Three Recommendations for Improving Periodontal and Systemic Health

In an effort to improve both the periodontal and systemic health of our patients, several studies over the past 10-20 years have tried to better define the association between periodontal health and systemic conditions.

To that end, the American Academy of Periodontology (AAP), in collaboration with the European Federation of Periodontology (EFP), recently published a series of reports that analyze the scientific evidence linking periodontal disease to other systemic diseases, including diabetes, cardiovascular disease and adverse pregnancy outcomes.

These reports, which appear in both the Journal of Periodontology and the Journal of Clinical Periodontology, also outline clinical recommendations for dental professionals to use when treating patients at risk for, or presenting with, certain medical conditions.

Specifically, the consensus reports conclude:

  • There is strong epidemiologic evidence that periodontitis provides an increased risk for future cardiovascular disease. Dental professionals should discuss other risk factors for cardiovascular disease with their patients, including hypertension, obesity, and tobacco use. The treatment of periodontitis in patients with a history of cardiovascular disease should follow the American Heart Association guidelines for elective procedures.
  • There is an independent association between moderate to severe periodontitis and an increased risk for the development or progression of diabetes. Periodontal interventions may provide beneficial effects on diabetes outcomes in some patients, so regular comprehensive periodontal evaluations should be part of an ongoing diabetes management program.
  • While some studies suggest a modest association between maternal periodontitis and adverse pregnancy outcomes, there is currently insufficient evidence that periodontal therapy can be recommended as a means to improve pregnancy outcomes. Periodontal therapy is considered safe in pregnant women and can result in improved periodontal health, but dental professionals are urged to adhere to general obstetric guidelines that suggest elective procedures should be avoided in the first trimester.

Evidence suggests there is also a relationship between periodontitis and other systemic diseases, including chronic obstructive pulmonary disease, pneumonia, chronic kidney disease, rheumatoid arthritis, cognitive impairment, obesity, metabolic syndrome and cancer. However, additional studies are needed to better understand these associations
Developed at a joint workshop held in Segovia, Spain in November 2012, more than 70 international experts met to conduct an intense review of the available evidence supporting the association between periodontitis and other systemic diseases.

“These consensus reports confirm that periodontitis is related to other conditions, especially diabetes, cardiovascular disease and adverse pregnancy outcomes. Since we know that nearly half of U.S. adults have periodontitis, it is imperative that patients are made aware of their increased risk for systemic disease,” said Robert Genco, DDS, PhD, co-chair of the EFP-AAP 2012 Workshop Organizing Committee and Distinguished Professor at The State University of New York at Buffalo. “The AAP’s collaboration with the EFP provides the ability to promote the importance of periodontal health in maintaining overall health on a widespread scale.”

Nancy L. Newhouse, DDS, MS, President of the American Academy of Periodontology and an Assistant Clinical Professor at the University of Missouri – Kansas City School of Dentistry said, “The AAP was honored to be part of this milestone event.”

She continued, “Periodontists, and all dental professionals, share a responsibility in managing the periodontal health of our patients. These findings only help us be more effective.”

As the evidence in the consensus reports indicate, treating a patient for periodontal disease may help their overall health. Use these new consensus reports to better understand the relationship between periodontal disease and other diseases. Doing so will help you improve both the periodontal and systemic health of your patients.
(You may access the complete consensus reports for free online here.)

And, if any of your patients show signs of periodontal disease, let them know that new treatment options such as LANAP are available to them. Have them contact our office here []or call (904)-731-1324 to set up a consultation. With your help, we can reduce periodontal disease, and help your patients have the best overall health possible.