Talk:Periodontitis

message: "In Israeli population, individuals of Yemenite, North-African, South Asian, or Mediterranean origin have higher prevalence of periodontal disease than individuals from European descent."
This sounds odd, since there are many Europeans of Mediterranean descent (people from Spain, southern France, Italy, etc.). So, the two origins do not exclude each-other.--95.89.27.110 (talk) 20:27, 12 March 2013 (UTC)
thread_title: European vs. Mediterranean descent

message: ** As the links I added indicate, there are both bodies of scientific evidence that casts doubt on the effectiveness of routine cleaning or the frequency at which it should occur (the Cochrane review of 2005) and also then consideration as to the appropriateness of providing this as a service to patients (UK National Institute for Health and Clinical Excellence)
** I'm sure there are differing views taken by/between various dentists, but the original version seemed to be making a point of view, rather than adhering to WP:Neutral point of view policy.
*** If you wish to add a comment about dentists disagreeing with this meta-analysis or decision on service provision, then fine provided it is referenced. However I note the BBC news report quoting "Dentists have welcomed the move as 'common sense'".
* So back to the question you originally raised re deletion of passages. Looking between the edits, the only details removed (rather than rearranged or joining of sentences) seemed to be:
*# "Gingivitis can be stalled if a patient receives regular gum cleanings from his or her dentist every 3-6 months."- POV, now covered by new paragraph of "Whilst regular routine dental checks and gum cleanings are proposed as helping to prevent the onset of the condition, there is little evidence either to support this or the intervals at which this should occur.[1] Instead it is advocated that the interval between dental check-ups should be determined specifically for each patient.[2][3]"
*# "The cleanings are designed to disrupt and clean out bacterial plaque and toxins from below the gumline. This temporarily removes the bacterial plaque and toxins (the causes of the gum inflammation). But after 3-4 months the bacteria tend to grow back and have to be cleaned out again by the dentist."- temporary effect of cleaning is already covered by the rearranged text now found as the middle paragraphs of 'Prevention' and 'Treatment of established disease' sections. 
*# "It is important for all people to have regular gum cleanings every 3-6 months from their dentist. Otherwise continued inflammation (gingivitis) can over the years lead to loss of bone around the teeth (periodontitis)."- as per points raised for (1)
*# "Once bone breaks down around the jaws, it is very difficult or impossible to build it back."- Ok I agree this was lost, but surely what is lost is lost. the consequences are set out in the 'Aetiology' section (i.e. eventually tooth loss) and the difficulties of building up via bone grafting is mentioned at the end of 'Treatment of established disease' section. Please note a citation would be useful here (i.e. so people can look up how difficult or what the "mixed success" rates might be).
*# re cavitrons "and gives off a high-pitched whine when used." - I missed this out partly because it seemed irrelevant and also it (in the restructured version) seemed to divert from describing what is trying to be achieved.
*# "Fortunately, the science exists to routinely catch and prevent this catastrophic loss of teeth years before it actually happens, as long as the patient is regularly examined every 3-6 months by a dentist for bone loss and also dental decay."- I disliked the initial English and there are again issues of NPOV, see (1). The first clause is perhaps acceptable if patients having appropriate individual recall-interval checks are found to have onset of disease and action then taken (which is largely oral hygiene measures). The second clause seemed breach of NPOV for reasons previously given.
** I think this covers all the dropped sentences - in summary much duplicated itself, or became apparent as already being covered once I had restructured the article. The insistence on 3-6month routine checks as preventing seems POV and I tried to balance this past practice (I agree dentists used to advocate 6 monthly checks here in the UK too) with the latest summary of evidence and response from the NHS advisory body on good clinical care. With "the Faculty of General Dental Practitioners, worked on the new guidelines", this surely is the majority UK dentist viewpoint ?
* You commented "I would be more comfortable if a dentist or specialist edited dental topics". I would point out that no one or no group own  articles, as the Main Page states "... Wikipedia, the free encyclopedia that anyone can edit."
** Any editor can edit any article.
** Of course specialists are particularly welcome at wikipedia as they have a body of knowledge that they can help contribute with. In addition they can help ensure articles comprehensively cover topics, given they have a broad knowledge of a particular field.
** However any editor can contribute facts and description to a topic; provided of course they can cite sources for any claims made. Likewise any editor may copyedit an article for better English, or for better encyclopaedic writing or for Wikistyle.
** There is a danger (which I too am guilty ) for "specialists" to write articles like undergraduate/post-graduate textbooks or instruction manuals. Someone outside of a field may be helpful to a topic to help ensure it meets good standards: firstly as appropriately targeted for the non-specialists and secondly in style for a general encyclopaedia - although what an encyclopaedia wikipedia is :-)
* Please do feel free to respond to any of these points :-) Yours David Ruben  Talk  02:35, 11 May 2006 (UTC)
thread_title:  Vitamin C 

