Dental caries, gingivitis, periodontitis: a review

Microbial populations colonizing the teeth and periodontal tissues are a major source of pathogens responsible for oral and dental infections including dental caries, gingivitis, periodontitis etc. Dental caries is a multifactor and infectious disease resulting dueto interaction of three different aspects like dietary sugar, susceptible tooth enamel and oral microbial colonization. Plaques from caries active sites have significantly higher proportion of Streptococcus mutans (principle acid producer) with pH levels of 5.0 or lower. Dental decay occurs when normal demineralization remineralization is disturbed. On the other hand the most common form of gingivitis is chronic or long standing plaque induced gingivitis while acute necrotizing ulcerative gingivitis is most aggressive, developing gingivitis is associated with increasing numbers of Actinomyces israeliwhereas gingivitis with bleeding is associated with A. viscosus and pigmented Bacteroides. Periodontitis is defined as loss of alveolar support to the tooth and can be differentiated microbiologically and clinically into adult, localised juvenile and pre-pubertal periodontitis. Various species of Bacteroides, Actinomyces, Fusobacterium etc. have been isolated from cases of active periodontitis. Thus wherever possible both aerobic and anaerobic culture should be performed and appropriate antibiotic therapy should be prescribed instead of empirical treatment.

Antibiotic susceptibility of bacterial isolates in gingivitis and periodontitis.

The present study was conducted to isolate aerobic as well as anaerobic microbes from patients of gingivitis and adult periodontitis and to study the susceptibility patterns of these isolates to different antibiotics. In our study all the samples belonging to the control as well as the study groups yielded microbes. Aerobes and facultative anaerobes were isolated from 100 percent and 96 percent cases of normal gingiva and orodental infections respectively. Anaerobes were isolated from 80 percent of the normal gingival samples and 97 percent of the cases of orodental infections. Metronidazole was found to be the best for the anaerobes while the aerobes and facultative anaerobes showed good susceptibility to cefazolin and cefotaxime.