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Early Onset Periodontitis

 

Contrary to popular opinion, periodontal disease doesn’t only affect adults.  Young people, even children, are also susceptible to periodontal disease.  As a matter of fact, chronic gingivitis is very common in children and adolescents.  As in adults, gingivitis in children is treated with a thorough professional cleaning and daily brushing and flossing.  With proper treatment, gingivitis is reversible, but like in adults, if left untreated, gingivitis can progress into periodontitis with eventual tooth loss and health risks.

 

Early onset periodontitis is a group of periodontal diseases that affects young people.  It is a bacterial infection of the supporting tissues of the teeth that results in bone destruction and can eventually progress to tooth loss. 

 

Early onset periodontitis can be associated with systemic diseases such as diabetes, disorders of the white blood cells, Down’s syndrome, or AIDS. thorough medical examination, including blood tests, should be performed to rule out any systemic problem when there is a diagnosis of early onset periodontitis.

 

There are three forms of early onset periodontitis:

1.     Pre-pubertal periodontitis: When children are affected before puberty, the condition is associated with severe inflammation of the gums (they become red, swollen, and tender), rapid bone loss, mobility of the teeth and eventually tooth loss.  This condition can be localized around a few teeth or generalized, affecting the entire dentition.  Both primary (baby) and secondary (permanent) teeth can be affected.

2. Juvenile periodontitis (JP): Young adults that develop periodontal disease during or after puberty are diagnosed as having juvenile periodontitis.  This condition can also be generalized (affecting most teeth) or localized in which the front teeth and molars are more affected by bone loss.  It is more common in girls and it is usually characterized by a lack of the common clinical signs of periodontal disease (inflammation, bleeding, heavy plaque).  There may be a genetic predisposition to juvenile periodontitis and it has been linked with some problems of the immune system.

3. Rapidly progressive periodontitis (RPP): affects young adults and begins in the early 20’s or 30’s. This is a particularly aggressive form of periodontal disease in which there is severe inflammation and rapid bone destruction.

Treatment:

Successful treatment of early onset periodontitis depends on early diagnosis.  Children, as well as adults, should receive routine and thorough periodontal evaluations.  Treatment of early onset periodontitis begins with the elimination of the bacteria that cause the disease and the control of risk factors.  As in adults, treatment consists of scaling and root planing and thorough oral hygiene instructions that include brushing and flossing.  Periodontal surgery and systemic antibiotics may be needed.  After active treatment, patients should be on a strict supportive periodontal maintenance schedule.  This will help prevent the recurrence and progression of periodontal disease.

 

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