A 32‑year‑old patient presented to the clinic in the early hours, reporting that his tooth had fallen out while brushing. He gave a history of mobile teeth for the past six months.
On examination, all anterior and posterior teeth were severely mobile, with a recessed gum line and heavy deposits of tartar. Habit history revealed smoking, and genetic history indicated that his mother had similar issues. These findings suggest a classic case of aggressive periodontitis.
Aggressive Periodontitis
Aggressive periodontitis can be localized or generalized:
.Localized aggressive periodontitis – involves one or two teeth, with deep pockets and attachment loss, without obvious etiological factors.
.Generalized aggressive periodontitis – characterized by attachment loss affecting at least three permanent teeth.
Several etiological factors, including microbiologic, genetic, immunologic, and environmental/behavioral risks, determine the onset, course, and severity of the disease.
Pathogenic bacteria in dental plaque, such as Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis, play an indispensable role by eliciting an aggravated host response. The patient’s genetic and immunologic profile, further modified by environmental risk factors like smoking, contributes to disease progression.
Patients may also complain of halitosis and pus discharge from the gums in some cases.
What can we do:
-
Early diagnosis and treatment ,including surgical therapy where indicated.
-
Replacement therapy with dentures if teeth cannot be saved.
-
Behavioral counseling, as losing teeth at an early age can affect confidence and may lead to depression. Is there any better option that we introduce genetic screening and behavioral modification programs into routine dental practice to improve early detection and management of aggressive periodontitis?
MBH/PS