Philip Preshaw BDS, FDS RCSEd, Phd
Patients often describe the negative consequences of periodontitis affecting many aspects of their daily living and quality of life. The dental biofilm plays a fundamental role in initiating and perpetuating the chronic inflammation that leads to the tissue damage that we recognize clinically as disease. However, as any dental clinician is aware, there are clear inter-individual variations in susceptibility to this common disease, with, at one end of the scale, some individuals with relatively good oral hygiene appearing to be highly susceptible to early disease presentation and rapid progression, whereas other patients may have poor oral hygiene yet appear to be relatively resistant to the development of advanced periodontitis.
Susceptibility factors clearly play a role, therefore, and these will be the topic of discussion in this webinar. The two most important risk factors for periodontitis are smoking and diabetes. Smoking clearly increases the susceptibility to periodontitis and smokers are likely to have less favourable treatment outcomes compared to non-smokers. Furthermore, the response to periodontal treatment has been shown to be improved in patients who manage to quit smoking compared to those who continue to smoke. Strategies for managing smoking patients and the role of the dental team in helping patients to quit will be considered.
The other major risk factor for periodontitis is diabetes, and currently, many populations around the world are experiencing huge increases in the prevalence of obesity and diabetes as a result of lifestyle changes. Poorly controlled diabetes is associated with increased susceptibility to periodontitis, and there is evidence that treating periodontitis can be associated with improved diabetes control. The importance of diabetes as a risk factor for periodontitis will be discussed.
The management of risk should be considered as part of the overall management of patients with periodontitis. Tools for assessing risk will be considered that are accessible to the dental team, and that can help to educate and inform patients about the importance of reducing their risk factors for disease.