Mechanical, Chemical and Herbal Aspects of Periodontitis: a Review

Periodontitis is a common and widespread disease, which occurs due to the pathogenic bacterial infections (like Porphyromonas gingivalis, Bacteroides spp., E. coli, Staphylococcus aureus, S. mutans etc.) established within the gingival sulcus. This condition, when not arrested, will cause formation of periodontal pocket. In order to eliminate or control the disease and arrest further periodontal tissue destruction, periodontal pockets need repeated sub gingival mechanical cleansing. This scaling procedure is unpleasant and painful. Systemic antibiotics have their role to play, but are limited by the duration of treatment and also the availability of the antibiotic at the site of action in sufficient quantity. It is not possible to administer broad spectrum antibiotics at its optimum dosage levels, multiple times over large periods. The spread of drug resistant pathogens is one of the most serious threats to successful treatment of microbial diseases. Down the ages essential oils and other extracts of plants have evoked interest as alternates for bacterial infections. Dental plaque is the main etiological factor of periodontal diseases and this article is focused on its prevention through mechanical, chemical and herbal techniques. INTRODUCTION: The word "periodontitis" comes from peri ("around"), odont ("tooth") and -itis ("redness"). Periodontitis is a set of diseases which usually attacks the peridontium. The periodontium is the specialized tissues that both surround and support the teeth, maintaining them in the maxillary and mandibular bones. The periodontium includes the alveolar bone, the cementum (on the root surface of teeth), the gingiva (gums), and the periodontal ligament (between the tooth and bone). Periodontitis in comparison with Gingivitis is a more severe inflammation, because not only it affects the tissues, but also, it affects the bottom of the teeth. If it is not treated at all, it may lead to a loss of teeth 1, . Periodontal disease is one of the most important concerns for dentists and patients. Morris et al., (2001) reported that in the United Kingdom 40-45% of adults have moderate destructive periodontal disease and 510% has a severe form of the disease. They also reported that 72% of adults have visible plaque; which is the main causative factor of periodontal disease. In the United States 50% of adults have gingivitis affecting at least 3-4 teeth; two-thirds of the population has sub gingival calculus, and about a onethird have periodontitis 3, 4. Albandar and Rams in (2002) reported that more than 82% of the United States adolescents have overt gingivitis and signs of gingival bleeding. They reported that the prevalence of gingivitis for children and adolescents in other parts of the world is almost the