message: I am a total noob at this wikipedia thing, but I have some opinions that need to be expressed.  Whether or not these items are deemed meritable I will leave up to the members and readers.  
Firstly, there is an issue with nomenclature in this article.  I feel it is important to point this out as it lead to considerable confusion for me as a dental undergraduate, and therefore I feel it may lead to confusion in others (I realise this is an encyclopedic article and not a textbook article).  IMHO, the term periodontal disease is not the same as periodontitis or pyrrhoea.  Periodontal disease is an envelope term used to describe and group diseases of the periodontium, that is the supporting tissues of the teeth (including cementum, periodontal ligament, bone and gingivae).  Therefore, periodontitis in all its forms is a subset of diseases under the heading of periodontal diseases, as is gingivitis, ANUG, ANUP, primary herpetic gingivostomatitis and others.  I feel that this article is considerably too narrow in scope to be called 'Periodontal Disease'.  I know I am probably splitting hairs.  
This is where criticism of this article gets difficult, because the profession of dentistry continues to re-evaluate the nomenclature and classification of periodontal diseases (it seems there is a new system every bloody week :D).  Because this article is encyclopedic and not scholarly in scope, lines must be drawn and boundaries made in order to make information accessible to the average reader.  I feel that Wikipedia tends to confusingly sit on both sides of the fence on this issue.  The scope of this article needs to be adjusted if it is to be considered encyclopedic and not scholarly, and must not pass itself off as scholarly when it is not written by a trained and educated academic of that particular subject.  I refer in particular to the description of vertical and horizontal bony defects.  This belongs not in an encyclopedic article but in an undergraduate textbook.
Because this article is encyclopedic and not scholarly, I am opposed on ethical grounds to including overly detailed information about treatment and diagnosis as this may lead the untrained individual to (possibly) incorrect self-diagnosis and self-prescription.  If this information is to be retained, the article should contain a caveat of some sort, possibly along the lines that this information does not substitute advice from a trained professional in a clinical setting.  For ethical (and legal) reasons, I personally would never engage in giving information about treatment on the internet, over the phone, via mail or any other means unless I had previously seen or was currently seeing that patient in a clinical setting.  Just my opinion.
Thirdly, while 'pocket' may be a misnomer in lay terms, in the dental profession a pocket is a pathologically affected site, clinically and histologically distinct from a healthy 'sulcus'.  Just thought that that might clear up some confusion.
Lastly, while I understand that Wikipedia articles are not owned by any one person, I have a tendency to agree with Mamounjo about the use of knowledge from trained dentists and specialists.  I also agree with you that anyone can read and cite articles, but it is only people who are trained in the interpretation of scientific articles that should really use them in this context.  General medical practitioners no doubt have an understanding of the basis of diseases that happen in the mouth, but dentists and specialists are likely more aware of the peculiarities of the oral milieu in both a clincial and (patho)physiological sense.  Nowhere is this more acutely highlighted than in periodontal disease, which, I imagine is moderately understood by even a significant portion of the dental profession (IMO!!) in a pathophysiological sense because it is one of the most highly complex and unique pathophysiological processes in the body, which is not fully understood by science as of yet.  
Health care professionals are interpreters in the main; we interpret sign and symptom to produce a diagnosis which in turn influences treatment planning and prognosis.  Each health care professional is trained to interpret a particular set of signs and symptoms.  While these sets may overlap to a degree (for instance dentists need to know quite a bit about general medicine, as I'm sure doctors need to know a good bit about the mouth), there are certain portions of these sets that are best interpreted by the professional trained and more experienced in their interpretation.  No offense.  I would hope no-one would expect me to diagnose an ingrown toenail or other things of that nature!  I would know it was an infection, have an idea of the treatment but I really wouldn't like to have a go at definitive diagnosis or treatment.  By the same token, each professional should be trained and be experienced in the interpretation of scientific and scholarly articles in terms of quality and merit in their own area of expertise.  As such, this is a criticism of Wikipedia as a whole and not one particular contributor.  Its one inherent drawback, I suppose! 
I do feel that this article is quite good for what it is, it just needs to make up its mind - scholarly or encyclopedic. 8 August 2006 (UTC)
* Thank you for interesting and well argued points. Issues of nomenclature seem, to myself a non-specialist, as you set out. Certainly term as most commonly encountered by non-specialists is as currently used in article vs. being more umbrella term to also includes herpes infections etc - which approach would be correct for the article is clearly matter for those with greater knowledge of overall field of dentistry. I note though that "a new system every bloody week", so it might prove challenging to decide what to state as the general dental consensus and to WP:Cite to WP:Verify whatever position is therefore taken.
*re "information about treatment and diagnosis" - I agree care must be taken as to not seeming to give professional healthcare advice, but that does not exclude giving some overview of the typical range of approaches that may be taken, perhaps with suitable generally pointers as to what aspects of a condition affect decisions as to which of several treatment options to take (e.g. for coronary angioplasty vs. open heart bypass grafting:  issues of patient suitability to undergo general anaesthetic & rigors of operation, number/length/extent of blockages, invasiveness of procedures vs. interval before having to repeat). 
* As for "caveat" or disclaimers, this gets raised at intervals on medical topics too, but it is repeatedly pointed out that each page already has at the bottom a 'Disclaimers' link to Wikipedia:General disclaimer which includes "Not professional advice" section. But yes you are quite correct to remind us of these principles in considering our editorial style of writing.
* I understand the points you raise in your most polite comment about non-specialist input to article, and quite take them as "criticism of Wikipedia as a whole and not one particular contributor".. Yes ideally a well-written encyclopaedic article is written first time by a  specialist, to a quality that needs no amendment. However the lay editor can help with modifying the level to pitch the explanation at (academics good at teaching undergraduates but may either over or under simplify for the rest of us), indicate where a specialist's assumption of a fact being universally accepted is not self-evident to a lay reader and that verification and additional sources requested. If you look at the overall changes in article between my 1st and last edits to the contents (here), you will see considerable wikifying of the mark up as per the pre-existing wikify tag (i.e. proper section headers) and correction of the dental information itself - namely reversion of unsubstantiated POV that "It is important for all people to have regular gum cleanings every 3-6 months from their dentist" and "patient is regularly examined every 3-6 months by a dentist" which I knew was some 18months out of date for UK practice. This was not my POV but that of the NICE guidelines for "interval between dental check-ups should be determined specifically for each patient between every 3 to 24 months" and this had been accepted by the 18,000 dentists of the British Dental Association – I was merely deferring to NICE/BDA "portions of these sets that are best interpreted by the professional trained" :-) 
* re "scholarly or encyclopedic" - yes constantly a difficult decision to make - clearly must at least be encyclopaedic, but to what level also scholarly ? Too high a level obviously ends up with minutiae being debated and large numbers of papers having to be cited. I tend to feel the level should be pitched for high-school students to gain a basic overview of topics and with enough specifics for an undergraduate to feel that a suitable outline to a topic has been covered. (i.e. Masters or PhD level not required) David Ruben  Talk  01:49, 8 August 2006 (UTC)
replies: text: Well, I believe periodontitis should indeed not redirect here, and periodontal disease is indeed an umbrella term, e.g. .--Steven Fruitsmaak (Reply) 18:20, 11 December 2006 (UTC)
replies: text: Absolutely periodontal disease and periodontitis should be different articles. Periodontitis is a form of periodontal disease and is also the proper name. Periodontal disease should be an article of all diseases affecting the periodontium. Thus, this article should be moved to Periodontitis, and a new article describing all periodontal diseases should be written here. - Dozenist talk 02:47, 12 December 2006 (UTC)
replies: text: Per the above discussion, I've moved this page to Periodontitis, leaving a redirect at Periodontal disease.  I guess now somebody should write an article there, about periodontal disease in general. -GTBacchus(talk) 03:28, 18 January 2007 (UTC)
thread_title: Some Small Points

