The Traditional Approach To Treating Periodontal Disease

Dentist have "grown up" with the understanding that periodontal disease is caused by certain pathogenic bacteria. Simply stated, the traditional view is that these bacteria adhere to the teeth in the form of plaque and, if not removed, the bacteria and their by-products can lead to gingival inflammation (gingivitis), which if left untreated will lead to eventual destruction of the periodontal attachment and supporting structure including bone (destructive periodontitis).

This view of the bacterial etiology of periodontal disease was the foundation of a methodology for treating the disease using specific therapeutic regimens and then monitoring the response of treatment using certain clinical assessment tools. In essence, following the course of disease after therapy relies on such well-established parameters as bleeding on probing, attachment loss, evidence of further bone loss, suppuration and related clinical findings. Treatment very often has two major objectives: elimination of bacteria and pockets. Indeed, for many dentists, the existence of a pocket is interpreted as a sign of active periodontal disease and is used to justify more aggressive treatment. Does this traditional viewpoint of the etiology, treatment and monitoring of periodontal disease accurately reflect current research findings? In light of growing legal concerns over failure to document and appropriately treat active periodontal disease, are today's dentists armed with the correct tools for accurately assessing patients? Indeed, could it be possible that overtreatment of some patients amy prove to be as problematic a legal issue as undertreatment?

An examination of the current understanding of the etiology of periodontal disease sheds light on the previous questions, and the answers give cause for serious reflection regarding the need to supplement our current methodologies for assessing the presence and severity of the disease, planning treatment and monitoring patients.

Source: Professional Dental Technologies, Inc.