The Importance of the Inflammation Link

For many years, periodontists focused primarily on bacterial etiology…

Most periodontists were confident that if periodontal pathogenic bacteria could be minimized and patients were urged to commit to excellent plaque control, periodontal disease could be arrested or prevented.

This philosophy provided a simple equation for achieving periodontal health, and the concept of “soft tissue management” took hold.

If periodontal disease progressed, there could be only two possible explanations: the education of patients failed to motivate them to better care for their teeth and gums, or adequate mechanical therapy was not performed.

However, in recent years, the periodontal community has turned its attention to the role of inflammation in the progression of periodontal disease.

Over the past few decades, scientific literature has identified the inflammatory process as a primary modifier of many chronic diseases, including periodontists.

Consequently, the presence of inflammation has become more widely accepted in the specialty as the basis for explaining the perio-systemic link, and treatment planning has evolved beyond simple soft-tissue management.

Periodontists now understand that the inflammatory response is genetically predetermined; it has been estimated that up to 50% of chronic adult periodontists has a strong genetic component.

Also, this predisposition to inflammation and disease may change over a patient’s lifetime as susceptibility is modified by environment, stress, nutrition, or the onset of other diseases of aging such as cardiovascular disease or diabetes – a process known as epigenetic.