During the last decade new information has been gained in understanding plaque-related periodontal disease in children and adolescents. Previously, periodontal disease was considered to be a disease of adulthood with little attention paid to younger patients.

Gingivitis is the most prevalent disease of mankind. While all ages are affected, there is often an increase at the onset of puberty. More than 90 percent of all children have some form of gingivitis. It is a disease caused by an accumulation of bacteria and plaque. The signs are redness, swelling and bleeding of the gingivae (gums). The biggest problem with gingivitis is that if left untreated it may progress on to periodontitis.

The increase in gingivitis during puberty has several contributing factors.

Constantly changing hormonal levels cause the gingival tissue to become more sensitive to plaque and bacteria. Poor oral hygiene in the teenager is another factor. Frequently teenagers do not clean their teeth adequately. Poor dietary habits also contribute to the increase in gingivitis. Insufficient quantities of fruits and vegetables in the diet leading to vitamin deficiency may be an important component of the problem. The management of gingivitis can be achieved by daily removal of bacteria and plaque using correct tooth brushing techniques and by professional dental cleaning every six months.

The prevalence of periodontal disease also increases during puberty due to the some of the same factors which cause gingivitis. Constant changes in hormonal levels, poor oral hygiene, poorly aligned or crowded teeth and untreated decayed teeth are important components of the problem.

The signs of periodontal disease are similar to gingivitis though more advanced. The additional components are chronic infection and breakdown of supporting bone.

Poor oral hygiene plays a key role in the development of periodontal disease, and during puberty. The oral hygiene habits used in childhood are not adequate for the permanent dentition. The size shape and spacing of the primary teeth make them easy to clean. However, the permanent teeth are larger, closer together and contoured differently. Better brushing techniques and regular flossing are essential in the permanent dentition.

Untreated decayed teeth can be a constant irritant that contributes to the inflammation and bone loss of periodontal disease. Any decayed teeth should be repaired as soon as possible to avoid this problem. Frequent mouth breathing also acts as an irritant which increases the inflammation of the gingival tissues.

Treatment for periodontal disease consists of oral hygiene instruction and repeated professional cleaning.

-- Dr. Janie Brown, Health Dept.