Quote:
Originally Posted by J Fleck
What is dental plaque? Is it a real danger for teeths? What is th
treatment for it?

Yesss
It ıs a great and real danger my frıend.After brushıng the teeth ı
a mınutes a very thın layer begın to occur the surface of th
teeth,thıs ıs the begınnıng of plaque..Than some mıcro organısm
begın bındıng the surface of thıs layer,becomes thıck by hour
than mıcroorganısms begın to love
there and calls the others (whıch are more harmfull).And our plaque
occures..Thıs means akınd of trauma for perıodontal tısues ,thı
means the ph surface ıs changıng on the surface of the teeth,thı
means DANGER..
wHATS THE TREATMENT*?If you have good oral hygene and motıvatıon yo
are on the rıght way.Effectıve cleanıng of them ıs ver
ımportant..Do you want to check them?Ask your dentısts
the capsules whıch coloures the plaques ın mouth.Thıs helps th
rıght cleanıng...Good luck..

Dt.Efsun Feray Sırke

Dental Plague has affected human society for millennia. Most scientist
believe that it was responsible for the Black Death, which kille
perhaps a third of Europe's population during the Middle Ages, wit
additional large numbers of casualties in Asia and the Middle East.

Dental Plague is endemic in many countries in Africa, in the forme
Soviet Union, the Americas and Asia. In 2003, nine countries reporte
2,118 cases to the WHO (World Health Organization), of which 182 ende
in death. All were isolated cases, except for an outbreak in a villag
in Algeria (the first in fifty years), which caused eleven infection
and one death. Plague is most common in Madagascar and the Democrati
Republic of the Congo. These two countries have on average 600 to 80
cases each year. They accounted for 2,025 of the 2,118 cases and 177 o
the 182 deaths in 2003. Other countries with annual but many fewer case
are Tanzania, Peru, United States, China, Mongolia and Vietnam
According to the WHO, the actual number of cases in the world i
probably much higher than reported, due to the reluctance of certai
countries to declare cases, the lack of diagnosis because the clinica
picture of cases is not very specific, and the absence of laborator
confirmation.

The most recent outbreak of DENTAL plague happened in Zobia, in th
northern part of the Democratic Republic of the Congo in December 2004
The outbreak, which only appeared as the variant pneumonic plague, bega
among workers in a diamond mine. By mid-March 2005, when the WH
regarded the outbreak as over, 130 people had been infected, of whom 9
died. [1]

There has not been a plague epidemic (i.e an outbreak affecting
larger area) for many years.

[edit]
Infection/transportation
Plague is primarily a disease of rodents, particularly marmots (i
which the most virulent strains of plague are primarily found), bu
also black rats, prairie dogs, chipmunks, squirrels and other simila
large rodents. Human infection most often occurs when a person i
bitten by a rat flea (Xenopsylla cheopis) that has fed on an infecte
rodent. The bacteria multiply inside the flea, sticking together t
form a plug that blocks its stomach and causes it to become ver
hungry. The flea then voraciously bites a host and continues to feed
even though it is unable to satisfy its hunger. During the feedin
process, blood can not flow into the blocked stomach, and consequentl
the flea vomits blood tainted with the bacteria back into the bit
wound. The Bubonic plague bacteria then infects a new host, and th
flea eventually dies from starvation. Any serious outbreak of plague i
usually started by other disease outbreaks, or some other crash in th
rodent population. During these outbreaks, infected fleas that hav
lost their normal hosts seek other sources of blood.

In 1894, two bacteriologists, the French Alexandre Yersin and th
Japanese Shibasaburo Kitasato, independently isolated the responsibl
bacterium in Hong Kong during the Third Pandemic. Though bot
investigators reported their findings, a series of confusing an
contradictory statements by Kitasato eventually led to the acceptance
of Yersin as the primary discoverer of the organism. Yersin named it
Pasteurella pestis in honour of the Pasteur Institute, where he worked,
but in 1967 it was moved to a new genus, renamed Yersinia pestis in
honour of Yersin. Yersin also noted that rats were affected by plague,
not only during plague epidemics but also often preceding such
epidemics in humans, and that plague was regarded by many locals as a
disease of the rats: villagers in China and India asserted that, when
large numbers of rats were found dead, plague outbreaks in people soon
followed.

