Emerging concepts in periodontal disease treatmentUncategorised
Posted by: The Probe 19th July 2020
There has been a growing body of evidence that demonstrates a possible link between periodontal disease (PD) and systemic conditions. This could prove significant for both dentists and allied healthcare professionals in daily practice, particularly as the general public are increasingly aware that such links may exist and, in many cases, are concerned about the implications for them as individuals. A 2017 study published in the BMJ suggested that dental practices are ideal locations to screen patients for diabetes, especially as PD might be an early complication of the condition.[i]
Dr Paul Renton-Harper believes dental professionals have an important role to play in the wider healthcare setting with regard to the treatment of PD and systemic conditions such as diabetes. As a Specialist Periodontist and the owner of Renton-Harper Periodontics in Bristol, Paul and his dental team already measure patients’ glycated haemoglobin levels when assessing their PD risk. He says:
“We do identify a significant number of people who are pre-diabetic and, occasionally, those who are probably diabetic. One of the things I have realised is that this investigation is a good public health measure. We’ve identified pre-diabetic patients who have responded to the information we have given them – increased their exercise and improved their diet – which has helped them reverse their pre-diabetes.
“If dental professionals can identify diabetes at the earliest stage and give patients the chance to do something about it, they can have a positive impact on patients’ overall health. This may involve collaborating and co-ordinating with other healthcare professionals, which should be coming to the fore in day-to-day practice. For a long time, dentistry in the UK has been thought of as separate from the rest of medicine and yet, dentists treat problems inside the mouth – why is this different to treating the soft and hard tissues in other areas of the body?”
Advanced diagnostic and monitoring techniques for periodontal disease will be a key theme of an insightful lecture Paul will present in the Next Generation Conference at this year’s British Dental Conference and Dentistry Show. Paul will discuss the aetiology of PD and how emerging concepts may prove useful in the assessment and treatment of these conditions, particularly in more complex cases.
“In the future, dental professionals will be able to look at the microbiology and immunology of PD, as well as environmental effects in terms of deciding how active the disease is in each patient,” says Paul. “By doing this, we can look at other ways to effectively target the different mechanisms involved in the development and progression of PD in advanced cases.”
The vast majority of practitioners would agree that effective plaque control through oral hygiene is the basis of periodontal treatment. Professional cleaning in practice combined with good oral hygiene at home is sufficient for most patients to improve their periodontal condition. If clinicians have carried out appropriate treatment but are not seeing the response to this that they would expect, then this might indicate that the patient is failing to achieve the necessary standard of oral hygiene.
“Some patients are simply much more susceptible to PD, so their level of oral hygiene will need to be higher,” Paul comments. “However, there are a very small number of patients who present with more complex problems and require more advanced care, having not responded to careful, straight-forward and rigorous periodontal treatment. We need to look at how we can help these patients, particularly considering the current litigious climate. If practitioners fail to treat such cases – whether in-house or through referrals – and patients start to lose their teeth, then dentolegal problems could arise.”
During his lecture, Paul will also explore a new generation of chemical aids that can support oral hygiene for the most vulnerable, high-risk patients.
“Having demonstrated its clinical efficacy through years of research, Perio Plus+ is an innovative product range comprised of mouth rinses, toothpaste and gel that contain natural ingredients,” he says. “Perio Plus+ can be used in practice immediately in between stages of treatment in order to combat plaque. After all, good plaque control is fundamental to the success of periodontal treatment.”
Speaking about the British Dental Conference and Dentistry Show, Paul adds: “I would encourage dental professionals to attend this event because its’s always interesting. There are CPD opportunities to benefit from and it’s good to keep up-to-date with the latest developments in dentistry. I’m looking forward to meeting friends, colleagues and members of the trade that work closely with my practice. I’m also looking forward to seeing any new and exciting innovations that might help with the treatment of patients.”
Don’t miss out on the chance to be part of this exceptional event – register for free online today!
The next British Dental Conference and Dentistry Show will be held on Friday 21st and Saturday 22nd May 2021, Birmingham NEC, co-located with DTS.
[i] Teeuw, W. J., Kosho, M. X. F., Poland, D. C. W., Gerdes, V. E. A. and Loos, B. G. (2017) Periodontitis as a possible early sign of diabetes mellitus. BMJ Open Diabetes Research and Care. 5: e000326. DOI: 10.1136/bmjdrc-2016-000326.
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