, in individuals who have glycogen storage disease, these individuals are missing one particular type of an enzyme that will allow that breakdown to occur. By the way, there are ten different types of glycogen storage diseases classification zero all the way up to nine. But the vast majority of glycogen storage disease patients will fall in either type one, which is von Gierke’s disease. Type three Cori disease can also be called Forbes disease or type four Andersen’s disease. Really, the main piece to know with regards to individuals who have glycogen storage disease is that this is oftentimes seen early on in youth, it’s hereditary, so it’s passed down from the parents to the child through an abnormal gene mutation. And individuals who have glycogen storage disease will demonstrate general symptoms like not growing fast enough. They are oftentimes heat intolerant. They bruise very easily. They oftentimes have hypoglycemic issues. Stay tuned as we talk about that in a minute, an enlargement of their liver or their belly, weak or low muscle toning and muscle pain or cramping, typically during exercise. So, of course, our main concern as clinicians is that hypoglycemia and we know that we can see gingival changes or observations whenever an individual is experiencing metabolic challenges associated with hypoglycemia. Well, interestingly enough, one of the challenges that we do see as this relates to perio is that these individuals are absolutely going to demonstrate some of that imbalance with the concentration of or rather the reduction of glucose concentration in their bloodstream.
So we will see challenges associated with their delayed wound healing. And we will also see challenges in oral manifestations of the gingiva. It is believed that there is a mixture of chronic inflammation, dryness of the gingiva and maybe a slight glycogen accumulation within the fibroblasts which create an etiology of gingival overgrowth in many patients. In addition, we’ve actually seen the presence of cleft palate and even a bifurcated Uvula in many patients who have glycogen storage disease. And finally, of course the major concern is that there is often times a frequent intake of carbohydrates for individuals who have glycogen storage disease in order to support that decreased or declined blood glucose level. So of course we understand that we’re going to likely see an elevated risk of these individuals not only experiencing periodontitis as we will see with these types of cases, but also we will likely see these individuals experiencing an elevated risk for perio and decay. Stay tuned as we continue the conversation, next week we’re going to be talking about infantile genetic agranulocytosis. That’s a mouthful! So stay tuned to check in with us next time. Have a wonderful day.
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 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 We’ll see you next week for another Fast Fact!

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