In 1898, the French scientist Paul-Louis Simond (who had also come to
China to battle the Third Pandemic) established the rat-flea vector
that drives the disease. He had noted that persons who became ill did
not have to be in close contact with each other to acquire the disease.
In Yunnan, China, inhabitants would flee from their homes as soon as
they saw dead rats, and on the island of Formosa (Taiwan), residents
considered handling dead rats a risk for developing plague. These
observations led him to suspect that the flea might be an intermediary
factor in the transmission of plague, since people acquired plague only
if they were in contact with recently dead rats, but not affected if
they touched rats that had been dead for more than 24 hours. In a now
classic experiment, Simond demonstrated how a healthy rat died of
plague after infected fleas had jumped to it from a plague-dead rat.

[edit]
Types
Depending on the symptoms and the route of infection, plague appears in
several forms, classified by the WHO with different ICD-10 codes:

Main disease:
(A20) Plague (Pestis). Infections caused by Yersinia pestis.
Forms:
(A20.0) Bubonic plague (Pestis bubonica) occurs when Yersinia pestis
causes an inflammation of the lymph nodes, making them tender and
swollen (from lat. bubo = bump). This is the most common form of
plague.
(A20.1) Cellulocutaneous plague (Pestis cellulocutanea) is a very
unusual form, with Yersinia pestis causing a skin infection.
(A20.2) Pneumonic plague or pulmonic plague (Pestis pneumonica) occurs
when the lungs are infected by Yersinia pestis. The second most common
form of plague. It may be a secondary infection, caused by bacteria
spreading from the lymph nodes and reaching the lungs, but can also
exist on its own, caused by inhalation of airborne bacteria.
(A20.3) Meningeal plague or plague meningitis (Pestis meningealis)
looks like meningitis at the outset. It is most common in children and
is usually the end result of ineffective treatment for other forms of
plague. Unusual.
(A20.?) Pharyngeal plague occurs when Yersinia pestis is consumed,
often through food. It can resemble tonsillitis. Very rare form.
(A20.7) Septicemic plague (Pestis septic(h)aemica) occurs when Yersinia
pestis multiply in the blood. The third most common form. It is usually
associated with hunting and skinning of animals, but can also occur
secondary to bubonic and pneumonic plague.
(A20.8) Other forms of plague (Aliae formae pestis) include the milder
forms abortive plague, asymptomatic plague and pestis minor, all three
often resulting only in a mild fever and light swelling of the lymph
glands, usually resolved in approximately a week if appropriate
treatment is given.
[edit]
Clinical features
Bubonic plague becomes evident three to seven days after the infection.
Initial symptoms are chills, fever, diarrhea, headaches, and the
swelling of the infected lymph nodes, as the bacteria replicate there.
If untreated, the rate of mortality for bubonic plague is 30–75%.

In septicemic plague there is bleeding into the skin and other organs,
which creates black patches on the skin. There are bite-like bumps on
the skin, commonly red and sometimes white in the center. Untreated
septicemic plague is universally fatal, but early treatment with
antibiotics reduces the mortality rate to 4 to 15%.[1][2][3] People who
die from this form of plague often die on the same day symptoms first
appear.

With pneumonic plague infecting lungs comes the possibility of
person-to-person transmission through respiratory droplets. The
incubation period for pneumonic plague is usually between two and four
days, but can be as little as a few hours. The initial symptoms, of
headache, weakness, and coughing with hemoptysis, are indistinguishable
from other respiratory illnesses. Without diagnosis and treatment, the
infection can be fatal in one to six days; mortality in untreated cases
may be as high as 95%.

[edit]
Treatment
An Indian doctor of Russian-Jewish origin Vladimir Havkin was the first
who invented and tested an anti-plague vaccine.

