The 2017 World Workshop on the Classification of Periodontal and Peri-implant Diseases and Condition identified the gingivitis case by the presence of gingival inflammation at one or more sites and agreed upon bleeding on probing as the primary parameter for diagnosis of gingivitis. Clinical gingival health is generally associated with an inflammatory infiltrate and a host response consistent with homeostasis. The molecules that play a role in the pathogenesis are divided into two main groups: those derived from the subgingival microbiota (i.e., microbial virulence factors) and those derived from the host immune-inflammatory response. The immune system is essential for the maintenance of periodontal health and is categorized as innate immune system and the adaptive immune system. Innate immunity reflects the capacity of the host to defend against infectious attacks. Understanding the disease processes is important for the development of improved treatment strategies.
Part of the book: Oral Diseases
Dental caries is a multifactorial disease caused by the interaction of dietary sugars, dental biofilm, and the dental tissue of the host. It results from repeated cycles of demineralization and remineralization at the interface of the biofilm and the tooth surface. Demineralization is the process of removing mineral ions from hydroxyapatite crystals in hard tissues, such as enamel, which can lead to dental caries if left unchecked. The remineralization process can reverse the lost mineral ions that occur during demineralization. The degree of demineralization and remineralization depends on several variables, including the amount of available calcium and phosphate and salivary pH levels. Over the past several decades, remineralizing or calcifying fluids with variable calcium, phosphate, and fluoride formulations have been developed. The management of early caries by remineralization has the potential to significantly advance the noninvasive clinical management of the disease. The chapter outlines the mechanisms by which the demineralization-remineralization process occurs and the use of remineralizing agents that reverse demineralization or enhance remineralization.
Part of the book: Dental Caries