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periodontaldisease 在 HK FOODIE ● ANNIE CHAN Facebook 的最讚貼文

HK FOODIE ● ANNIE CHAN By HK FOODIE ● ANNIE CHAN

2021-03-07 16:34:28 有 1 人按讚
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periodontaldisease 在 腸活webメディア「腸内革命」 Facebook 的最佳貼文

腸活webメディア「腸内革命」 By 腸活webメディア「腸内革命」

2018-04-07 17:38:05 有 1 人按讚
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みなさん、毎日ちゃんと歯を磨いていますか？ そして、定期的に歯医者さんでクリーニングしていますか？ 実はいわゆる歯周病菌(ジンジバリス菌)は、大きな病気にもつながりかねない危険な菌。 体質的に歯周病菌が多い人は、かなり注意をして歯周病菌と共存していかないと、歯がなくなるとか、溶けるだけでなく、血管の病である動脈硬化や脳卒中にもなりかねないんです。 今回はそんな歯周病菌(ジンジバリス菌ほか)の正体や、歯周病菌の中でも有名なジンジバリス菌を減らす方法をまとめてみました。 「歯周病菌」とは？ 歯周病菌というのは、菌業界ではよくある総称…あだ名のようなものです。 歯周病にする可能性がある菌をすべて歯周病菌と呼んでいるので、歯周病菌という菌があるわけではありません。 一般社団法人奈良県歯科医師会の資料によると、歯周病菌として有名な菌には、以下の3つがあるそう・・・。 トレポネーマ・デンティコーラ ポルフィロモナス・ジンジバリス タネレラ・フォーサイシア ジンジバリス菌はテレビなどのメディアでも取り上げられることが多いので、聞いたことがある方も多いのではないでしょうか？ 「歯周病菌」が歯周病を起こすメカニズム 歯周病は、歯と歯茎の間にプラークと呼ばれる歯垢がもとになる病気です。 このプラークの中にいるジンジバリス菌をはじめとする歯周病菌が、歯肉に炎症を起こして、歯を支えている骨を溶かしていきます。 最初の炎症の段階では痛みがないので、自分では歯周病の進行に気が付くことができません。でもこのまま歯周病をほおっておくと、骨がどんどん溶けていき、歯を支えることができなくなるので、抜歯をせざるを得ない状況になります。 「歯周病菌」は糖尿病や動脈硬化にも関連がある？ 歯周病菌は、歯肉に炎症をもたらすことがわかりました。 この「炎症」が実は重要で、炎症を起こした歯肉の血管にジンジバリス菌が入り込むと血液を介して、炎症を起こす物質が体内に放出されてしまいます。 そして、血管にも炎症が起こり始めてしまい、血液に関する病気を招くことが実際にあるのだとか。 ▼炎症のメカニズム 歯周病になる ↓ 歯周病菌や炎症物質が血管に入り込む ↓ 心臓や腎臓、大腸などの臓器にも歯周病菌や炎症物質が入り込む ↓ 大きな病気につながる 大きな病気への関与は、まだ研究が進められているところではありますが、動脈硬化や糖尿病は歯周病菌の関連が深いといわれています。 「歯周病菌」を減らす方法 こんな恐ろしい歯周病菌ですので、もちろん毎日歯磨きをちゃんとすることや、定期的に歯医者さんでクリーニングやプラークチェックをしてもらうことはとても重要です。 そして最近では、そのほかにもいろいろとセルフケアの方法について研究が進んでいます。 ココアの「歯周病菌」殺菌効果 森永製菓さんは、ココアと歯周病菌の関係についてこんな研究結果を発表しています。 歯周病に関連する主要な菌、即ち、ジンジバリス菌（P. gingivalis） ,フゾバクテリウム菌（F. nucleatum）,インターメディア菌（P. intermedia）に対する抗菌効果を示しています。 横軸が培養時間を、縦軸が生菌数を表します。3種類の菌ともに、ココアの添加量が多いほど抗菌効果が強く見られることが分かりました。 飲用濃度に近い3% ココアを添加した場合では、 ジンジバリス菌では培養１時間後、 フゾバクテリウム菌では培養３時間後生菌数は検出限界以下になりました。 参考： ココアに含まれるポリフェノールには、口の中の殺菌作用、特に歯周病菌に対する殺菌作用があることがわかったとのこと！ これは歯周病を恐れる人生100年時代の私たちには朗報かもしれませんね。 歯周病菌(ジンジバリス菌ほか)を減らす方法まとめ 歯周病は私たちにとってとても身近で、痛さがない分なかなか気が付けない病気です。 しかし、歯のケアを怠ると、歯周病菌が歯肉に炎症を起こし、歯を溶かしてしまうだけでなく、今度は血管を通じて炎症物質や歯周病菌が回ってしまい、糖尿病や動脈硬化などの病気になりやすくなってしまうことがわかっています。 このような状態を防ぐために重要なのは、もちろん毎日自分で行う歯のケアと定期的に歯医者さんで行うクリーニングやチェックです。 最近では、それだけではなく、食べ物でも歯周病菌を殺菌する方法が注目され始めています。その食べ物とは…ココア。 ココアには歯周病菌を殺菌する効果があることが発表されています。 わたし、フゾバクテリウム菌、いっぱいいるんです！笑 ココアを定期的に飲むようにしようかな。ココアは最初からお砂糖がたくさん含まれている市販の飲み物が多いので、ココアの粉末だけを買ってきて、ココア甘酒にするのがよさそうです。 みなさんも参考にしてみてくださいね。

