Gum disease
Gum disease, also known as periodontal disease, is a set of inflammatory conditions that affect the tissues surrounding and supporting the teeth. A periodontist is a dentist who specializes in the prevention, diagnosis, and treatment of gum disease.
Periodontistry - a 5 year horizon
- Digital periodontic probe
- Lab developed test - Salivary hemoglobin A1C + lactate dehydrogenase
- Lab developed test - Salivary bacterial endotoxin detection
- Ultrasound - acoustic bone vibration
Cause
Plaque is a layer of microorganisms that grows on surfaces within the mouth. It is a sticky colorless deposit at first, but when it forms tartar, it is often brown or pale yellow. Gum disease is caused by the buildup of plaque on teeth near and below the gum line. This leads to:
- Bacterial infection of the gum tissues
- Inflammation of the periodontium (tissues supporting the teeth)
- Potential destruction of gum tissue, cementum, alveolar bone, and periodontal ligaments
Types of gum disease
🟡 Gingivitis
- Early, milder form of gum disease.
- Red, swollen gums that may bleed easily when brushing or flossing.
- Reversible with proper oral hygiene and professional cleaning.
đź”´ Periodontitis
- More advanced form of gum disease.
- Develops when untreated gingivitis progresses.
- Gums pull away from the teeth, forming pockets that become infected.
- Can lead to bone and tissue loss, leading to loose teeth and tooth loss.
Diagnosis
There are 4 levels, 1-2 is reversible, 3-4 can only be stabilised, there’s no way to regain bone without bone graft surgery.
History
- 1947: Periodontistry recognized as a dental specialty in 1947 by the American Dental Association.
In-person with a dentist
- Visual Inspection: Visually inspect the gums for signs of inflammation such as redness, swelling, bleeding, receding gums, and pockets between the teeth and gums.
- Periodontal Probing: A periodontal probe is used to measure the depth of the pockets between the teeth and gums. Healthy gums typically have pocket depths of 1 to 3 millimeters, while depths of 4 millimeters or more may indicate gum disease. 4-5mm is Gingivitis, >5mm is periodontitis. The deeper the probe goes, the more severe the gum disease. Designed to check for bone loss.
- Xray: Standard radiography with visual inspection.
Manual periodontal probe:
See also: Toothbrush innovation
Technology Review
2023: Celebrating breakthrough in dental diagnostics: FDA approval of an AI model for diagnosis of periodontal diseases: A correspondence
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First AI-powered gum disease diagnosis model is Videa Perio Assist and cleared FDA approval as of September 2023. It uses X-ray images.
During the clinical testing phase, a total of 189 radiographs and over 2350 lines were examined. VPA demonstrated its compliance with predetermined acceptance criteria on bitewing radiographs, achieving a sensitivity of 92.8%, specificity of 89.4%, and maintaining mean absolute error within the acceptable range. Similarly, VPA met the established acceptance criteria on periapical radiographs, exhibiting a sensitivity of 88.3%, specificity of 87.0%, and maintaining mean absolute error within the defined thresholds. The clinical testing provided compelling evidence of the efficacy of VPA in accurately diagnosing periodontal diseases.
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Gum disease affects 47.2% of adults
Bristle Health - Get personalized solutions for the problems in your mouth
- Oral microbiome testing provider.
- Goal is to sell you probiotic for bad breath.
- Dubious efficacy.
2022: Salivary Tests: A New Personalized Approach for the Early Diagnosis of Oral and Periodontal Diseases
Salivary Tests: A New Personalized Approach for the Early Diagnosis of Oral and Periodontal Diseases
- “Saliva-based periodontitis diagnostic tests are now technically possible, according to recent advancements in point-of-care (POC) testing. There have been reports of a variety of promising salivary biomarkers linked to periodontitis.”
- “The detection of disease activity at each specific tooth location is not possible with saliva-based periodontitis diagnosis; this can only be achieved with standard clinical assessments.”
- “Patients may easily identify their periodontitis at home and visit dental clinics at the appropriate time if periodontitis is detected by a POC device utilizing saliva.”
- “Biomarker signals in biofluids can now be found thanks to considerable advancements in technology. For instance, real-time monitoring of biomarkers in a small body fluid volume at POC sites is made possible by integrating microfluidic and lab-on-a-chip technologies.”
- Experimentation continues.
2024: ToMoBrush: Exploring Dental Health Sensing using a Sonic Toothbrush
ToMoBrush: Exploring Dental Health Sensing using a Sonic Toothbrush
- “This paper presents ToMoBrush, a dental health sensing system that explores using off-the-shelf sonic toothbrushes for dental condition detection. Our solution leverages the fact that a sonic toothbrush produces rich acoustic signals when in contact with teeth, which contain important information about each tooth’s status.”
2018: Photoacoustic imaging for monitoring periodontal health: A first human study
Photoacoustic imaging for monitoring periodontal health: A first human study
- “The gold-standard periodontal probe is an aging tool that can detect periodontitis and monitor gingival health but is highly error-prone, does not fully characterize the periodontal pocket, and causes pain.”
- “A 40 MHz ultrasound frequency could spatially resolve the periodontal anatomy, including tooth, gum, gingival margin, and gingival thickness of tooth numbers 7–10 and 22–27. The photoacoustic-ultrasound measurements were more precise (0.01 mm) than those taken with physical probes by a dental hygienist. Furthermore, the full geometry of the pockets could be visualized with relative standard deviations of 10% (n = 5).
2022: Is tele-diagnosis of dental conditions reliable during COVID-19 pandemic? Agreement between tentative diagnosis via synchronous audioconferencing and definitive clinical diagnosis
- “Remote tentative diagnosis using synchronous audioconferencing teledentistry/ audio-dentistry is safe and reliable.”
- “Audio-dentistry diagnosis of pulpitis and periodontitis exhibited the most frequent disagreements with definitive clinical face-to-face diagnosis.”
2020: Comparison Between Hand and Sonic/ Ultrasonic Instruments for Periodontal Treatment: Systematic Review with Meta-Analysis
2020: Digital scanning is more accurate than using a periodontal probe to measure the keratinized tissue width
2021: Optical coherence tomography’s current clinical medical and dental applications: a review
Optical coherence tomography’s current clinical medical and dental applications: a review