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Dental Disease, Inflammation, Cardiovascular Disease, Nutrition and Nutritional Supplements
Published in Stephen T. Sinatra, Mark C. Houston, Nutritional and Integrative Strategies in Cardiovascular Medicine, 2022
Douglas G. Thompson, Gregori M. Kurtzman, Chelsea Q. Watkins
As outlined, periodontal disease is identified by the presence of gingival bleeding, increased probing depth, evidence of bone loss on radiographs and potential tooth mobility during routine examination. Once identified, goal of treatment is the mechanical debridement (scaling and root planing) of the periodontal pockets and the associated teeth to remove hard formations (calculus), and disrupt and remove the soft sulcular biofilm (plaque) to levels that do not provoke a host response. Additionally, other host modulatory strategies, for example better nutrition, may be employed to alter the host response and to strengthen the autoimmune system. Salivary testing is performed prior to treatment to identify those patients who are at higher risk based on pathogenicity of the bacteria present and their concentrations. This information serves as a pretreatment baseline to compare to a post-treatment report confirming if the flora has been altered and if additional care is required. Genetic testing can also be obtained to learn information about the possible severity of the innate and acquired host response.
Periodontal Diseases
Published in Lars Granath, William D. McHugh, Systematized Prevention of Oral Disease: Theory and Practice, 2019
William D. McHugh, Lars Matsson, Sigmund S. Socransky
Scaling and root planing are the simplest methods of pocket elimination and involve the meticulous removal of calculus and plaque, and the planing of roughened and otherwise altered root surfaces. Their clinical effectiveness as a separate entity is difficult to assess since they are always combined with measures to control plaque, which of themselves, have a significant therapeutic effect. Scaling and root planing combined with oral hygiene have been shown to reduce pocket depth.58,150,155 They have also been shown to maintain attachment levels and to prevent further increases in pocket depth.119,123
The Dental Connection to Health
Published in Aruna Bakhru, Nutrition and Integrative Medicine, 2018
Alyse Shockey, Lisa Marie Samaha, Dawn Ewing
Periodontics became an approved specialty of dentistry in the United States in 1947.28 Regrettably, the standard-of-care for the diagnosis and treatment of periodontal disease has remained mostly unchanged, focusing on a traditional therapeutic technique known as “scaling and root planing.”29 The traditional technique has consisted of mechanical removal of the soft, sticky biofilm known as “plaque,” and the hard, calcified concretions that result from mineral deposition within plaque, known as “calculus” via a mechanical process known as scaling and root planing. It is noteworthy that when such a procedure is performed, bacteria is mobilized into the bloodstream creating a systemic bacteremia, which can result in untoward medical issues elsewhere in the body. Salivary bacterial DNA testing to properly identify the pathogens involved in the individual's periodontal disease before clinical care is instituted can help protect the patient, as DNA testing will allow for the prescribing of the appropriate, targeted systemic or oral antibiotic rinses to help prevent negative sequelae in the rest of the body and allow for improved therapeutic results of periodontal therapy. Historically, diagnostics have only consisted of clinical signs and symptoms of bleeding upon probing, increased probing depth, evidence of radiographic bone loss, gingival recession, mobility, and clinical attachment loss.
Chemotherapy-Induced Oral Complications and Prophylaxis Strategies
Published in Cancer Investigation, 2023
Aleksandra Śledzińska, Paulina Śledzińska, Marek Bebyn, Oskar Komisarek
A program of aggressive oral preventative care appears to reduce the occurrence of all oral complications associated with chemotherapy (159–163). Scaling and root planing, caries treatment, and endodontic therapy should be included in pretreatment oral hygiene routines. A tooth extraction should be considered in cases of severe odontogenic disease. Dental or endodontic treatment should be pursued solely in patients with symptoms consistent with acute periapical infection (29). In patients with periodontal disease, pretherapy dental treatment is often recommended to minimize potential sources of odontogenic infection (27). Prior dental care can reduce the number of oral bacteria and the risk of infection during chemotherapy (164). Invasive manipulation of the soft tissues prior to chemotherapy appears to have no negative influence on the eventual occurrence of fever or bacteremia (165).
Potential Treponema denticola-based periodontal vaccine to resolve a global public health challenge: a narrative literature review
Published in Expert Review of Vaccines, 2022
Navid Mirmohammadsadegh, Neshaut Mashreghi Mohammadi, Mohsen Amin
According to a report, the global financial burden of periodontal diseases (PD) was estimated to be 54 billion USD/year in lost productivity causing 3.5 million years lived with disability [1]. The global prevalence of periodontitis is estimated to increase in the following years due to the growth in the elderly population worldwide [1]. At first glance, periodontitis seems to be a localized inflammation leading to gum inflammation. Nevertheless, the inflammation may damage the supportive structure of the teeth and is a risk factor for other systemic inflammations such as rheumatoid arthritis, osteoporosis, brain damage, diabetes mellitus, cardiovascular disease, and adverse pregnancy outcomes [2]. As shown in a systematic analysis in 2018, the indirect costs because of periodontal disease amounted to $150.57 billion in the US and €156.12 billion in Europe [3]. Hence, some insurance companies have expanded 100% coverage for non-surgical periodontal remedies such as periodontal scaling and root planing [4].
Salivary concentrations of macrophage activation-related chemokines are influenced by non-surgical periodontal treatment: a 12-week follow-up study
Published in Journal of Oral Microbiology, 2020
Maria A. Grande, Daniel Belstrøm, Christian Damgaard, Palle Holmstrup, Eija Könönen, Mervi Gursoy, Ulvi Kahraman Gursoy
The study was performed from September 2016 to the beginning of January 2017 at the Department of Odontology, University of Copenhagen. Non-surgical periodontal treatment was performed at baseline. The treatment consisted of comprehensive individual hygiene instructions followed by scaling and root planing. Full-mouth periodontal recordings (third molars excluded) were obtained at baseline and 12 weeks after therapy. The periodontal recordings were measured at six sites per tooth and included registrations of plaque index (PI), bleeding on probing (BOP), probing pocket depth (PD) and clinical attachment level (CAL). Control visits were performed 2 and 6 weeks after treatment. PI and BOP were recorded, and oral hygiene instructions were repeated, if plaque was present upon application of erythrosine. All recordings and treatments were performed by the same clinician (MAG).