RESUMO
En España entre el 85-94% de la población mayor de 35 años sufre algún problema de las encías, y entre el 15-30% padece periodontitis, siendo las formas severas un 5-11% de los casos. A diferencia de otras entidades inflamatorias, la enfermedad periodontal rara vez causa molestias, limita la vida o causa alteraciones funcionales hasta que la enfermedad progresa y aparecen signos clínicos (recesión gingival, migración patológica de los dientes, movilidad) en estadios avanzados de la enfermedad. El desconocimiento de la enfermedad, ligado con la falsa creencia de que la pérdida dentaria es una causa inexorable de la edad, repercute en un diagnóstico tardío, requiriendo enfoques del tratamiento más complejos y con un peor pronóstico. En el ámbito de la medicina de atención primaria hay una serie de fármacos asociados con la enfermedad periodontal, con la presencia de agrandamiento gingival (anticonvulsivantes, inmunosupresores y bloqueadores de los canales del calcio) como efectos secundarios, con variabilidad en cuanto a su presencia y severidad en función de la cantidad de placa acumulada. El estrés y la depresión son estados que alteran la respuesta del sistema inmune y aumentan la respuesta inflamatoria, incrementando la susceptibilidad de la periodontitis. Asimismo, se han asociado una serie de enfermedades sistémicas a la periodontitis, entre las que se encuentran la diabetes mellitus, la enfermedad cardiovascular, las enfermedades respiratorias y las complicaciones de la gestación (AU)
About 85-94% of the Spanish adults older than 35 experience gum problems, and about 15-30% suffer from periodontitis, being severe in up to 5-11% of them. Unlike other inflammatory conditions, periodontal disease rarely causes discomfort, or limits life or causes functional limitations until its advanced stages, when clinical signs and symptoms arise (gingival recession, pathological teeth migration, or mobility). Lack of knowledge about the disease, together with the idea that tooth loss is linked to ageing, frequently results in a late diagnosis, requiring extensive treatments with a worse prognosis. At Primary Care level, there is series of drugs have been related to periodontal disease (anticonvulsants, immunosuppressive drugs, and calcium channel blockers) as secondary effects, which vary as regards their frequency and severity depending of the amount of accumulated plaque. Stress and depression have also been reported to alter the immune response and to increase the inflammatory response as well as periodontal susceptibility. Certain systemic conditions, such as diabetes mellitus, cardiovascular disorders, respiratory diseases, as well as low-weight pre-term birth, have also been linked to periodontitis (AU)
Assuntos
Humanos , Masculino , Feminino , Adulto , Medicina de Família e Comunidade/tendências , Periodontite/epidemiologia , Periodontite/prevenção & controle , Estresse Psicológico/complicações , Depressão/complicações , Imunossupressores/efeitos adversos , Gengivite/epidemiologia , Periodontite/etiologia , Periodontite/terapiaRESUMO
About 85-94% of the Spanish adults older than 35 experience gum problems, and about 15-30% suffer from periodontitis, being severe in up to 5-11% of them. Unlike other inflammatory conditions, periodontal disease rarely causes discomfort, or limits life or causes functional limitations until its advanced stages, when clinical signs and symptoms arise (gingival recession, pathological teeth migration, or mobility). Lack of knowledge about the disease, together with the idea that tooth loss is linked to ageing, frequently results in a late diagnosis, requiring extensive treatments with a worse prognosis. At Primary Care level, there is series of drugs have been related to periodontal disease (anticonvulsants, immunosuppressive drugs, and calcium channel blockers) as secondary effects, which vary as regards their frequency and severity depending of the amount of accumulated plaque. Stress and depression have also been reported to alter the immune response and to increase the inflammatory response as well as periodontal susceptibility. Certain systemic conditions, such as diabetes mellitus, cardiovascular disorders, respiratory diseases, as well as low-weight pre-term birth, have also been linked to periodontitis.
