periodontitis

That is very true.

Let's move from the tooth itself to the foundation, preventing periodontal disease.

In the past, I've heard this described to patients like the foundation of a house slowly washing away.

But that feels a bit, I don't know, passive.

It's not just erosion, is it? It's more like friendly fire.

Friendly fire is a vastly more accurate biological analogy.

Periodontal disease is essentially an autoimmune-like response.

Oh, really?

And starting with gingivitis, which is bleeding gums, which is not normal, to advanced periodontitis, which is you're losing your teeth.

So periodontitis and gingivitis, two different types of gum disease.

Periodontitis, destruction of the periodontal ligaments, a more invasive form of gum disease than gingivitis.

But gingivitis is a source of chronic inflammation.

Root canal infections, cavitations, we'll talk a little bit more about that.

... anniversary celebration in the summer for them.

And it's, it's been a real epiphany because, I, I mean I say this on the courses, and I said it when we were in Ireland, when we play that sound of periodontitis video, we fall into the trap as clinicians of, "Oh, it's just another patient with that same disease as the last one.

I'll treat it the same and I'll move on," and, and it becomes a bit robotic and you forget the human side of perio.

And-

It comes from the Romanian Journal of Diabetes Nutrition and Metabolic Diseases.

The title is Heart Rate Variability as a Predictor of Autonomic Dysfunction and Cardiovascular Risk in Periodontitis.

The authors are Vinitha Semmanathan, Saravanan Ayavu, Jayabano Murugiah, Kalyana Praba Prem Sundar, Rohini Pushparaj, and Thamara Selvi Kanagaraj.

Periodontitis is a chronic inflammatory disease of the supporting structures of the teeth, the gums, the periodontal ligament, and the bone of the jaw beneath the gums.

It is driven by the immune response to bacterial biofilm accumulation, and its epidemiology shows strong links to systemic cardiovascular disease.

The proposed mechanisms include bacteremia, bacteria entering the bloodstream from inflamed gum tissue, systemic elevation of inflammatory cytokines, and endothelial dysfunction driven by chronic peripheral infection.

Established, it means that there were some studies which were done and evidence was found.

So in terms of the diabetes, definitely there is a high risk of the patients who are having periodontitis making your diabetes worse.

So in a sense that you get, um, the bac- the bacteria that is growing in your mouth, that is caused by this disease called a periodontal disease, and then what then happens is that your body starts getting an inflammation.

That inflammation then gets transmitted to the system, which is now referred to as a systemic inflammation.

So now that will affect the way your body controls the glucose, and then that now worsens your diabetes.

So same ap- uh, uh, will apply with the other way around.

When your diabetes is not controlled, it can also make the periodontal disease worse.

It can also cause the bacteria to be, um, imbalanced in your body.

And the pathogenesis behind that transition is highly complex.

Periodontitis basically acts as an opportunistic infection.

Plaque bacteria accumulate in the subgingival biofilm under the gum line.

Underneath, yeah.

Let's do a quick recap of the entire deep dive.

Sounds good.

Periodontitis is a host destructive opportunistic infection.

The plaque bacteria start the alarm, but your immune system's overreaction causes the physical damage.