The predominant form of periodontal disease in children and adolescents is gingivitis which is a nonspecific inflammatory reaction of the marginal gingiva the inflammatory reaction in the tissue initiated by dental plaque accumulation starts early during infancy and reflects the bacterial challenge to the host. Children and adolescents are subject to several periodontal diseases although there is a much lower prevalence of destructive periodontal diseases in children than in adults children can develop severe forms of periodontitis in some cases this destructive disease is a manifestation of a known underlying systemic disease. Since 2000 studies experiments and clinical observations revealed high prevalence of periodontal diseases among children and adolescents. A diverse microflora containing putative periodontal pathogens can be found in the subgingival plaque biofilm in teenagers 8 9 indeed tannerella forsythensis has been strongly associated with. Periodontal diseases in children and adolescents healthy gingivae in children are soft and slightly red as compared to those of adults since the blood vessels in connective tissues are relatively transparent due to the loose collagen fibers under the thin keratinocyte layer
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