Unraveling the Etiology of Periodontitis

Abstract

Across the globe, incidence of oral afflictions like gingivitis and periodontitis are increasing at a very fast pace. Evidencearethere to support the fact that despite of being an oro-dental infection, periodontitis is associated with the systemic diseases too. Different ecological niches of oral cavity can harbor both pathogenic and non-pathogenic micro-organisms. Although the main cause of the disease is the anaerobic or the facultative anaerobic bacteria, other factors such as poor personal hygiene, diet and immune related disorders are also responsible for the progression of the disease. The vicious circle starts from deposition of the bacterial plaque/biofilm on the tooth surface then leading to gingivitis. If left untreated, it progresses to the development of periodontal pockets and ultimately tooth loss. However traditional treatment modalities like high dose of systemic antibiotics are available but antimicrobial resistance and virulence of the periodontal pathogens is the major cause of the treatment failures. This review primarily focuses on the etiology, pathogenesis and microbiology of the periodontitis. It also discusses the virulence and antimicrobial resistance factors of the periodontopathic micro-organisms. It is an attempt to develop the thorough understanding of the disease so that better therapeutic outcomes of periodonto-therapy can be attained.