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periodontaldisease 在 コバにゃんチャンネル Youtube 的最佳解答

コバにゃんチャンネル By コバにゃんチャンネル

2021-10-01 13:19:08 有 9 人看過 有 1 人喜歡
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コバにゃんチャンネル

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コバにゃん☆です?
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periodontaldisease 在 大象中醫 Youtube 的最佳解答

大象中醫 By 大象中醫

2021-10-01 13:10:45 有 0 人看過 有 0 人喜歡
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大象中醫

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長照是一個劇變的旋轉舞台 百年難得一見 沒有準備的人 被旋轉舞台甩出去 不是坐下就是躺下 而大象中醫是太極的推手 推動著旋轉舞台 讓 所有爬不起來的人 背後有一股推手力量 支撐再站起來
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periodontaldisease 在 大象中醫 Youtube 的最佳解答

大象中醫 By 大象中醫

2021-10-01 13:09:56 有 0 人看過 有 0 人喜歡
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大象中醫

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長照是一個劇變的旋轉舞台 百年難得一見 沒有準備的人 被旋轉舞台甩出去 不是坐下就是躺下 而大象中醫是太極的推手 推動著旋轉舞台 讓 所有爬不起來的人 背後有一股推手力量 支撐再站起來
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periodontaldisease 在 Periodontal Disease - YouTube 的推薦與評價

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Nearly 75% of adults have some degree of periodontal disease. Aside from the traditionally discussed dental complications of gum recession, ... ... <看更多>

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#1. Periodontal Disease | Division of Oral Health | CDC

Periodontal diseases are mainly the result of infections and inflammation of the gums and bone that surround and support the teeth. In its early stage, called ...

#2. Periodontitis - Symptoms and causes - Mayo Clinic

Periodontitis (per-e-o-don-TIE-tis), also called gum disease, is a serious gum infection that damages the soft tissue and, without treatment ...

#3. Periodontal (Gum) Disease

Periodontal (gum) disease is an infection of the tissues that hold your teeth in place. It's typically caused by poor brushing and flossing habits that ...

#4. Periodontal disease - Wikipedia

Periodontal disease, also known as gum disease, is a set of inflammatory conditions affecting the tissues surrounding the teeth. ... In its early stage, called ...

#5. Gum Disease (Gingivitis & Periodontitis) - WebMD

Periodontitis, also generally called gum disease or periodontal disease, begins with bacterial growth in your mouth and may end -- if not ...

#6. Periodontal Diseases | Johns Hopkins Medicine

The word periodontal means "around the tooth." Periodontal diseases, also called gum diseases, are serious bacterial infections that attack the gums and the ...

#7. Periodontitis: Symptoms, Causes, and Treatments

Periodontal disease is a progressed form of gingivitis. It first starts off with a buildup of bacteria and plaque within the gums and the teeth. Over time, ...

#8. Gum Disease Information

Gums separate from the teeth, forming pockets between the teeth and gums that can become infected. As the disease progresses, the pockets deepen and more gum ...

