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So it turns out that gingivitis is not really an early form of periodontitis. I am beginning to think my nickname should be Dr. Heresy. I have done a fair amount of research recently on this topic and gingivitis is actually the gate keeper to periodontitis, not a mild or early form of it. We know this through several avenues of information. From a tissue level perspective, gingivitis is primarily a T cell mediated response and periondontitis is primarily a B cell and plasma cell mediated response. From a clinical level we know that progression of gingivitis to periodontitis does not occur automatically, does not occur in every patient, and does not occur in every site. We also know that periodontitis only occurs in genetically susceptible individuals. The most surprising result of my research is that most of this is not new info at all. How the heck it was not widely acknowledged is stunning to me, unless of course it was and I was the only one in the dark. Much more to follow. Any and all thoughts welcome as always.
Richard H. Nagelberg, DDS
Every patient, every time, any level of perio disease

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Vicki Cheeseman Comment by Vicki Cheeseman on February 9, 2010 at 9:21am
You're making me laugh there, Mary Jane! Sounds like me before I've had my coffee... :)
Mary Jane Comment by Mary Jane on February 9, 2010 at 5:56am
My sister is an English professor..she cringes everytime she reads what I don't edit...the word I am proud to spell and say is profession..haven't had enough coffee
Mary Jane Comment by Mary Jane on February 8, 2010 at 11:14am
From my graduation in 1974 to now, the research, changes, etc. make me very proud to be in this professuin. I need to add my thanks to Vicki's, Dr.
Richard H. Nagelberg Comment by Richard H. Nagelberg on February 8, 2010 at 9:30am
Thanks for your kind words Vicki. There is presently exponential growth in terms of research findings. When we look back at this period of time, some years in the future, it will be recognized as a time in which the profession changed dramatically.
Vicki Cheeseman Comment by Vicki Cheeseman on February 8, 2010 at 9:18am
Dr. Nagelberg, thank you for this post. You are doing a tremendous job of keeping us in the dental community abreast of the latest philosophy about all aspects of periodontal disease. Science continues to develop as new clinical evidence presents itself. The important thing is to keep learning and researching and growing. That is how the oral health of society as a whole has a hope of better health.
Mary Jane Comment by Mary Jane on February 3, 2010 at 12:54pm
Left out the O"
Richard H. Nagelberg Comment by Richard H. Nagelberg on February 3, 2010 at 11:11am
Thank you MJ for your insightful comments.
Mary Jane Comment by Mary Jane on February 3, 2010 at 10:57am
Different bacteria are the cause of different problems i.e. caries, gingivitis, different aspects of periodontal issues i.e.juvenile periodontitis. we are not vulnerable to them all as we all have different immunities, heredities, envirnmental factors, etc. If life could be simple, teeth would not decalcify and tissue would not be destroyed by a mediated response. But human beings are so much more complicated than that as are my second most favorite living creatures..my cats and dogs. Different pathogens..equally deadly and in a smaller creature with a shorter life span..think about it.

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D. Kellus Pruitt DDS
General dentist in Fort Worth, Texas. I surround myself with the most wonderful staff and the kindest patients in the nation. It is our mutual confidence and respect that grants me the freedom to stand nose-to-nose with anyone in the marketplace. I’m blessed. And I like to write.

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