Oral Bone Loss-Just for The Old?

Author: Dr. David Dickerhoff, DDS, MAGD, FOCOI

I come from a generation of adults that may have looked at tooth loss as a process involved with aging. Losing teeth through the actions of progressive bone loss was viewed as a physiologic process. The older you got, eventually teeth were going to fall out.

We now know that tooth loss through periodontal disease is a pathologic process. It is caused by bacterial plaque producing pathogens and the body‘s reaction to these pathogens that causes progressive bone loss and subsequent tooth loss. Removing this bacterial plaque and teaching you how to remove it is what your hygienist does for you.

But most people associate this disease entity (periodontal disease) with older adults and the elderly. But did you know that there are forms of this disease that affect the young, adolescents and young adults?

Aggressive periodontitis is a disease entity that is characterized by progressive bone loss usually associated with the permanent first molars (six year molars) and anterior incisors (front teeth). Patient demographics show that it typically affects the young adolescent population. It is thought that the hormones associated with adolescence are a potential food source for the overgrowth of specific bacteria that are especially harmful for healthy bone growth. While the young adult may “outgrow” this disease, the attachment apparatus of the tooth to the bone and the bone levels may be irreversibly affected. The mechanism for this destruction is thought to be associated with a particular immune system defect in the at risk patient, a neutrophil cell chemotaxis defect. Neutrophils are immune system cells tasked with protecting us from bacterial invasion. When these cells have a chemotactic defect, they do not recognize bacteria significantly enough to perform this protection role.

While this is a very insidious disease that potentially can cause a lot of destruction, early detection and treatment can bring about a good prognosis. This aggressive periodontitis responds favorably to bacterial plaque control, antibiotic therapy and oral chemotherapeutics (specific mouthwashes and locally placed antibiotic medications).

The key to successful treatment is early detection and aggressive therapy until the patient is through their adolescent period. Having an experienced and stable hygiene staff at Spring Lake Dental Group helps our dentists to detect and treat this disease. Regular check–ups with full mouth probing and radiographs are an essential part of maintaining great oral health. Don‘t let your regular check–ups lapse. You have been prescribed a recall period that fits your particular risk factors, whatever they may be. We, at Spring Lake Dental Group love knowing that we are never treating a stranger.