Periodontal Medicine

A. Prof. Sok Chea D.D.S, F.A.D.I, F.I.C.C.D.E, F.C.S.P

Post Graduate Diploma in Periodontology
Periodontal Specialist
Cert. Periodontic (Japan)
Cert. Intensive Oral Implantology (H.K, U.S.A)
Senior Lecturer and Clinical Demonstrator
Health Science University, Faculty of Odontostomatology

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Prevalence rate change of dental

caries and periodontal disease
Data of 12 years olds
Actual condition survey by Ministry Health:
Dental caries

Gingival condition

Average of number of dental caries/ one pe

100

25
85.06

86.01

84.77

85.64

80

20
64.29

60

12.51

13.19
44.79

14.55

68.07

14.98

40
20

15
10

18.17

0
1975

1981

1987

1993

Philosophy Changes of dental science in US

NIDR
(National Institute of Dental Research)
Science of dental disease
Preserved the tooth

NIDCR
(National Institute of Dental & Craniofacial Research)
The science of Maxillo facial, oral and tooth for the systemic health

The aim of dental science is to contributed

for systemic health
http://www.nidcr.nih.gov/index.htm

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Periodontal pocket is a good place

for inhabit of anaerobic bacteria
tooth

Gingiva
Chronicinfectionbyanaerobicbacteria

enamel
periodontitis

bacillaemia

Dentalfocalinfection
root
Destructionof
periodontaltissue

Badinfluenceto
otherorgan

Destructive
periodontitis (the
advanced lesion)
Destructive periodontitis occurs a result
of progression from the reversible
damage seen in chromic marginal
gingivitis to the irreversible destruction
of periodontal support, with associated
alveolar bone resorption persist, and in
a number of respects the inflammatory
infiltrate is similar, although significant
additional changes occur.

Scanning electron
micrograph
showing early
plaque, consisting
of single and small
colonies of coccal
bacteria attached to
the tooth surface by
extracellular matrix

Scanning
electron
micrograph
showing the
surface of mature
supragingival
plaque. There are
filamentous
bacteria at right
angle to the
surface and
many cocci
adhering to them

Periodontal pocket is the place of infection

by anaerobic bacteria
If 28 teeth, diameter
10 mm of root with 5 6 mm
periodontal pocket, become
to be 72 2 square with
periodontal bacteria that
is same size as hand of adult

Periodontal pocket occurs

chronic bacillaemia

Conjecture organs related periodontitis

Concept: Periodontal disease is a high
risk factors of systemic disease
Cardiovascular and heart disease
Respiratory disease
Diabetes
Fat
Low weight birth

Normal coronary

Coronary atherosclerosis

Periodontal pathogenic microbe infected bacterial endocarditis

Dental
plaque

Dental plaque
was detected at
surroundings of
mitral valve
and surface of
endocardium.

The features of respiratory diseases

1: Aspiration (misswallowing)pneumon
2: Fever
3: Lot of cases in old people
4: Lot of cases in bedridden old people
Dental plaque
moves through
upper airway and
lower airway to
lung.

Oral bacteria established pneumonia!

In the lung, dental

plaque adheres
first, then makes
colonies.

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First visit

3 month later

Battambang Project
Name of health center
Referral Hospital
Ou Char Health Center
Omal Health Center

Phnom Sampov
Center

Health

Chamkar Somroung Health

Center

Location
Provincial Town
Provincial Town
Omal Commune
Phnom Sampov
Commune
Somrong 2

Number of patients
7
41
23
45
48

Investigation result
Ratio of male and female
Male: 66
M

Female: 98

Total: 164
Average of age: 35.4

Conclusion
Periodontal infection is very strongly involved with all age group at the targeted
area
Oral health service has not been provided in the targeted area where most of the
people are living in that area.
All most 60 per-cent of the people do not have any knowledge of appropriate
plaque control procedure.
People have very low knowledge about oral health education at targeted area
Most of the people living at targeted have deep pocket condition
Just only eleven per-cent of the people have good oral hygiene
Twenty five per-cent of the people living at targeted area are related to systemic
diseases, such as Diabetes, Heart disease, Hypertension and Tropical infection

 Conclusion
Periodontal disease bad
influence to systemic body
Periodontal treatment is bound
with systemic health
Oral conditions may become to
be excellent marker of systemic
conditions.

Thanks