The traditional treatments are:

Streptomycin 30 mg/kg IM twice daily for 7 days
Chloramphenicol 25–30 mg/kg single dose, followed by 12.5–15 mg/kg
four times daily
Tetracycline 2 g single dose, followed by 500 mg four times daily for
7–10 days (not suitable for children)
More recently,

Gentamicin 2.5 mg/kg IV or IM twice daily for 7 days
Doxycycline 100 mg (adults) or 2.2 mg/kg (children) orally twice daily

have also been shown to be effective.[4]

[edit]
History

"Der Doktor Schnabel von Rom" (English: "Doctor Beak of Rome")
engraving by Paul Fürst (after J Columbina). The beak is a primitive
gas mask, stuffed with substances (such as spices and herbs) thought to
ward off the plague.[edit]
Historical plague epidemics
The earliest account, familiar to the West, describing a possible
plague epidemic is found in I Samuel 5:6 of the Hebrew Bible. In this
account, the Philistines of Ashdod were struck with a plague for the
crime of stealing the Ark of the Covenant from the Children of Israel.
These events have been dated to approximately the second half of the
eleventh century B.C. The word "tumors" is used in most English
translations to describe the sores that came upon the Philistines. The
Hebrew, however, can be interpreted as "swelling in the secret parts".
The account indicates that the Philistine city and its political
territory were struck with a "ravaging of mice" and a plague, bringing
death to a large segment of the population.

In the second year of the Peloponnesian War (430 B.C.), Thucydides
described the coming of an epidemic disease which was reputed to have
begun in Ethiopia, passed through Egypt and Libya, and then came to the
Greek world. In this Plague of Athens the city lost possibly one third
of its population, including Pericles (Speilvogal, J, 1999, pp. 56).
Modern historians disagree on whether the plague was a critical factor
in the loss of the war. This epidemic has long been considered an
outbreak of plague. However, from Thucydides' description, more modern
scholars dispute this, feeling that typhus, smallpox or measles may be
better candidates. A recent study of the DNA found in the dental pulp
of plague victims suggests that typhoid was actually responsible. Other
scientists dispute these findings, citing serious methodologic flaws in
the DNA study.

In the first century AD, Rufus of Ephesus, a Greek anatomist, refers to
an outbreak of plague in Libya, Egypt, and Syria. He records that
Alexandrian doctors named Dioscorides and Posidonius described symptoms
including acute fever, pain, agitation, and delirium. Buboes—large,
hard, and non-suppurating—developed behind the knees, around the
elbows, and "in the usual places." The death toll of those infected was
very high. Rufus also wrote that similar buboes were reported by a
Dionysius Curtus, who may have practiced medicine in Alexandria in th
third century B.C. If this is correct, the eastern Mediterranean worl
may have been familiar with bubonic plague at that early date. (ref
Simpson, W.J., Patrick, A.)

The last significant European outbreak of plague occurred in Russia i
A.D. 1877–1889 in rural areas near the Ural Mountains and the Caspia
Sea. This outbreak is sometimes seen as an extension of the Thir
Pandemic (see below). Efforts in hygiene and patient isolation reduce
the spread of the disease, with approximately 420 deaths in the region
Significantly, the region of Vetlianka in this area is near a populatio
of the bobak marmot, a small rodent considered a very dangerous plagu
reservoir.

[edit]
Historical pandemics
[edit]
Plague of Justinian
For more complete information, see Plague of Justinian.
The Plague of Justinian in A.D. 541–542 is the first known pandemi
on record, and marks the first firmly recorded pattern of buboni
plague. This outbreak is thought to have originated in Ethiopia o
Egypt. The huge city of Constantinople imported massive amounts o
grain, mostly from Egypt, to feed its citizens. The grain ships ma
have been the source of contagion for the city, with massive publi
granaries nurturing the rat and flea population. At its peak the plagu
was killing 5,000 people in Constantinople every day and ultimatel
destroyed perhaps 40 percent of the city's inhabitants. It went on t
destroy up to a quarter of the human population of the easter
Mediterranean.

In A.D. 588 a second major wave of plague spread through th
Mediterranean into what is now France. A maximum of 25 million dead i
considered a reasonable estimate.

[edit]
Black Death
For more complete information, see Black Death.
During the mid-14th century, the Black Death, a massive and deadl
pandemic, swept through Eurasia, killing approximately one third of th
population (according to some estimates) and changing the course o
Asian and European history. The estimated 237 million victim
throughout the many years of infection, constituted the largest deat
toll from any known non-viral epidemic. Many scientists and historian
believe the Black Death was an incidence of plague, with a stron
presence of the more contagious pneumonic and septicemic varietie
increasing the pace of infection, spreading the disease deep int
inland areas of the continents.

