What’s the evidence on the best approach to supportive periodontal therapy?

Periodontitis (gum disease) is a chronic condition caused by bacteria, which stimulate inflammation and destruction of the bone and gum tissue supporting teeth. People treated for periodontitis can reduce the probability of re-infection and disease progression through regular supportive periodontal therapy (SPT). SPT starts once periodontitis has been treated satisfactorily, meaning that inflammation has been controlled and destruction of tissues supporting the tooth (bone and gums) has been arrested. SPT aims to maintain teeth in function, without pain, excessive mobility or persistent infection over the long term. SPT treatment typically includes ensuring excellent oral hygiene, frequent monitoring for progression or recurrence of disease, and removal of microbial deposits by dental professionals. Although success of SPT has been suggested through a number of long-term, retrospective studies, it is important to consider evidence available from randomised controlled trials (RCTs). Continue reading

Treating gum disease to prevent heart disease: the evidence is unclear

Heart diseaseGum disease is a common chronic or persisting condition that can get worse over time. It involves inflammation of the gums, which surround and support the teeth, causing swollen and painful gums and in severe cases loss of the bone (alveolar) that supports the teeth. Clinical investigations have shown that there might be a link or association between chronic, ongoing gum disease and heart and blood vessel disease (cardiovascular disease). Some investigators believe that the treatment for gum disease, which gets rid of bacteria and infection and controls inflammation, might prevent the occurrence or recurrence.

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No evidence that treatment of gum disease reduces the number of babies born before 37 weeks of pregnancy

Periodontal disease is a disease of the supporting tissues of the teeth that may affect the gums, periodontal ligament membrane, and bone around the tooth socket. It has been linked with infections, which some researchers believe could lead to or have an impact on a number of conditions, including problems in pregnancy. Periodontal disease is common in women of reproductive age, and gum conditions tend to worsen during pregnancy due to hormonal changes. The treatment involves bringing plaque on the teeth down to minimal levels, to reduce and resolve inflammation of the gums. It could involve counselling on oral hygiene measures, removing the plaque and calculus by using hand instruments (e.g. scale and polish) or ultrasound equipment (e.g. mechanical debridement), sometimes alongside the use of antibiotics or antiseptic mouthwashes or gels. If the nonsurgical treatment is not successful, surgery is sometimes required. This review assessed studies where pregnant women with gum disease were treated using a combination of techniques, with or without antibiotics. Continue reading

Treating gum disease: can it help diabetics control their blood sugar levels?

iStock_000013589042_SmallGum disease treatment is used to reduce swelling and infection from gum disease. Keeping blood sugar levels under control is a key issue for people with diabetes, and some clinical research suggests a relationship exists between gum disease treatment and glycaemic control. As a result, it is important to discover if gum disease treatment does improve glycaemic control to encourage better use of clinical resources.

There is a broad range of gum disease treatments available for treating patients with diabetes. This review considered:

1. Does gum disease treatment improve blood sugar control in people with diabetes?
2. Does one type of gum disease treatment have a bigger effect than another in improving blood sugar control?

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Treating all teeth within 24 hours for chronic gum disease

FMSGum disease or periodontitis is a chronic inflammatory disease that causes damage to the soft tissue and bone around the teeth. Mild periodontitis is common in adults with severe periodontitis occurring in up to 20% of the population. Non-surgical treatments based on the mechanical removal of bacteria from infected root surfaces are used in order to arrest and control the loss of the bone and tissue that support the tooth in adults suffering from chronic gum disease. These treatments can be carried out in a different area of the mouth in separate sessions over a period of several weeks (SRP), which is the conventional method, or alternatively, can be done within 24 hours in one or two sessions, which is termed ‘full-mouth scaling’ (FMS). When an antiseptic agent (such as chlorhexidine for example) is added to the full-mouth scaling the intervention is called ‘full-mouth disinfection’ (FMD). The rationale for full-mouth approaches is that they may reduce the likelihood of re-infection in already treated sites. This review is an update of one originally published in 2008, and considers the effectiveness of full mouth treatments. Continue reading

Treating chronic gum disease – can it help to prevent heart disease?

Heart diseaseGum disease (periodontitis) is a common chronic or persistent condition that can get worse over time. It involves inflammation of the gums, which surround and support the teeth, causing swollen and painful gums and in severe cases loss of the bone that supports the teeth. Clinical investigations have shown that there might be a link between chronic, ongoing gum disease and heart and blood vessel disease (cardiovascular disease). Some investigators believe that the treatment for gum disease, which gets rid of bacteria and infection and controls inflammation, might prevent the occurrence or recurrence of heart disease. Continue reading

Triclosan / copolymer containing toothpastes for oral health

ToothpasteGum disease and dental decay are the main reasons for tooth loss. Plaque (a film of bacteria) can build up on the teeth, leading to swelling and redness of the gums (gingivitis) which if left untreated can develop into a more serious form of gum disease (periodontitis). Periodontitis can cause pain, eating difficulties and tooth loss. The build up of plaque can also cause teeth to decay. Adding an effective and safe antibacterial ingredient to toothpastes could be an easy and low-cost answer to these problems. Continue reading