Our periodontal maintenance report includes over 300 pieces of clinical information, developed specifically for the patient’s general dentist and hygienist, providing a complete and thorough update on that patient’s periodontal status. In the past, most clincians, understandably, have focused primarily on the pocket depths. While these are certainly important numbers, they are not the most critical piece of information. The most vital information given by this report is the “plaque control” and the “bleeding index”, the numbers that tell us the presence or absence of inflammation and the risk of recurrent disease activity.
We now know that inflammation is the periodontal “red flag” which guides us in the detection, treatment and control of gum disease. The AAP reports:
“Research has long suggested an association between gum disease and other health issues including heart disease, stroke and diabetes, but now scientists are beginning to shift their focus to understanding why these connections exist. An emerging theory, and one gaining support from researchers worldwide, is that inflammation may link the mouth to the body. Inflammation is the body’s instinctive reaction to fight off infection, guard against injury or shield against irritation. Inflammation is often characterized by swelling, redness, heat and pain around the affected area. While inflammation initially intends to heal the body over time, chronic inflammation can lead to dysfunction of the infected tissues, and therefore more severe health complications.
According to Dr. Susan Karabin, Past President of the American Academy of Periodontology and a practicing periodontist in New York City, periodontal disease is a textbook example of an inflammatory disorder: ‘for many years, dental professionals believed that gum disease was solely the result of a bacterial infection caused by a build-up of plaque between the teeth and under the gums. While plaque accumulation is still a factor in the development and progression of gum disease, researchers now suspect that the more severe symptoms, namely swollen, bleeding gums; recession around the gum line, and loss of the bone that holds the teeth in place, may be caused by the chronic inflammatory response to the bacterial infection, rather than the bacteria itself’.
American Academy of Periodontology-November 24, 2008
The success or failure of periodontal treatment is very much dependent upon control of the inflammation. This requires a record keeping system designed to focus upon inflammation and its cause, not just the pockets. This requires a time commitment from the clinician, devoted to helping the patient achieve plaque control effectiveness at home.
Bottom line – be on the look out for inflammation. If insurance limits the feasible amount of time you can devote to helping patients with their home care, make sure that the periodontist you work with is on top of inflammation!
Questions or comments? Feel free to contact us at 412-487-8288 or visit our website at www.pittsburghimplantsandperio.com