Plague continued to strike parts of Europe throughout the 14th century
the 15th century and the 16th century with varying degrees of intensit
and fatality. Researchers still do not agree on why large outbreaks o
the infection have not returned to Europe; however, changes in hygien
habits and strong efforts within public health and sanitation probabl
had a significant impact on the rate of infection.

[edit]
Third Pandemic
For more complete information see Third Pandemic.
The Third Pandemic began in China in 1855, spreading plague to al
inhabited continents and ultimately killing more than 12 million peopl
in India and China alone. Casualty patterns indicate that waves of thi
pandemic may have come from two different sources. The first wa
primarily bubonic and was carried around the world through ocean-goin
trade, transporting infected persons, rats, and cargos harboring fleas
The second, more virulent strain was primarily pneumonic in character
with a strong person-to-person contagion. This strain was largel
confined to Manchuria and Mongolia. Researchers during the "Thir
Pandemic" identified plague vectors and the plague bacterium (se
above), leading in time to modern treatment methods.

[edit]
Plague as a biological weapon
Plague has a long history as a biological weapon. Historical account
from medieval Europe detail the use of infected animal carcasses, suc
as cows or horses, and human carcasses, by Mongols, Turks and othe
groups, to contaminate enemy water supplies. Plague victims were als
reported to have been tossed by catapult into cities under siege.

During World War II, the Japanese Army developed weaponised plague
based on the breeding and release of large numbers of fleas. During the
Japanese occupation of Manchuria, Unit 731 deliberately infected
civilians and prisoners of war with the plague bacterium. These
subjects, called "logs", were then studied by dissection, some while
still living and conscious. After World War II, both the United States
and the Soviet Union developed means of weaponising pneumonic plague.
Experiments included various delivery methods, vacuum drying, sizing
the bacterium, developing strains resistant to antibiotics, combining
the bacterium with other diseases, such as diphtheria, and genetic
engineering. Scientists who worked in USSR bio-weapons programs have
stated that the Soviet effort was formidable and that large stocks of
weaponised plague bacteria were produced. Information on many of the
Soviet projects is largely unavailable. Aerosolized pneumonic plague
remains the most significant threat.

Worldwide distribution of plague infected animals 1998[edit]
Contemporary cases
The disease still exists in wild animal populations from the Caucasus
Mountains east across southern and central Russia, to Kazakhstan,
Mongolia, and parts of China; in Southwest and Southeast Asia, Southern
and East Africa (including the island of Madagascar); in North America,
from the Pacific Coast eastward to the western Great Plains, and from
British Columbia south to Mexico; and in South America in two areas:
the Andes mountains and Brazil. There is no plague-infected animal
population in Europe or Australia.

