plaque bacteria produces a number of by products/ factors which operate either: Directly or Indirectly to result in damage/destruction of the periodontist

Direct effect/destruction to gingival tissue, enable other bacteria by products to enter gingival tissue. in order to cause direct damage bacteria must: colonise gingival crevice, by products permeate and damage the crevicular epithelial barrier and subsequently underlying connective tissue. (endotoxins, exotoxins, enzymes, waste products)

Inflammatory and immune reactions are stimulated due to the presence by products. various mechanisms that can damage the effectiveness of the host defence cells.

acute inflammation: non specific, local protective response elected by injury or destruction of tissue. which serves to destroy, dilute or wall off both the injurious agent and the injured tissues. (response to any foreign body, WBC can indirectly cause damage to the tissues)

stimulated inflammatory cells release destructive enzymes either by: spillage during phagocytosis, lysis (WBC burst enzymes release that damage healthy tissue and cells)

specific, how your body recognises and defends itself again bacteria, viruses and substance that appear foreign and harmful. body programmes specific WBC to response to specific foreign body (or antigen) in a specific way to destroy antigen. WBC can indirectly cause damage to the tissues.

patients at risk of progressive periodontal disease have an abnormal inflammatory or immune response to plaque bacteria.