Fast Facts: Perio Edition – Ehlers-Danlos

Fast Facts: Perio Edition Episode 67
 
[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 dialogue around Periodontitis as a Manifestation of Systemic Disease, and I’m actually really excited to talk about (I’m always excited), but I’m particularly excited to talk about this week’s condition, and that is Ehlers-Danlos. You see, we’ve been having this dialogue discussing different types of systemic diseases and conditions that have a contributory factor in periodontitis manifesting itself. And Ehlers-Danlos is a very interesting one. You see, all of the diseases we’ve looked at thus far have been genetic in nature or congenital. And Ehlers-Danlos is no exception. It’s a group of hereditary disorders. There are about 13 different kinds of different displays of Ehlers-Danlos. But Interestingly enough, this is a group of disorders associated with a connective tissue. And because it affects collagen structure, collagen function, or some type of a protein associated with connective tissue, this is where we’re going to start to see challenges from a systemic standpoint in joint hyper-mobility or maybe easy dislocation of joints. These patients may have a history of scoliosis or other joint deformities. They may have hyper extensibility so their skin can be stretched out really far. And of course, along with this hyper mobility, this challenge in the strength, function, structure or form of collagen or connective tissue. We can also see things like abnormal scarring, hernias or organ prolapses, and in some rare conditions, we can see even like cardiac valve issues, which can be a challenge.
 
Ehlers-Danlos is oftentimes seen systemically, however, we can also see it intraorally. As you can imagine, if this is a disease that impacts the connective tissue or lamina propria, we are going to likely see some challenges in the mechanical protection of the periodontium. And that’s exactly what we often see in some of these periodontal manifestations of Ehlers-Danlos cases. So we will oftentimes see as a major criterion, generalized lack of attached gingiva in cases. And so we understand that that’s absolutely going to elevate the risk of severe periodontitis or early onset periodontitis in childhood or adolescents, as well as some challenges associated with a family history. These individuals may say, my mom or my dad had this challenge, and so we absolutely understand that this congenital nature certainly can move through affected family members. Interestingly enough, on a side note, we were working with a particular patient in our periodontal practice, this was about two years ago, and this particular patient was submitted to our practice because they had advanced periodontal pocketing and the patient was non responsive to treatment in the general practice. The patient had gone through non surgical scaling and root planing. In our practice, we had done several rounds of laser assisted osseous and flap surgeries. And although the root surface was impeccable and the gum tissues pure healthy with absolutely no bleeding. We simply could not get this patient to experience any pocket reduction. The only thing on the patient’s health history of noteworthy was that the patient had had several surgeries on the ligaments in their feet. So I contacted my sister, Dr. Sanders who is a foot and ankle surgeon And I said, hey, what do you know about a patient who’s had several surgeries on their foot ligaments? And we just aren’t seeing any response in the gum tissues. We’re thinking it’s something systemic but we don’t know what’s going on. What are your thoughts? And she said, oh, I bet this patient has ED. She meant Ehlers-Danlos. And of course the whole point being this is absolute situation where the patient had demonstrated that they experienced connective tissue issues in other areas of their body. In this case the patient’s foot. So we told the patient, hey, you should get tested for Ehlers-Danlos. And you know it? The patient had Ehlers-Danlos and not a single member of their family had any idea. And so, of course that created a cascade of first degree relatives who also met any of those diagnostic criterion. Also getting tested for Ehlers-Danlos. What an exciting time for us to be in the dental profession and what a cool way as a dental hygienist to support our patients in the oral and subsequent systemic link. With that that concludes today’s conversation about Ehlers-Danlos Syndrome. Join us next time as we continue the conversation around 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!