Periodontal disease/ root caries
Aetiology and pathology:
- Dental bacterial plaque is the major aetiological factor in both these hard tissue disorders.
- In periodontal disease it has been demonstrated that organisms present in microbial plaque, or substances derived from them, constitute the primary aetiological agent in inflammatory gingival and periodontal diseases.
- Some plaque bacteria ferment dietary carbohydrate producing acids that-acting in susceptible dental sites, particularly root surfaces-result in carious lesions.
- Periodontal breakdown can be assessed clinically by the use of loss of attachment charting used in conjunction with clinical radiographs.
- Rootcaries can be detected by careful examination using a dry field and good illumination of the region .
- Confirmation of the lesion can be gained by either bite-wing or periapical radiographs of the tooth involved.
Management: Prevention in both cases is the best form of management. This would involve good oral hygiene measures to prevent plaque accumulation and dietary advice to reduce the amount of fermentable carbohydrate available. Clearly intervention will be required when the disease process has progressed and therefore conservative treatment and periodontal management will no longer just involve preventative measures.