Journal Article: “Comparative Evaluation of serum folic acid levels in
smokers and non-smokers with Chronic Periodontitis.”
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I read an article about Chronic periodontitis and the effects of smoking on folic acid levels. Folic acid is a vitamin that is crucial for cellular division and new cell production. Folic acid is very important for periodontal tissues, so without it the tissue cells do not divide properly for regeneration. To see if cigarette smoking affects folic acid levels, a study was done to compare folic acid levels in patients with chronic periodontitis in relation to smoking habits. The study consisted of 60 subjects that were divided into two groups. One of the groups was smokers with chronic periodontitis and the other group was non-smokers with chronic periodontits. Each subject had a clinical exam and the gingival index, plaque index, bleeding on probing, probing depth, and clinical attachment level was recorded for each subject. Blood was also collected and tested in a laboratory for each subject to test their folic acid levels. After the results were studied, the data showed that folic acid levels of smokers with chronic periodontitis were significantly lower than the levels of the non-smokers.
Description of Disease:
Chronic Periodontitis is the most common form of periodontitis. It is a bacterial infection within the supporting tissues of the teeth. This disease progression is characterized by loss of connective tissue and resorption of alveolar bone.
Distinguishing Diagnostic Factors:
Clinical signs include destruction of periodontal ligament fibers and alveolar bone by pocket formation and recession
of the gingival margin. Bacterial plaque biofilm and subgingival calculus are frequently found.
Etiology of Disease:
Chronic periodontitis is caused by the body’s host response to bacterial pathogens in plaque biofilms, which causes
tissue destruction. The destruction is very consistent with local factors such as calculus and plaque biofilm. Smoking is also a local risk factor. Diabetes mellitus is a major systemic risk factor that has a large association with chronic
periodontitis as well.
Pathogens Associated with Chronic Periodontitis:
-Aggregatibacter actinomycetemcomitans (Gram -)
-Campylobacter rectus (Gram -)
-Fusobacterium nucleatum (Gram -)
-Prevotella intermedia (Gram -)
-Prevotella nigrescens (Gram -)
-Porphyromonas gingivalis (Gram -)
-Tannerella forsythia (Gram -)
-Streptococcus intermedius (Gram +)
-Eubacterium nodatum (Gram +)
-Peptostreptococcus micros (Gram +)
AAP Classification (American Academy of Periodontology):
Type II
Prevalence:
Chronic periodontitis is most prevalent in adults, but is also found in children and adolescents as well.
Patient Education:
It is strongly recommended to educate the patient about their chronic periodontitis condition. Targeting the finding out their cause and local factors can help the patient realize what is causing the condition. It is also important for the hygienist to educate the patient on proper oral hygiene.
Treatment Recommendations:
Once the local factors are identified, the patient can eliminate these factors with the help of the hygienist and the
dental team. The patient can also get help from the hygienist to help control systemic factors as well. The hygienist can also help remove calculus and help disrupt the formation of plaque biofilm.
Maintenance Recommendations:
The patient should continue with proper oral hygiene and continue to schedule dental appointments every 3-4 months for regular recare maintenance.
References:
B., S., S., S., M., A., & P., S. (2011). Comparative evaluation of serum folic acid levels in smokers and non-smokers with chronic
periodontitis. Bangladesh Journal Of Medical Science, 10(2), 83-90.
Nield-Gehrig, J. S. (2011). Foundations of periodontics for the dental hygienist. (3rd ed., pp. 76-103). Philadelphia: Lippincott Williams & Wilkins.
Description of Disease:
Chronic Periodontitis is the most common form of periodontitis. It is a bacterial infection within the supporting tissues of the teeth. This disease progression is characterized by loss of connective tissue and resorption of alveolar bone.
Distinguishing Diagnostic Factors:
Clinical signs include destruction of periodontal ligament fibers and alveolar bone by pocket formation and recession
of the gingival margin. Bacterial plaque biofilm and subgingival calculus are frequently found.
Etiology of Disease:
Chronic periodontitis is caused by the body’s host response to bacterial pathogens in plaque biofilms, which causes
tissue destruction. The destruction is very consistent with local factors such as calculus and plaque biofilm. Smoking is also a local risk factor. Diabetes mellitus is a major systemic risk factor that has a large association with chronic
periodontitis as well.
Pathogens Associated with Chronic Periodontitis:
-Aggregatibacter actinomycetemcomitans (Gram -)
-Campylobacter rectus (Gram -)
-Fusobacterium nucleatum (Gram -)
-Prevotella intermedia (Gram -)
-Prevotella nigrescens (Gram -)
-Porphyromonas gingivalis (Gram -)
-Tannerella forsythia (Gram -)
-Streptococcus intermedius (Gram +)
-Eubacterium nodatum (Gram +)
-Peptostreptococcus micros (Gram +)
AAP Classification (American Academy of Periodontology):
Type II
Prevalence:
Chronic periodontitis is most prevalent in adults, but is also found in children and adolescents as well.
Patient Education:
It is strongly recommended to educate the patient about their chronic periodontitis condition. Targeting the finding out their cause and local factors can help the patient realize what is causing the condition. It is also important for the hygienist to educate the patient on proper oral hygiene.
Treatment Recommendations:
Once the local factors are identified, the patient can eliminate these factors with the help of the hygienist and the
dental team. The patient can also get help from the hygienist to help control systemic factors as well. The hygienist can also help remove calculus and help disrupt the formation of plaque biofilm.
Maintenance Recommendations:
The patient should continue with proper oral hygiene and continue to schedule dental appointments every 3-4 months for regular recare maintenance.
References:
B., S., S., S., M., A., & P., S. (2011). Comparative evaluation of serum folic acid levels in smokers and non-smokers with chronic
periodontitis. Bangladesh Journal Of Medical Science, 10(2), 83-90.
Nield-Gehrig, J. S. (2011). Foundations of periodontics for the dental hygienist. (3rd ed., pp. 76-103). Philadelphia: Lippincott Williams & Wilkins.