Amber and Charlene
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Periodontitis as a Manifestation of System Disease

The clinical manifestations of systemic diseases that cause periodontitis appear at an early age and may be confused with aggressive forms of periodontitis with rapid attachment loss and the potential for early tooth loss. Some systemic diseases include hematologic disorders such as acquired neutropenia and leukemia, and also genetic disorders such as familial and cyclic neutropenia, down syndrome, and leukocyte adhesion deficiency syndromes. When chronic periodontitis occurs in a patient with systemic disease that influences the effectiveness of the host response, such as Diabetes, the rate of periodontal destruction may be increased.

— 1. What it would look like clinically: An increase in bleeding on probing, increase in edema, erythema, recession, and an increase in tooth mobility. Also, in patients with diabetes may exihibit frequent periodontal abscesses. In diseases such as leukemia we would see gingival enlargement and spontaneous bleeding. The gingiva initially appears bluish red and cyanotic, with a rounding and tenseness of the gingival margin; then it increases in size, most often in the interdental papilla and partially covering the crowns of the teeth.

— 2. What it would look like radiographically: The alveolar crest will move apical, we may see horizontal or vertical bone defects. Generalized bone loss, and a periodontal abscess may appear as a round, unilocular radiolucency.

— 3. How you would diagnosis it: The most important way to determine a proper diagnosis is to review a thorough medical history to know if the patient has any systemic diseases or disorder that can have an effect on their oral health. Another way that can help us to determine if the periodontitis is caused by a systemic disease it to look at the amount of plaque and calculus. If you have a patient that appears to have very little plaque and calculus, you might want to consider other risk factors such as a disease or disorder that could be the cause. You can refer your patient to see his or her physician if you suspect something abnormal occuring before we continue with treatment.