Elsevier

Dental Abstracts

Volume 60, Issue 1, January–February 2015, Pages 21-22
Dental Abstracts

The Big Picture
Changing the scope of practice

https://doi.org/10.1016/j.denabs.2014.07.014Get rights and content

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Background

In November 2012 the European Federation of Periodontology (EFP) and the American Academy of Periodontology (AAP) met jointly to try to understand the implications of the increasing literature documenting the impact of periodontal inflammation on chronic systemic diseases associated with aging and to develop consensus statements. The rigorous scientific analysis of the evidence was presented in 12 systematic reviews detailing the relationship between periodontitis and cardiovascular disease,

Mechanisms of Action

The evidence points to biological mechanisms behind the association between periodontal inflammation and systemic disease. The most plausible mechanism at work is that the chronic low-grade bacteremia produced by eating, speaking, and oral hygiene procedures triggers an inflammatory response (acute-phase response) by the liver. As a result, the blood levels of C-reactive protein become elevated and oxygen radicals are released by circulating leukocytes, especially neutrophils. These species and

Results

It is clear that successful periodontal treatment improves tooth retention and restoring periodontal health has a positive effect on general health and well-being. As a result, health-care systems are now elevating periodontal inflammation to status as one of the top six most important chronic noncommunicable diseases (NCDs) found in humans. Resolving periodontal inflammation may soon be considered a cost-effective and achievable primary prevention strategy in managing chronic systemic diseases

Discussion

The EFP’s manifesto is a call for action and support and not just a report on the state of evidence-based practice. If members of the dental team are to fulfill the requirement to manage patients with chronic NCDs and prevent the development of these disorders, changes are needed.

Clinical Significance

The practice of dentistry is at a point where it can make a real difference in the lives of patients through an expansion of its traditional scope of practice. Patients tend to come to the dentist

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Chapple I, Wilson N: Chronic non-communicable diseases. Br Dent J 216:487, 2014

Reprints available from News Editor Kate Quinlan, British Dental Journal, The Macmillan Bldg, 4 Crinan St, London, N1 9XW; e-mail: [email protected]

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