Infective Periodontitis Case Study

The level of periodontal break down depends on the balance between destructive and protective inflammatory mediators. While periodontal bacteria are required for infective periodontal disease, individual response determines disease progression. In vitro, it has been found that individual response is affected by genetic signaling pathways that affect the expression of inflammatory mediators in response to bacterial lipopolysaccharides (23, 25).
Risk factors for periodontitis In the past, it was believed that all individuals were equally liable to developing chronic periodontitis and that only accumulation of dental plaque, poor oral hygiene and sometimes occlusal trauma were able to cause periodontitis. However, in the past four decades it had accepted that periodontitis is caused by specific bacterial
Modifiable risk factors are always known as environmental and it is behavioral in nature where non-modifiable risk factors are mainly intrinsic to the individual and therefore not easily changed. Non-modifiable risk factors may be called also determinants (26). Modifiable risk factors for periodontitis are smoking with associated dose dependency (27). A lot of studies indicated that the nicotine found in tobacco products increases the production of cytokines in the body caused by decreased oxygen levels. When nicotine found with oral bacteria, such as P. gingivalis, it results in higher levels of cytokines, leading to damage of the supporting tissues of the teeth (27, 28). Studies showed that smokers are 11-times more likely than non-smokers to harbor the pathogenic bacteria that cause periodontal disease and four-times more likely to have advanced periodontitis (27). Also, the risk of periodontal disease increases with the increase in number of cigarettes smoked daily. It is important to know that smoking cigars and pipes carries the same risk as smoking cigarettes