message: Periodontitis is defined as loss of clinical attachment.  While this will invariably lead to loss of bone (i.e. blunting of crests/loss of crestal cortication, progressing towards more well defined horizontal/vertical defects), this does not define the diagnosis of periodontitis.  Loss of clinical attachment, resulting in suprabony pockets, for example, in which there is no loss of crestal cortication, would indeed be defined as localized periodontitis, regardless of the lack of associated bone loss.  Thus, while it should be surely be mentioned, as they virtually go hand-in-hand, bone loss is not a criteria but merely a sign.  It is the loss of clinical attachment that defines whether or not an individual suffers from periodontitis.There are multiple statments made in the Carranza reference text (cited at the end of the article) which refer to both loss of attachment as well as bone as being the "outcomes" or "indicators" of periodontitis.  However, careful examination shows that it is loss of attachment alone that defines the onset of the disease.  "The clinical feature that distinguishes periodontitis from gingivitis is the presence of clinically detectable attachment loss.  This often is accompanied by periodontal pocket formation and changes in the density and height of subjacent alveolar bone." page 67 in chapter 4 of 9th Edition of Carranza, as mentioned in the footnotes in the article. DRosenbach (Talk | Contribs) 13:24, 22 March 2007 (UTC)
thread_title:  Loss of bone vs. loss of clinical attachment 