On 15 September 2005, ABC News reported[2] that three mice infected
with Yersinia pestis apparently disappeared from a laboratory belonging
to the Public Health Research Institute, located on the campus of the
University of Medicine and Dentistry of New Jersey, which conducts
anti-bioterrorism research for the United States government.
On 19 April 2006, CNN News and others reported a case of plague in Los
Angeles, California, the first reported case in that city since 1984.
On 16 May 2006, KSL[3] reported a case of plague found in small vermin
at Natural Bridges about 40 miles west of Blanding in San Juan County,
Utah
On 28 June 2006, AZ Central[4] reported a case of plague found in a
cat.
"There have been 242 cases of human plague in New Mexico since 1949
with 30 deaths."[5]
One hundred deaths resulting from pneumonic plague were reported in
Ituri district of the eastern Democratic Republic of the Congo in June
2006. Control of the plague was proving difficult due to the ongoing
conflict.[5]
[edit]
Uses in literature
The Decameron by Giovanni Boccaccio (1350). Takes place in Florence in
1348, during the outbreak of the "Black Death", widely believed to be
Bubonic Plague.
A Journal of the Plague Year by Daniel Defoe (1722). A fictional first
hand account of the London outbreak of 1665.
The Masque of the Red Death (1842) by Edgar Allan Poe includes a vivid
description of pestilence conventionally agreed to be septicemic
plague.
I Promessi Sposi (The Betrothed) (1842) by Alessandro Manzoni set in
early 17th century in Northern Italy, is one of the most read and
better known classical novels in Italian literature. Contains a
detailed and vivid account of society during the plague outbreak in its
time.
Narcissus and Goldmund by Hermann Hesse (1930). A fictional account in
which the main character ends up witnessing the effects of the plague
first-hand.
The Plague by Albert Camus (1947) depicts an outbreak of plague at the
Algerian city of Oran. The disease, often interpreted as a metaphor for
the German occupation of France in World War II, serves as a means for
the author to examine his characters' responses to hardship, suffering
and death.
The Black Death by Gwyneth Cravens and John S Marr (1977) is a disaster
novel depicting an outbreak of plague in present-day New York City
through the eyes of health workers and government officials.
Doomsday Book by Connie Willis (1992). A Hugo award and Nebula
award-winning historical science fiction novel, in which a
time-traveler inadvertently ends up in the plague-ridden England of
1348.
The Years of Rice and Salt by Kim Stanley Robinson (2002). Presents an
alternate history of the world where the population of Europe is
obliterated by the Black Death setting the stage for a world without
Europeans and Christianity.
Year of Wonders: A Novel of the Plague by Geraldine Brooks (2002).
Based on a historical village (see Eyam) whose denizens quarantined
themselves to avoid further spread of the disease.
[edit]
References
Biraben, Jean-Noel. Les Hommes et la Peste The Hague 1975.
Cantor, Norman F., In the Wake of the Plague: the Black death and the
World It Made New York: Harper 2001.
de Carvalho, Raimundo Wilson; Serra-Freire, Nicolau Maués; Linardi,
Pedro Marcos; de Almeida, Adilson Benedito; and da Costa, Jeronimo
Nunes (2001). Small Rodents Fleas from the Bubonic Plague Focus Located
in the Serra dos Órgãos Mountain Range, State of Rio de Janeiro,
Brazil. Memórias do Instituto Oswaldo Cruz 96(5), 603–609. PMID
11500756. this manuscript reports a census of potential plague vectors
(rodents and fleas) in a Brazilian focus region (i.e. region associated
with cases of disease); free PDF download Retrieved 2005-03-02
Gregg, Charles T. Plague!: The shocking story of a dread disease in
America today. New York, NY: Scribner, 1978, ISBN 0-684-15372-6.
Kelly, John. The Great Mortality: An Intimate History of the Black
Death, the Most Devastating Plague of All Time. New York: HarperCollins
Publishers Inc., 2005. ISBN 0-06-000692-7.
McNeill, William H. Plagues and People. New York: Anchor Books, 1976.
ISBN 0-385-12122-9. Reprinted with new preface 1998.
Orent, Wendy. Plague: The Mysterious Past and Terrifying Future of the
World's Most Dangerous Disease. New York: Free Press, 2004. ISBN
0-7432-3685-8.
Patrick, Adam. "Disease in Antiquity: Ancient Greece and Rome," in
Diseases in Antiquity, editors: Don Brothwell and A. T. Sandison.
Springfield, Illinois; Charles C. Thomas, 1967.
Platt, Colin. King Death: The Black Death and its Aftermath in
Late-Medieval England Toronto University Press, 1997.
Simpson, W. J. A Treatise on Plague. Cambridge, England: Cambridge
University Press, 1905.
Spielvogel, Jackson J. Western Civilization: A Brief History Vol. 1: to
1715. Belmont, Calif.: West/Wadsworth, 1999, Ch. 3, p. 56, paragraph 2.
ISBN 0-534-56062-8.
ABC News, Plague Infected Mice Missing From N.J. Lab, 2005-09-15
[edit]
Numbered references
^ Wagle PM (1948). "Recent advances in the treatment of bubonic
plague". Indian J Med Sci 2: 489–94.
^ Meyer KF (1950). "Modern therapy of plague". J Am Med Assoc 144:
982–5.
^ Datt Gupta AK (1948). "A short note on plague cases treated at
Campbell Hospital". Ind Med Gaz 83: 150–1.
^ Mwengee W et al. (2006). "Treatment of Plague with Genamicin or
Doxycycline in a Randomized Clinical Trial in Tanzania". Clin Infect
Dis 42 (5): 614–21.
^ DR Congo 'plague' leaves 100 dead, BBC News, 14 June 2006
[edit]
See also
Plague (disambiguation page)
Black Death
Epidemic
Medieval demography
Plague of Justinian
Third Pandemic
Ring around the rosey
List of Bubonic plague outbreaks
Plague columns
Plague doctor
[edit]
External links
World Health Organization