There are five key concepts that an oral health provider should know about periodontitis risk factors. Our patients need to be educated on what periodontitis is and the associated risk factors for the disease. A periodontal exam and assessment of both new and current patients in the dental practice is more important than ever.
Prevalence of Gingivitis and Periodontitis
The first concept is that the prevalence of the two major periodontal diseases is still high in the United States population. Gingivitis is highly prevalent in both the adolescent and adult patients. A more advanced disease of periodontitis, which is chronic inflammation and bone loss can be found to one extent or another in potentially up to 50 percent of the population over 35. The best way to identify a periodontal condition in a patient is still through periodontal probing and pocket depth measurements and evaluation for recession, bleeding and mobility. A baseline full mouth series of radiographs is required to evaluate bone levels of the dentition.
Understanding who is at risk for periodontitis is also important and beneficial to the patient. Risk factors are not the etiology of the disease, but play a role in determining who may potentially develop the disease. A simple questionnaire or assessment can provide this information and educate the patient on potential oral health care issues. The most studied factors are the following: smoking, diabetes, poor oral hygiene, obesity and osteoporosis.
The Connection of Periodontitis and Systemic Illnesses
It is important that we identify who is at risk for the disease and who presents to our offices with the disease, not only to prevent tooth loss in our patients because there is now enough evidence that shows a connection between systemic disease and periodontitis. Because of this relationship, periodontitis is now a risk factor for certain systemic illnesses. The most studied are the following health issues: diabetes mellitus, cardiovascular disease and pregnancy complications.
Other illnesses being evaluated for possible connections include pancreatic cancer, pulmonary disease and rheumatoid arthritis. Therefore it is important for professionals to be aware of the latest research and keep patients informed. Patients need to be aware that if they have periodontitis which can be effectively treated and if they do not have the disease, it can be prevented. Patients at risk should be seen a minimum of at least once a year if they have no periodontal disease. Patients with periodontal disease, even if effectively treated in the past, must be seen a minimum of twice a year if not more. This preventive care approach has been clinically shown to work. Home care remains to be extremely important and patients can be referred to the Colgate website for the latest information on oral hygiene products that are effective in maintaining good oral health.
Implants and Periodontal Disease
Implants have been a significant clinical advancement for our patients. However like natural teeth, they can also develop periodontal conditions. There are two diseases that have been identified around functioning dental implants in the oral cavity. The first is peri-implant mucositis, which is gingival inflammation with no bone loss around the implant. The tissue will show redness, swelling and bleeding. The second is inflammation with suppuration (pus) and progressive bone loss.
The risk factors for developing these diseases are prior history of periodontitis, poor oral hygiene, smoking, diabetes, implant cement beyond the margin of the crown, occlusal overload and genetic factors. Implants in function for a significant number years can develop peri-implantitis. It has been reported that up to 35 percent of implant patients can have periodontal issues around their implants. Treatment can be both nonsurgical and surgical, depending on the severity of the problem.
If these five concepts can form the core competency of the hygiene center of your practice today, your office and your patients will benefit immediately.