#9. Gum disease - NHS

Gum disease is where the gums become red, swollen and sore, and bleed. It's very common, but it's important to get it checked by a dentist.

#10. Gum Disease - Periodontal Disease - MouthHealthy

It is a major cause of tooth loss in adults. Because gum disease is usually painless, you may not know you have it. Also referred to as periodontal disease, gum ...

#11. Periodontal Disease | NEJM

PERIODONTAL disease is a general term used to describe specific diseases that affect the gingiva and the supporting connective tissue and ...

#12. Periodontitis (Gum Disease): Symptoms, Stages & Treatment

Periodontitis is a serious form of gum disease. It's a bacterial infection that starts by inflaming the soft tissues around your teeth. Left ...

#13. Periodontal Disease & How You Can Prevent It | Colgate®

Periodontal means "around the tooth," so periodontal disease refers to the infection and inflammation of the gums, ligaments, or bone that ...

#14. Periodontal Disease - ScienceDirect.com

Periodontal disease is the most commonly diagnosed problem in small animal veterinary medicine. In the vast majority of cases, however, there are little to ...

#15. Periodontal diseases | Nature Reviews Disease Primers

The term 'periodontal diseases' encompasses a wide variety of chronic inflammatory conditions of the gingiva (or gums, the soft tissue ...

#16. Periodontal disease-Tri-Service General Hospital

What is periodontal disease?, ,, There are many different types of periodontal disease but gingivitis and periodontitis are the most common.

#17. Periodontal disease Information | Mount Sinai - New York

Periodontal disease is caused by dental plaque, which contains harmful bacteria. The mouth is full of bacteria but they tend to be harmless varieties.

#18. A review of the frequency and impact of periodontal disease in ...

Periodontal disease is an inflammatory condition that affects the periodontium, the specialised tissues that surround and support the tooth. The ...

#19. Periodontal (Gum) Disease in Dogs - PetMD

Dr. Elizabeth McCalley explains why your dog's dental health is so important. Periodontal disease in dogs is something all pet parents ...

#20. Stages of Periodontal Disease

Gum disease is one of the leading causes of tooth loss. Gum disease has two primary stages. If diagnosed and treated in the first stage, the condition can ...

#21. Periodontitis: Treatment, home remedies, and symptoms

Can you fix periodontal disease? In the early stages, called gingivitis, good oral hygiene can reverse some changes and prevent further deterioration. As the ...

#22. Periodontitis | American Dental Association

Attachment and bone loss associated with periodontal disease are results of the body's immune response to plaque biofilm and its metabolic ...

#23. Periodontitis - Dental Disorders - MSD Manual Professional ...

Periodontitis is a chronic inflammatory oral disease that progressively destroys the tooth-supporting apparatus. It usually manifests as a worsening of ...

#24. Periodontal disease: the portrait of an epidemic - Nocini

Periodontal disease is conventionally defined as an inflammatory disorder involving both soft and hard periodontal structures (1).

#25. Gum disease - Healthdirect

Periodontitis may cause the area of the gum closest to the tooth to become weak. Spaces may form between the tooth and the gum, and these may trap germs, ...

#26. Periodontal Disease | Gum Disease | Gingivitis

What is Periodontal Disease? ... Your gums and supporting bone hold your teeth in place. Issues with either can have serious consequences. When ...

#27. Periodontal Disease in Dogs | Small Door Veterinary

Periodontal disease in dogs can lead to gum infections, teeth loss and serious health problems, so regular teeth brushing and dental checkups are vital.

#28. Periodontal Disease in Dogs: Symptoms, Causes & ...

Your dog's oral health (along with her overall health and wellbeing) can be gravely impacted by periodontal disease.

#29. Dental Disease in Dogs - VCA Animal Hospitals

Dental disease is one of the most common medical conditions seen by veterinarians. The most common dental problems seen in dogs are periodontal disease and ...

#30. Periodontal Disease | Children's Hospital of Philadelphia

Periodontal diseases, also called gum diseases, are serious bacterial infections that destroy the gums and the surrounding tissues of the mouth. If the ...

#31. Periodontal Disease: The Good, The Bad, and The Unknown

Keystone microbial pathogens and sustained gingival inflammation are critical to periodontal disease progression. However, recent studies have ...

#32. Periodontal Disease in Dogs: Symptoms, Causes & ...

