Fast Facts: Perio Edition Episode 70
[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. Today we are concluding the conversation around Periodontitis as a Manifestation of Systemic Disease. I know y'all, I feel like this has been such an ongoing conversation and what I love about it is how critical this conversation truly is. You see, when we're looking at these conditions, Periodontitis as a Manifestation of Systemic Disease is a display in which our patients who have these systemic diseases will experience some layer of periodontitis. And to wrap up this conversation, we are looking at hematologic diseases.
Now, we know hematologic diseases are disorders of the blood or can be disorders of blood forming organs and this affects millions of Americans. When we take a look at some of these different types of diseases, we are looking at things like blood cell cancers, hematologic diseases, including rare genetic disorders, anemias, conditions that can be related to HIV, sickle cell disease, or even in some cases, complications affiliated with chemotherapy or transfusions. So when we take a look at these hematologic disorders or diseases, what we're really looking at is how do these particular diseases or disorders then subsequently impact the body's ability to fight infection?
So we've seen a lot of interesting data coming down about how this particular inflammatory burden of periodontal disease creates or exacerbates infection or activity within the bone marrow. This is where we really start to see this interdependent relationship back and forth. And it's interesting, although these classifications have been well studied since 1999, and even in the new proceedings in 2017 and 2018, we are still kicking out research. The newest research coming in from 2021, indicating that periodontal manifestations can be seen with particular blood disorders. So we've seen, for example, recent studies that have demonstrated that bacteria like Porphomonas gingivalis does govern aspects of osteoclast differentiation, meaning that the way that our own cells, our own bone cells, are able to break down bone is readily influenced by the presence of this Gram Negative anaerobic bacteria. We know that p. gingivalis can even govern cell population. So how specific T Cells show up. And we know that these T Cells, these immunosuppressive activities are critical for how periodontal infection is going to continue to move. So it's really critical for us as clinicians to note that although periodontal disease is considered that low grade inflammatory burden, that this low grade inflammatory burden oftentimes enhances the cells in our body that break down bone and subsequently break down attachment.
We've seen changes in serum biomarkers for patients who present with various types of anemias, and we have seen a higher activity of inflammatory cytokines within the macrophages of individuals who have these blood disorders. And so the reality becomes when patients present with these hematologic disorders, they are absolutely presenting with a delayed immune response and a more exaggerated or exacerbated response to inflammatory burdens associated with periodontal therapy.
So that concludes our conversation around Periodontitis as a Manifestation of Systemic Disease. Remember all of these conditions neutropenia, trisomy 21 leukocyte adhesion deficiency syndrome, Papillon-Lefèvre. All of these conditions are conditions that will readily render our patients at a higher risk for experiencing attachment loss. Join us next time as we shift the conversation into exploring peri implant diseases and conditions.
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!
Papapanou, P. N., Sanz, M., Buduneli, N., Dietrich, T., Feres, M., Fine, D. H., ... & Tonetti, M. S. (2018). Jepsen S, Caton JG, Albandar JM, Bissada NF, Bouchard P, Cortellini P, Demirel K, de Sanctis M, Ercoli C, Fan J, Geurs NC, Hughes FJ, Jin L, Kantarci A, Lalla E, Madianos PN, Matthews D, McGuire MK, Mills MP, Preshaw PM, Reynolds MA, Sculean A, Susin C, West NX, Yamazaki K. Periodontal manifestations of systemic diseases and developmental and acquired conditions: Consensus report of workgroup 3 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Periodontol. 2018 Jun;89 Suppl 1:S237-S248. doi: 10.1002/JPER.17-0733. PMID: 29926943.
Botelho, J., Machado, V. & Mendes, J.J. Periodontal Health and Blood Disorders. Curr Oral Health Rep 8, 107–116 (2021). https://doi.org/10.1007/s40496-021-00301-w