Vol,2 Periodontal disease and disease risk


Mr. Tanaka : I would like to ask you a few questions about periodontal disease and the risk of other diseases as well as oral environment and saliva. Thank you for the opportunity.
Please let me start with periodontal disease. It has been a major issue of odontology in Japan.

We often hear about periodontal disease, but exactly what are the symptoms patients must have so that an odonatologist can diagnosis periodontal disease?


Pr. Tsukinoki :
Periodontal disease is a very common ailment. In fact, 70 % of our nation’s citizens are estimated to be affected.

Periodontal disease includes two types.
The first disease is gingivitis.
The other type is periodontitis.

歯周病Periodontitis shows not only gum inflammation around the teeth, but also the destraction of alveolar bone and causing the teeth to become loose in this case. This serious stage is called periodontitis.

These two types of diseases are included in periodontal disease.
And, the obvious sign of these two diseases is bleeding during daily cleaning with a toothbrush like people do in the morning, mid-day, or at night.
This blood indicates that serious underlying inflammation. Some people may decide to stop brushing when seeing this blood, or get frightened and brush only in very gentle manner.

However, this bleeding is coming from the inflammation caused by poor oral hygiene, therefore they must clean better. The blood is a sign of poor oral hygiene.
So, the blood in the saliva or blood during gargling will be a significant sign for periodontal disease.

Mr. Tanaka : Thank you very much.
I believe periodontal disease is mainly seen as a localized dental disease, but does it influence other issues outside of oral health? For example, how does periodontal disease related to lifestyle disease or any infectious disease?

Pr. Tsukinoki : When you have periodontal disease, especially periodontitis I mentioned earlier, deep periodontal pockets are created, a space between the teeth and the gum line caused by inflammation. These pockets can become filled with bacteria. These accumulated bacteria cause more infections.

Now, periodontal disease is known to greatly influence, like you said, lifestyle diseases, dementia, or many other systematic diseases.
Especially the study concerning its relationship with diabetes has been promoted recently. There are many diabetes patients, and an enormous number of prediabetes patients in the world.

We now know periodontal disease affects blood sugar control for diabetic patients and reduces the effects of necessary drug.

Right now, periodontal disease has become a serious risk factor for diabetic treatments. Although we can’t affirm that diabetics will get better when good oral hygiene is maintained, it is certain that oral conditions can make it hard to control blood sugar levels.

Mr. Tanaka : Thank you very much.
I understand very well about the relationship of periodontal disease and lifestyle disease.
Do you think that a good plaque-control toothbrush is effective in preventing periodontal disease in terms of maintaining oral health and wellness and hindering further related lifestyle disease?

Pr. Tsukinoki :
ブラッシングPeriodontal disease is unquestionably caused by poor oral hygiene.
So, good cleaning definitely lowers the risk of the periodontal disease.

Brushing the teeth well can prevent periodontal disease at a very high rate.
For example, when a person puts effort into an anti-cancer lifestyle, it is difficult to prevent a cancer completely or only very small change if there is.
But brushing one’s teeth well goes a long way to preventing periodontal disease. So, the more you brush well, the more you can prevent the disease.

Periodontal disease is a very preventable disease.

That is why it is very important to clean your teeth well. But tooth brushing is not a simple task. 
I don’t think it’s well-known, but oral conditions vary person to person.
Depending on the tooth alignment, brushing can get more difficult. Using a good toothbrush can be vital in these cases.

I think choosing a toothbrush is very important.

Mr. Tanaka :
Thank you very much.
It is said that bacteria in the mouth significantly increases during the night.
As you said, I understand that brushing habits are particularly important, but how about tongue cleaning? Do you think it helps to prevent periodontal disease?

Pr. Tsukinoki : Yes, the tongue coating looks like plaque covering the surface. This coating is made of trapped bacteria, as well as the dead cells of tongue epithelium or dirt. In fact, collected debris is what makes this coating.

So, tongue hygiene can influence the numbers of bacteria in the mouth.
Tongue care also became significantly important and I also suggest to our patients.
Many tongue cleaners are now available and it is becoming a part of good oral care.

Mr. Tanaka : I see. Thank you very much.
I understand the cause of periodontal disease.