message: I've heard of tobacco use staining the teeth, but it seems the nicotine and the other harsh chemicals in most commercial tobacco products would be toxic to much of the bacteria shown to cause this disease.
Not that it would surprise me if tobacco caused periodontitis, I was just curious if there was any scientific data to support the claim.
Additionally, what's an acceptable amount of time to give for a questionable claim to be cited prior to it's removal from an article?  —Preceding unsigned comment added by Smidgewidgeon (talk • contribs) 03:14, 28 January 2008 (UTC)
replies: text: I don't know what the official policy is, but I think most editors wait about a week after placing a  tag for things that they strongly suspect are false, and as much as a month for something that seems likely to be false.  If it's something that might be true, or is probably true but deserves a reference, then you can wait as long as you want.  Of course, if it's an obscure article, it might take a few days before anyone even notices that you've tagged it.  WhatamIdoing (talk) 02:31, 29 January 2008 (UTC)
thread_title:  Citation Requests 

message: I just read this article and came to the following sentence:
" A contributing cause may be low smegma in the diet: "Results showed that smegma has the strongest association with gum disease, with low levels increasing the risk by 13 fold." "
I did not knew the word "smegma" before so I looked it up in a few sites and all had basically the same description. I think that smegma does not belong into any diet. So was this only a perverse joke of somebody or what?  — Preceding unsigned comment added by 176.2.84.58 (talk) 23:29, 4 December 2011 (UTC)
thread_title:  A question regarding the word smegma 

message: A section on the history of periodontology would be interesting.  Deipnosophista (talk) 17:06, 19 December 2008 (UTC)
thread_title:  History 

message: Chronic Periodontitis, the most common form of the disease, progresses relatively slowly and typically becomes clinically evident in adulthood. Aggressive Periodontitis is a rarer form, but as its name implies, progresses more rapidly and becomes clinically evident in adolescence. Although the different forms of periodontitis are all caused by microorganism and mycotic infections, a variety of factors affect the severity of the disease. Important "risk factors" include smoking, poorly-controlled diabetes, and inherited (genetic) susceptibility.
Feel free to contribute, edit, etc. (This ain't my article) DRosenbach (Talk | Contribs) 04:05, 25 November 2009 (UTC)
thread_title:  Cut from leader -- to be replaced in another place shortly 

