Monday, November 17, 2008

Periodontal Disease

Since I am on my two week break from my magnificent education at Midwestern University College of Dental Medicine, I thought I would not completely free myself from dental related material and make a post about periodontal disease.

This is obviously a very advanced case.

First of all, after spending a semester in school and covering a handful of diseases related to the oral cavity along with other systemic diseases, it is interesting to see how many problems with our body are related to the ubiquitous "inflammatory response". You see, as our immune system detects a problem, it sends in the cavalry to put out the fire. This all seems fine and dandy except for there is a little collateral damage, especially when the infection is chronic which makes our fibroblasts and other cells mess up the surrounding tissues. Periodontal disease is no exception. Basically, periodontal disease is a chronic inflammatory disease of the periodontium, which includes the alveolar bone, gingiva, periodontal ligament, and cementum (jaw bones, gums, the ligament that holds the tooth in the socket, and the root surface). Although the exact method of this tissue degradation is not completely understood, we know it is caused by some environmental factors as well as predisposing factors thus it is termed "multifactorial".

Check out the bone resorption.

We have all heard the term, "gingivitis", right? If you decide to stop flossing your teeth and decide to not pick up you tooth brush for a little under a week, you will notice your gums seem a little inflamed, tender, and red. This is a classic inflammatory response that the body produces to fight the bacteria causing the damage. Gingivitis is the precursor for periodontal disease. Basically, gingivitis is not a big deal, it is not chronic and can clear up in a week or so with good brushing, flossing, and mouth rinse. It is reversible. BUT, if left untreated for a month, this can progress into a chronic state as the bacteria migrate down the tooth towards the root and overwhelm the body's immune response causing bone resorption and degrading the tooth-socket interface. In short Periodontitis is the situation where bacteria are running willy-nilly up and down your teeth causing tooth detachment and bone loss in addition to an infection which can spread throughout your body causing all sorts of systemic issues which is a topic for another day.

Where does the problem originate?? Well, in our mouths we have a thriving population of bugs that like to eat the stuff that we like (mostly sugars). These bacteria basically poop and pee out an acidic slurry that demineralizes out bone as well as release endotoxin.

Our favorite perio-patient, Bleeding Gums Murphy!

In closing, brush, floss, and see your dentist for regular check ups. Although the destruction of periodontal disease is irreversible, it can be halted with proper attention and a little scraping and possible surgery from the neighborhood periodontist.

Friday, November 14, 2008


It has been a few weeks since my last post and through the prompting of my friend Aaron, my one and only and faithful blog reader, I have decided to sit down and write about what has been going on in my life at dental school. It seems as the last few weeks have been nothing but studying, or at least thinking about studying. At the close of the first semester at MWU, we had a gauntlet of exams to run through from ethics class, prevention, dental anatomy, waxing practical, psychology, and two basic science tests that included musculo-skeletal systems and gross anatomy. Phew, I'm glad it is all over and I have some time to regroup and enjoy doing nothing. I do have plans to run over to my friendly neighborhood dental lab and throw some wax around and work on my dental anatomy by waxing up some crowns. I also wanted to spend some time going over my biochemistry and polishing up on metabolic processes as well as spend some time in my prevention book reading up on oral health issues.

The last day of school was pretty awesome. We started the day with an anatomy exam. Once that was all over we regrouped in the cafeteria for some intense ping pong action. I held my ground pretty well until JP kicked my trash. We then all headed back to the "OG", Ocotillo Hall room G for a guest speaker, Dr. Richard V. Tucker. Dick Tucker is one of those "dental celebrities" as I like to call them. He is an 86 year old master of gold casting that is still in private practice. Dr. tucker was a very meek and humble man who we learned a lot from. Dr. Tucker inspired me to do my best always. I do not think that he was a young dentist and thought that he would be a great dentist. I think he was a dentist who would not settle for anything less than his best, and his best was excellent. In so doing, he built up a successful practice and a world wide reputation for excellence. His work is beautiful and I hope someday I can restore teeth as beautifully as he can. His patients are proud to have his restorations in their mouths.

Here is what some of his work looks like

We are all pretty lucky here at MWU to have Dr. Simonsen as our dean, not only because he is awesome but because he has made it. He has made it in a sense that he is standing on the mountain top of excellence with the select few who have also decided to not just be dentists, but to advance dentistry through research and the development of new materials and methods. Through his associations, we have had great examples in dentistry come to our school to speak to us. We have had Dr. Gordon Christensen, Dr. Arthur Dugoni, Dr. Tucker, and Dr. Donovan. These speakers shared a wealth of information to us as they spoke but the thing that stood out to me most was their commitment to excellence. These individuals sometime along their career decided that they wanted to not just go through the motions, but to promote dentistry and oral health through excellence, thus they are dental celebrities to me. Even though I have just started my dental education, I look to these examples as where I would like to be thirty or forty years down the road. I hope that I can grow my practice and reputation on my clinical skills and how I treat my patients as these guys have. We had a BBQ lunch provided after our last final, I think the relief we all felt knowing we were done with the first semester made the hamburgers and hotdogs taste that much better.

Well our dedicated and faithful Class Historian, BJ, has made a video that I thought I'd post. It is a "We made it through the first semester" video that highlights a few things at MWU. So with that, here's the video...

Here are some of my fellow comrads in line waiting for food after our last exam.