Periodontitis: from Infection to Inflammation

Abstract

The purpose of this study is to discuss the current understanding of periodontitis causation. The understanding of periodontitis as a monocausal infection has hindered the investigation of other potential causes that influence periodontitis morbidity and does not reflect the complexity of periodontitis etiology. Still today, the periodontal literature frequently defines periodontitis as an infection, whereas other potential causes of periodontitis, like smoking, which seems to be causally related to periodontitis, are typically called modifying or susceptibility factors. Instead of addressing the complexity of periodontitis, the field has narrowed its focus trying to find the most important bacteria or gene. Distal causes of periodontitis and interaction between constellations of causes at multiple levels have been commonly neglected. Understanding periodontitis as a group of signs and symptoms characterized by inflammatory destruction of the periodontium would provide a better frame for future etiological research.