The Dental Connection to Health
Aruna Bakhru in Nutrition and Integrative Medicine, 2018
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.
Dental Disease, Inflammation, Cardiovascular Disease, Nutrition and Nutritional Supplements
Stephen T. Sinatra, Mark C. Houston in Nutritional and Integrative Strategies in Cardiovascular Medicine, 2022
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
Lars Granath, William D. McHugh in Systematized Prevention of Oral Disease: Theory and Practice, 2019
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
Activity of five antimicrobial peptides against periodontal as well as non-periodontal pathogenic strains
Published in Journal of Oral Microbiology, 2020
Katharina Enigk, Holger Jentsch, Arne C. Rodloff, Klaus Eschrich, Catalina-Suzana Stingu
The key factor in the etiology of periodontitis is the microbial biofilm formed on the tooth surface. The mechanical destruction of dental calculus and biofilm in form of scaling and root planing is the gold standard of the clinical periodontal treatment [1,2]. Additionally, antiseptics such as chlorhexidine or antibiotics are used as chemical adjuncts [3,4]. Systemic antibiotics offer a significant clinical benefit only for certain groups of patients and should be restrictively used in order to prevent the emergence of resistant bacteria [5]. In 2017, the World Health Organization (WHO) declared drug-resistant bacteria as the greatest threat to human health [6]. As a result, the search for alternative antimicrobial substances with a lower risk of developing bacterial resistance is of high interest.
Treatment challenges and delivery systems in immunomodulation and probiotic therapies for periodontitis
Published in Expert Opinion on Drug Delivery, 2021
Anže Zidar, Julijana Kristl, Petra Kocbek, Špela Zupančič
Several factors are involved in the pathology of periodontitis, among which the most important are a microbial shift with reduced numbers of beneficial symbionts and/or increased numbers of periodontal pathogens in the subgingival plaque, and an ineffective immune response [1,2,6]. Current treatment of periodontitis includes physical removal of subgingival plaque by scaling and root planing, which is sometimes combined with systemic or local administration of antimicrobials [7,8]. Due to the disease complexity, some patients experience only temporary improvements to their conditions using conventional therapy, which are then followed by disease relapse [9]. Thus, there is a great need for the development of new and more effective therapeutic approaches and treatments that can prolong disease remission, or provide permanent recovery [1,2]. Through new discoveries in the etiology of periodontitis, the modulation of immune response with different drugs and the addition of beneficial symbionts (e.g., probiotics) appear to be powerful strategies to improve current periodontitis treatments, and thus to improve the quality of life of these patients.
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).
Related Knowledge Centers
- Biofilm
- Calculus
- Debridement
- Dentin
- Periodontium
- Cementum
- Dental Plaque
- Periodontal Scaler
- Periodontal Curette
- Tooth Polishing