message: An image used in this article, File:Wikicropped.jpg, has been nominated for speedy deletion for the following reason: All Wikipedia files with unknown copyright status 
;What should I do?
Don't panic; you should have time to contest the deletion (although please review deletion guidelines before doing so). The best way to contest this form of deletion is by posting on the image talk page.
* If the image is non-free then you may need to provide a fair use rationale
* If the image isn't freely licensed and there is no fair use rationale, then it cannot be uploaded or used.
* If the image has already been deleted you may want to try Deletion Review
To take part in any discussion, or to review a more detailed deletion rationale please visit the relevant image page (File:Wikicropped.jpg)
This is Bot placed notification, another user has nominated/tagged the image --CommonsNotificationBot (talk) 16:23, 7 March 2012 (UTC)
thread_title: File:Wikicropped.jpg Nominated for speedy Deletion

message: I have just removed the following text:
:Presumably, individuals living in East Asia (e.g. Japan, South Korea and Taiwan) have the lowest incident of periodontal disease in the world.
The wording was suspicious ("presumably"?), it is nonreferenced, and it seems at odds with the map /diagram immediately following. Feel free to reinstate/improve if this is indeed a known fact. Martinp (talk) 17:35, 18 June 2012 (UTC)
thread_title:  Incidence of periodontal disease: Asia 

message: Doc James (talk · contribs · email) 13:33, 24 March 2017 (UTC)
thread_title: Refs for update

message: If anyone wants to merge this into periodontitis feel free. Matthew Ferguson (talk) 14:13, 26 March 2017 (UTC)
replies: text: Looking better. Doc James (talk · contribs · email) 13:44, 29 March 2017 (UTC)
thread_title:  Content moved from [[Periodontal pathology]] as it deals with plaque-induced periodontitis only 

message: For more than a century, Entamoeba gingivalis has been described in active periodontal infections. This suggests from the microscopic examination of the sulcus biofilm a high correlation between the presence of the amoeba Entamoeba gingivalis and the active periodontal disease called then pyorrhea[52]. This notion was highlighted half a century later and corroborated by demonstrating that the biofilm of gingival health is constituted for the most part by nonmotile bacteria. Gingivitis on the other part predominantly contains motile bacteria of the bacillus, spirilla and vibrios type, accompanied by a significant number of PMN leukocytes. Finally periodontitis proceeds from a bacterial state similar to gingivitis but adding the frequent presence of the protozoan Entamoeba gingivalis, sometimes that of Trichomonas tenax and a more than significant number of granulocytes[53]. This view point, applied in the 1980s by a Canadian dentist, confirms, according to him, periodontal healing including bone regeneration by finding, through hygiene and pharmaceutical medical methods, a commensal biofilm made up for the most part of cocoid bacteria and various immobile filaments, and absence of leucocytes[54][55]. Entamoeba gingivalis has displacement capacity, apparent adherence to blood cells, stops PMN granular activity of PMN and clearly phagocytize PMN nucleus which makes it a potential aggressive pathogen[56]. This microscopic correlation has recently been confirmed with PCR molecular biology studies on the presence of this protozoan in cases of periodontal active disease and its absence in the gingival, even local, situation[57]. This antiparasitic technique proposed as an effective therapy to overcome periodontitis is based on the process of stopping phagocytosis of the leucocyte nucleus PMN by the amoeba, thus releasing an enucleated cell, discharging its content of proteolytic enzymes onto the surrounding tissues in the image of the amoebic abscess of the liver from Entamoeba histolytica considered pathogenic in amoebic dysentery[58]. It has the advantage of eliminating the pathogenic bacteria concomitant with the protozoa and may, at minimum, be seen as targets easy to visualize by the dentist and the patient on phase contrast microscopy on a saliva mount. This so-called exonucleophagy would be the cause of local deterioration beyond the control of the immune system in the periodontal pocket and possibly peri-implantitis, as a result of systematic presence of the protozoan. The phantom released PMNs cells hollowed out of their nucleus than are unable to continue their defense activity "NETS [archive]" nor normal apoptosis. Flagellate Trichomonas tenax pathogen is also present in about 5 to 20% of active periodontitis and seems to render periodontitis more aggressive[59]. Early data on such an antiparasitic treatment appear to be effective in healing the periodontal sulcus[60]. Microbes and white blood cell identification gives a new target for therapeutic attempts against this disease.Tdebouches (talk) 14:39, 17 January 2018 (UTC)
thread_title:  Biofilm Microscopy