http://www.mayoclinic.

com/health/periodonti tis/DS00369/DSECTION=causes Symptoms

Signs and symptoms of periodontitis can include:

Swollen gums Bright red or purplish gums Gums that feel tender when touched Gums that pull away from your teeth (recede), making your teeth look longer than normal New spaces developing between your teeth Pus between your teeth and gums Bad breath Bad taste in your mouth Loose teeth A change in the way your teeth fit together when you bite

There are different types, or classes, of periodontitis. Chronic periodontitis is the most common class, affecting mostly adults, though children may be affected as well. Aggressive periodontitis usually begins in childhood or early adulthood and affects only 1 to 2 percent of the population. When to see a dentist Healthy gums are firm and pale pink. If your gums are puffy, dusky red and bleed easily, or show other signs or symptoms of periodontitis, see your dentist soon. The sooner you seek care, the better your chances of reversing damage from periodontitis and preventing other serious health problems.

Causes
By Mayo Clinic staff It's thought that periodontitis begins with plaque. This sticky film is composed mainly of bacteria. Plaque forms on your teeth when starches and sugars in food interact with bacteria normally found in your mouth. Brushing your teeth removes plaque. But plaque re-forms quickly, usually within 24 hours.

Plaque that stays on your teeth longer than two or three days can harden under your gumline into tartar (calculus). Tartar makes plaque more difficult to remove and acts as a reservoir for bacteria. What's more, you usually can't get rid of tartar by brushing and flossing you need a professional dental cleaning to remove it. The longer plaque and tartar remain on your teeth, the more damage they can do. Initially, they may simply irritate and inflame the gingiva, the part of your gum around the base of your teeth. This is called gingivitis, the mildest form of periodontal disease. But ongoing inflammation eventually causes pockets to develop between your gums and teeth that fill with plaque, tartar and bacteria. In time, these pockets become deeper and more bacteria accumulate, eventually advancing under your gum tissue. These deep infections cause a loss of tissue and bone. If too much bone is destroyed, you may lose one or more teeth.

Risk factors
By Mayo Clinic staff Factors that can increase your risk of periodontitis include:
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Gingivitis Heredity Poor oral health habits Tobacco use iabetes Older age ecreased immunity, such as that occurring with leukemia or HIV/AIDS or chemotherapy Poor nutrition Certain medications Hormonal changes, such as those related to pregnancy or menopause Substance abuse Ill-fitting dental restorations

Complications
By Mayo Clinic staff The most obvious outcome of untreated periodontitis is:
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Tooth loss

You might be surprised by some other complications associated with gum disease, including:

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Coronary artery disease Stroke Low birth weight babies Poorly controlled diabetes Respiratory problems

Research suggests that the bacteria responsible for periodontitis can be inhaled or enter your bloodstream through your gum tissue, affecting your lungs, heart and other parts of your body. For instance, bacteria may travel to the arteries in your heart, where they can trigger a cycle of inflammation and arterial narrowing that contributes to heart attacks.

Prevention
By Mayo Clinic staff The best way to prevent periodontitis is to follow a program of good oral hygiene, one that you begin early and practice consistently throughout life. That means brushing your teeth at least twice daily in the morning and before going to bed and flossing at least once a day. Better yet, brush after every meal or snack or as your dentist recommends. A complete cleaning with a toothbrush and floss should take three to five minutes. Flossing before you brush allows you to clean away the loosened food particles and bacteria. Also, see your dentist or dental hygienist regularly for cleanings, usually every six to 12 months. If you have risk factors that increase your chance of developing periodontitis, you may need professional tooth cleaning more often.

Liver abscess DEFINITION:

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Liver abscess is a pus-filled cyst in the liver. - ABCESS- CYSTIt occurs when bacteria or protozoa destroy hepatic tissue, producing a cavity, which fills with infectious organisms, liquelled liver cells, and leukocytes. Bacterial liver abscess is often called pyogenic liver abscess.

Anaerobes that causes: -as defined earlier, are organisms that cannot survive in the presence of oxygen Bacteroides Fusobacterium Clostridium Actinomyces spp.

Reservoir

Modeof transmission
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Fecal-oral

Diagnosis Treatment:

PERIODONTITIS Definition:
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It is a type of Periodontal disease Periodontal disease- Periodontal disease (gum disease) is a chronic bacterial infection of the gums and bone supporting the teeth. It is a major cause of tooth loss in adults. However, because gum disease is usually painless, you may not even know you have it. inflammation of the gums and underlying bone It is caused by plaque and tartar build-up on the teeth, which eventually weakens the fibers that bond the gums to the teeth.

Anaerobes that cause disease: 1. Wolinella Porphyromonas GRAM POSITIVE COCI

Reservoir

Modeoftransmission Diagnosis Only the dentist can diagnose this by measuring 'probing depth' around the teeth Symptoms Swollen gums Bright red or purplish gums Gums that feel tender when touched Gums that pull away from your teeth (recede), making your teeth look longer than normal New spaces developing between your teeth Pus between your teeth and gums Bad breath Bad taste in your mouth

Loose teeth A change in the way your teeth fit together when you bite

In the pictures,the first picture shows a patient having gingivitis, with red, swollen, inflammed gum tissues around the teeth. The second one, is with mild periodontitis , Unremoved plaque hardens into calculus (tartar), As plaque and calculus continue to build up, the gums begin to recede( pull away) from the teeth, and pockets form between the teeth and gums. The 3rd, has advance periodontitis, the gums recede further, destroying more bone and the periodontal ligament. Even healthy teeth may become loose and need to be extracted

Other picture of patient with advance periodontitis.. Who are at risk of acquiring this disease? People who are diabetic have an increase risk. Smoking is one of the greatest risk factors due to the negative effect on the blood vessels in the gum. Incorrect brushing (too hard / poor brush quality and the wrong brushing technique) Teeth grinding / bruxism Position of the teeth in the bone (skew teeth collects more plaque and are much more difficult to keep clean.) Genetic component (Often history of parents with gum disease) Treatment Drastic treatment very often means referring the patient to a Periodontist (Gum Specialist). The specialist will physically remove the debri and plague from below the gum level to stimulate the re-growth of healthy tissue. Home care programmes (see Periodontal Programme) are a must for the patient to help establish a new cleaning routine. Regular follow up visits to the specialist to monitor maintenance (Periodontal Programme coming soon!)