What is periodontal disease? Your dog's mouth can be infected with a bacteria called periodontitis. Usually, you won't see any obvious signs or ...

#33. Chapter 5: Periodontal diseases - GOV.UK

This chronic and inflammatory disease is caused by a complex interplay of risk factors, with dental plaque being the most important.

#34. Causes of Periodontal Disease | Associates in Family Dentistry

Periodontal disease, which is also known as gum disease and periodontitis, is a progressive disease which, if left untreated, may result in tooth loss.

#35. What is periodontitis? - European Federation of Periodontology

Periodontitis is a gum disease. It is a chronic inflammatory disease that is triggered by bacterial microorganisms and involves a severe chronic ...

#36. Periodontal Disease | Patient Information - JAMA Network

Periodontal disease (unhealthy gums and teeth) often reflects serious health risks. Mild inflammation of the gums (gingivitis) can be ...

#37. Periodontal Disease in Small Animals - Digestive System

Periodontal disease is infection and inflammation of the periodontium (the tissues that surround and support the teeth) due to plaque bacteria and the ...

#38. Global Periodontal Health Project - FDI World Dental Federation

Gum health is often overlooked during daily oral health routines. Periodontal (gum) diseases including gingivitis (inflammation of the gums) and ...

#39. Periodontal disease news and latest updates - Medical Xpress

News tagged with periodontal disease. Periodontitis. Periodontitis (peri = around, odont = tooth, -itis = inflammation) refers to a number of inflammatory ...

#40. Oral health - World Health Organization (WHO)

The main risk factors for periodontal disease are poor oral hygiene and tobacco use. Edentulism (total tooth loss). Losing teeth is generally ...

#41. Feline Dental Disease

Diseases of the teeth and gums are common in cats but fortunately the most common forms of dental diseases are largely preventable or treatable with ...

#42. Gum Disease - Multiple Languages - MedlinePlus

Gum Disease: A Guide to Periodontal Disease - English PDF · Gum Disease: A Guide to Periodontal Disease - 繁體中文 (Chinese, ...

#43. Gum Disease - Canada.ca

Periodontal disease is a chronic inflammatory response to dental plaque. It can lead to weakened gums and ultimately tooth loss. Over time, bone ...

#44. Periodontal Disease as a Risk Factor for Ischemic Stroke

Periodontal disease is a chronic inflammatory disease with acute exacerbations and periods of quiescence, and periodontal conditions at the time of acute ...

#45. The Prevention and Therapy for Periodontal Disease 牙周病之 ...

Periodontal disease, also known as “ gum disease ”, is a chronic dental problem which can lead to bad breath, receding gums, mobile teeth, and tooth loss ...

#46. Gum Disease (Periodontal) Treatment - Humana

Periodontal disease can be treated in a variety of ways. Read more about the different options for how to treat gum disease with Humana.

#47. Periodontal Disease - YouTube

Nearly 75% of adults have some degree of periodontal disease. Aside from the traditionally discussed dental complications of gum recession, ...

#48. Periodontal Disease in Dogs and Cats - Veterinary Partner - VIN

Periodontal disease is inflammation of some or all of a tooth's support. When compared to gingivitis, periodontitis indicates bone loss.

#49. What Is Periodontal Disease? - - Wausau Smiles

Periodontal disease is another term for gum disease, and it refers to an infection of the tissue that surrounds and holds your teeth in ...

#50. Periodontal Disease in Children - Health Encyclopedia - URMC

Periodontal disease is a serious bacterial infection. It destroys the gums and supporting structures of the teeth. It is also called gum disease.

#51. What's the Difference Between Gingivitis and Periodontitis?

Gingivitis is gum inflammation and, when left untreated, can progress to more serious stages of periodontal disease, such as periodontitis.

#52. What Is Periodontal Disease? | Corsodyl

Periodontal disease is the medical term for gum disease. It can be used to refer to the whole spectrum of gum disease, including gingivitis, which is a mild ...

#53. What Is Periodontal Disease? | Colgate® Professional

Periodontal diseases are infections of the structures around the teeth, which include the gums, periodontal ligament and alveolar bone. In the earliest stage of ...

#54. Periodontitis: Symptoms, Causes, and Treatments - Crest

Periodontitis refers to advanced periodontal disease. With this form of gum disease, the gum tissue pulls away from the teeth, creating pockets where ...

