A Clinician's Guide to Systemic Effects of Periodontal by Ronald G. Craig, Angela R. Kamer

By Ronald G. Craig, Angela R. Kamer

A Clinician’s advisor to Systemic results of Periodontal Diseases will function a terrific, easy-to-use reference for the training health care professional. It summarizes the most recent study at the systemic results of periodontal ailments, discusses how the result of this learn will influence on scientific perform, and goals to assist the clinician to respond to questions that could be posed by way of sufferers, scientific colleagues, and the media. A relevant subject matter is the contribution of periodontal illnesses to systemic irritation yet different mechanisms, equivalent to systemic dissemination of oral pathogens, also are lined. A collaborative method related to famous investigators in every one box and scientific colleagues guarantees that every one chapters are of scientific relevance from either a dental and a clinical viewpoint. The booklet can also be visually enticing, with a variety of precis figures and images, bullet aspect tables, and spotlight bins deciding on the main clinically major points.

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As described in Chap. 2 of this volume, periodontal pathogens are essential for the initiation of the disease process yet insufficient by themselves to cause significant disease. It is recognized that periodontitis, an often silent disease if left untreated, can present a significant challenge to the entire body resulting from bacteremias, endotoxemia, and elevated levels of systemic inflammation as measured by elevations in high-sensitivity C-reactive protein (hsCRP) levels [20]. CRP may be a stronger predictor for heart attacks than cholesterol which is why most physicians now measure both hsCRP and cholesterol for the most accurate risk assessment for cardiovascular disease [21].

Acute endotoxemia and cytokine production (TNF-α, IL-1β, IL-6) induce insulin resistance and decrease insulin action. Chronic periodontal diseases can exacerbate insulin resistance and worsen glycemic control increasing the risk for the development of other long-term diabetic complications such as cardiovascular disease and kidney disease. A 2-year longitudinal trial demonstrated a sixfold increased risk of decreased glycemic control in patients with type 2 diabetes who had severe periodontitis compared to periodontally healthy patients [34].

With the realization that atherosclerosis is an inflammatory disease [6] and that increased systemic inflammation is associated with ASVD progression, systemic inflammation has also become recognized as a risk factor for ASVD. Therefore, means to decrease systemic inflammation have become a major focus of ASVD research. Periodontitis is highly prevalent in adult populations, can contribute to systemic inflammation, and is associated with ASVD. In addition, both ASVD and periodontitis share several common risk factors including increased age, cigarette smoking, and diabetes mellitus.

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