This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrowReprints and Permissions
Right arrow Copyright Information
Right arrow Books from ASM Press
Right arrow MicrobeWorld
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Loesche, W. J.
Right arrow Articles by Grossman, N. S.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Loesche, W. J.
Right arrow Articles by Grossman, N. S.

 Previous Article  |  Next Article 

Clinical Microbiology Reviews, October 2001, p. 727-752, Vol. 14, No. 4
0893-8512/01/$04.00+0   DOI: 10.1128/CMR.14.4.727-752.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.

Periodontal Disease as a Specific, albeit Chronic, Infection: Diagnosis and Treatment

Walter J. Loesche1,2,* and Natalie S. Grossman2

School of Dentistry2 and Department of Microbiology and Immunology, School of Medicine,1 University of Michigan, Ann Arbor, Michigan 48109

Periodontal disease is perhaps the most common chronic infection in adults. Evidence has been accumulating for the past 30 years which indicates that almost all forms of periodontal disease are chronic but specific bacterial infections due to the overgrowth in the dental plaque of a finite number of mostly anaerobic species such as Porphyromonas gingivalis, Bacteroides forsythus, and Treponema denticola. The success of traditional debridement procedures and/or antimicrobial agents in improving periodontal health can be associated with the reduction in levels of these anaerobes in the dental plaque. These findings suggest that patients and clinicians have a choice in the treatment of this overgrowth, either a debridement and surgery approach or a debridement and antimicrobial treatment approach. However, the antimicrobial approach, while supported by a wealth of scientific evidence, goes contrary to centuries of dental teaching that states that periodontal disease results from a "dirty mouth." If periodontal disease is demonstrated to be a risk factor for cardiovascular disease and stroke, it will be a modifiable risk factor since periodontal disease can be prevented and treated. Since the antimicrobial approach may be as effective as a surgical approach in the restoration and maintenance of a periodontally healthy dentition, this would give a cardiac or stroke patient and his or her physician a choice in the implementation of treatment seeking to improve the patient's periodontal condition so as to reduce and/or delay future cardiovascular events.

* Corresponding author. Mailing address: School of Dentistry, University of Michigan, 3211 Dentistry, 1011 N. University Ave., Ann Arbor, MI 48109. Phone: (734) 764-8386. Fax: (734) 647-2110. E-mail: Wloesche{at}umich.edu.

Clinical Microbiology Reviews, October 2001, p. 727-752, Vol. 14, No. 4
0893-8512/01/$04.00+0   DOI: 10.1128/CMR.14.4.727-752.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.


This article has been cited by other articles:

  • Tezal, M., Sullivan, M. A., Hyland, A., Marshall, J. R., Stoler, D., Reid, M. E., Loree, T. R., Rigual, N. R., Merzianu, M., Hauck, L., Lillis, C., Wactawski-Wende, J., Scannapieco, F. A. (2009). Chronic Periodontitis and the Incidence of Head and Neck Squamous Cell Carcinoma. Cancer Epidemiol. Biomarkers Prev. 18: 2406-2412 [Abstract] [Full Text]  
  • Tezal, M., Sullivan Nasca, M., Stoler, D. L., Melendy, T., Hyland, A., Smaldino, P. J., Rigual, N. R., Loree, T. R. (2009). Chronic Periodontitis-Human Papillomavirus Synergy in Base of Tongue Cancers. Arch Otolaryngol Head Neck Surg 135: 391-396 [Abstract] [Full Text]  
  • Stephan, B., Greife, H. A., Pridmore, A., Silley, P. (2008). Activity of Pradofloxacin against Porphyromonas and Prevotella spp. Implicated in Periodontal Disease in Dogs: Susceptibility Test Data from a European Multicenter Study. Antimicrob. Agents Chemother. 52: 2149-2155 [Abstract] [Full Text]  
  • Brissette, C. A., Lukehart, S. A. (2007). Mechanisms of Decreased Susceptibility to {beta}-Defensins by Treponema denticola. Infect. Immun. 75: 2307-2315 [Abstract] [Full Text]  
  • Tezal, M., Sullivan, M. A., Reid, M. E., Marshall, J. R., Hyland, A., Loree, T., Lillis, C., Hauck, L., Wactawski-Wende, J., Scannapieco, F. A. (2007). Chronic Periodontitis and the Risk of Tongue Cancer. Arch Otolaryngol Head Neck Surg 133: 450-454 [Abstract] [Full Text]  
  • Kshirsagar, A. V., Craig, R. G., Beck, J. D., Moss, K., Offenbacher, S., Kotanko, P., Yoshino, M., Levin, N. W., Yip, J. K., Almas, K., Lupovici, E., Falk, R. J. (2007). Severe Periodontitis Is Associated with Low Serum Albumin among Patients on Maintenance Hemodialysis Therapy. CJASN 2: 239-244 [Abstract] [Full Text]  
  • Ledder, R. G., Gilbert, P., Huws, S. A., Aarons, L., Ashley, M. P., Hull, P. S., McBain, A. J. (2007). Molecular Analysis of the Subgingival Microbiota in Health and Disease. Appl. Environ. Microbiol. 73: 516-523 [Abstract] [Full Text]  
  • Lee, Y., Tchaou, W.-S. S., Welch, K. B., Loesche, W. J. (2006). The transmission of BANA-positive periodontal bacterial species from caregivers to children.. Journal of the American Dental Association 137: 1539-1546 [Abstract] [Full Text]  
  • Zijnge, V., Welling, G. W., Degener, J. E., van Winkelhoff, A. J., Abbas, F., Harmsen, H. J. M. (2006). Denaturing gradient gel electrophoresis as a diagnostic tool in periodontal microbiology.. J. Clin. Microbiol. 44: 3628-3633 [Abstract] [Full Text]  
  • Edwards, A. M., Jenkinson, H. F., Woodward, M. J., Dymock, D. (2005). Binding Properties and Adhesion-Mediating Regions of the Major Sheath Protein of Treponema denticola ATCC 35405. Infect. Immun. 73: 2891-2898 [Abstract] [Full Text]  
  • Seshadri, R., Myers, G. S. A., Tettelin, H., Eisen, J. A., Heidelberg, J. F., Dodson, R. J., Davidsen, T. M., DeBoy, R. T., Fouts, D. E., Haft, D. H., Selengut, J., Ren, Q., Brinkac, L. M., Madupu, R., Kolonay, J., Durkin, S. A., Daugherty, S. C., Shetty, J., Shvartsbeyn, A., Gebregeorgis, E., Geer, K., Tsegaye, G., Malek, J., Ayodeji, B., Shatsman, S., McLeod, M. P., Smajs, D., Howell, J. K., Pal, S., Amin, A., Vashisth, P., McNeill, T. Z., Xiang, Q., Sodergren, E., Baca, E., Weinstock, G. M., Norris, S. J., Fraser, C. M., Paulsen, I. T. (2004). Comparison of the genome of the oral pathogen Treponema denticola with other spirochete genomes. Proc. Natl. Acad. Sci. USA 101: 5646-5651 [Abstract] [Full Text]  
  • Martin, M., Schifferle, R. E., Cuesta, N., Vogel, S. N., Katz, J., Michalek, S. M. (2003). Role of the Phosphatidylinositol 3 Kinase-Akt Pathway in the Regulation of IL-10 and IL-12 by Porphyromonas gingivalis Lipopolysaccharide. J. Immunol. 171: 717-725 [Abstract] [Full Text]  
  • Brissette, C. A., Lukehart, S. A. (2002). Treponema denticola Is Resistant to Human {beta}-Defensins. Infect. Immun. 70: 3982-3984 [Abstract] [Full Text]  


Copyright © 2009 by the American Society for Microbiology.   For an alternate route to Journals.ASM.org, visit: http://intl-journals.asm.org | More Info»