#55. What is Periodontal (Gum) Disease? | OLYMPIA, WA

Periodontal disease is most often preceded by gingivitis which is a bacterial infection of the gum tissue. A bacterial infection affects the gums when the ...

#56. How to Cure Periodontal Disease - New Teeth Now

The overpopulation of harmful bacteria will create plaque that builds on the teeth and infects the gums. Left unchecked, your mouth can develop ...

#57. What Is Periodontal Disease and Periodontitis? - Parodontax

Periodontitis is a severe, irreversible form of gum disease, caused by the build up of bacteria both above and below the gum line. Although periodontitis is ...

#58. Periodontal disease in children: Associated systemic conditions

Soft tissue lesions of the oral cavity are common in children, and distinguishing between findings that are normal and those that are ...

#59. Everything You Need to Know About Periodontal Disease

Periodontal disease is an inflammation of your gums that makes them tender and sore. If you do nothing when you have gingivitis, the condition morphs into ...

#60. Signs & Symptoms of Periodontal Disease

Periodontal disease (also known as periodontitis and gum disease) is a progressive condition and the leading cause of tooth loss amongst adults in the ...

#61. 5 Tips for Preventing Periodontal Disease

Periodontal disease is a serious condition that can lead to tooth loss. It's a common problem that you should avoid if possible. Here are a few tips to help ...

#62. Preventing Periodontal Disease in Dogs - Purdue Extension

Periodontal disease is one of the most common health problems affecting adult dogs. This disease occurs as a result of infection and inflammation of the gums,.

#63. Gum disease | Health Navigator NZ

Gum disease (also known as periodontal disease or periodontitis) is caused by an infection that destroys the bone surrounding and supporting your teeth.

#64. Classification of Periodontal Diseases in Infants, Children ...

Gingival diseases are categorized as dental plaque biofilminduced gingivitis or non-dental plaque-induced gingival diseases. Periodontal disease can be grouped ...

#65. Characteristics of Periodontal Disease - Dentalcare.com

Periodontal disease is an irreversible disease of the gingiva that effects the surrounding and supporting structures of the teeth.

#66. Current concepts and an alternative perspective on ...

Periodontal disease is generally considered to be an inflammatory disease induced and maintained by the microbiota of the dental biofilm ...

#67. Periodontal Disease: Symptoms, Treatment and Prevention

Periodontal disease is a chronic bacterial infection characterized by persistent inflammation, connective tissue breakdown and alveolar bone destruction.

#68. Factors That Make Periodontal Disease Worse

Periodontal disease is unhealthy gum tissue, but it can also lead to destruction of the teeth and underlying bone of the mouth. Its earliest stage is gingivitis ...

#69. Causes of Periodontal Disease | Santee, CA - Fossett DDS

Periodontal disease, which is also known as gum disease and periodontitis, is a progressive disease which, if left untreated, may result in tooth loss.

#70. How to Spot and Prevent Periodontal Disease in Dogs

Inflamed or red gums (gingivitis); Gum loss; Loss of bone around the teeth; Tooth loss. Does Periodontal Disease Have Any Complications? Yes.

#71. Gum Disease & Infection | Periodontitis | Bupa Dental Care UK

If your gingivitis isn't treated, the inflammation may spread to the ligaments and bones that hold your teeth in place. This is a type of gum disease called ...

#72. Periodontal Disease Risk Factors

Periodontal Disease can increase the risk of other diseases due to the harmful bacteria in the body. Inflammation throughout the body occurs when periodontal ...

#73. What Damage Can Periodontal Disease Cause? | Arizona ...

Periodontal disease can be quite a serious oral health condition, but the good news is that it can be both prevented and treated. This condition occurs when ...

#74. 15.7C: Periodontal Disease - Biology LibreTexts

Periodontal disease is a type of disease that affects one or more of the periodontal tissues, which include: the cementum, or the outer layer of ...

#75. Causes of Periodontal Disease | Stony Point, NY

Periodontal disease, which is also known as gum disease and periodontitis, is a progressive disease which, if left untreated, may result in tooth loss.

#76. Periodontal Diseases | American Hospital of Paris

Periodontal diseases are infectious diseases with multiple causes that affect the supporting tissues of the teeth: the gums, ...

#77. Gum disease - Oral Health Foundation

Long-standing gingivitis can turn into periodontal disease. There are a number of types of periodontal disease and they all affect the tissues supporting ...

#78. Types of Periodontal Disease | Grande Prairie Alberta

The advanced form of Gingivitis is called 'Periodontitis.' Periodontitis is considered to be one of the more serious types of periodontal disease. When left ...

#79. What is Periodontal Disease?

The word “periodontal” means “around the tooth.” Periodontal disease (also known as gum disease, pyorrhea or periodontal infection) is an ongoing bacterial ...

#80. Signs & Symptoms of Periodontal Disease | Oklahoma City, OK

Periodontal disease (also known as periodontitis and gum disease) is a progressive condition and the leading cause of tooth loss amongst adults in the ...

#81. Causes of Periodontal Disease| Thousand Oaks,CA

Periodontal disease, which is also known as gum disease and periodontitis, is a progressive disease which, if left untreated, may result in tooth loss.

#82. Veterinary Periodontal Disease

Periodontal disease consists of cycles of active destruction (periodontitis) and dormancy leading to progressive breakdown of tooth attachment. 1. Plaque ...

#83. Causes of Periodontal Disease - Victoria - Mayfair Dental Centre

Gum disease begins with the inflammation and irritation of the gingival tissues which surround and support the teeth. The cause of this inflammation is the ...

#84. PERIODONTAL DISEASE - Dental Health

Periodontal diseases are ongoing infections of the gums that gradually destroy the support of your natural teeth. Periodontal disease affects one or more of ...

#85. Periodontal Disease Pleasanton CA

Periodontal diseases are ongoing infections of the gums that gradually destroy the support of your natural teeth. Periodontal disease affects one or more of ...

#86. What Are the Stages of Periodontal Disease? | SD Perio

What is periodontal disease? Inadequate brushing and flossing allows bacteria to thrive where the teeth meet the gums, and the subsequent build-up of plaque and ...

#87. Understanding Periodontal Disease - Austin TX

Periodontal disease is the most common chronic health condition in the country. Dr. Ragsdale offers several treatments, including advanced laser therapy.

#88. Stages of Periodontal Disease - Before and After

Periodontal disease is known by a few names, including periodontitis and gum disease. Simply put, periodontal disease happens when a serious gum infection ...

#89. Causes of Periodontal Disease | Ladera Ranch, California

Periodontal disease, which is also known as gum disease and periodontitis, is a progressive disease which, if left untreated, may result in tooth loss.

#90. What is Periodontal Disease? - Mark E. Glover, DDS, MSD, PC

Periodontal disease (also known as "gum disease", "pyorrhea" or "periodontal infection") is an ongoing bacterial infection in the gums and bone around your ...

#91. Periodontal Disease - HE4928 - HealthEd

Periodontal disease (gum disease) is a disease that affects the tissues around the roots of the teeth. If it is not treated early, it can destroy the fibres ...

#92. How to Stop Periodontitis | Tips from Gum Disease Specialists

What is periodontal disease treatment? · Crown lengthening: Removes excess gum tissue (which gives teeth a shorter appearance). · Soft tissue ...

#93. The Different Stages Of Periodontal Disease

When gingivitis is left unchecked, it can quickly become periodontitis stage one which is destructive. The gum inflammation is caused by built- ...

#94. Periodontal (Gum) Disease | Galway Family Dentistry

As the bone tissue is lost, the gum tissues detach from the teeth and form little pockets that provide an even better place for bacteria to live — where your ...

#95. Recognising periodontal disease - London

There are many different types, or classes, of periodontal disease. Depending on the extent of the infection, symptoms can vary. Periodontal ...

#96. What is Periodontal Disease?

Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected. As the disease progresses, the pockets ...

#97. Periodontal Disease Poway CA | What is Gum Disease

Periodontal diseases are ongoing infections of the gums that gradually destroy the support of your natural teeth. Periodontal disease affects one or more of the ...

#98. Types of Periodontal Disease | Malvern, Arkansas

Periodontal disease (also known as periodontitis and gum disease) is a progressive disease which affects the supporting and surrounding tissue of the gums, ...

#99. About Periodontal Disease Charlotte NC

Periodontal diseases are ongoing infections of the gums that gradually destroy the support of your natural teeth. Periodontal disease ...