Clinical
The Big PictureDentists lead against noncommunicable oral disease
Section snippets
Background
The initial research on the impact of periodontal diseases on chronic systemic inflammatory diseases is reaching its end. Now we are faced with trying to understand the biological mechanisms behind the associations we’ve identified and whether improving periodontal health will improve the outcomes for patients with chronic systemic illnesses. We also need to clarify the dental practitioner’s role in the process.
Mechanisms of Action
The most likely mechanistic explanation for the periodontal disease−chronic inflammatory disease link is a chronic low-grade bacteremia that is induced by eating, speaking and oral hygiene procedures. This bacteremia triggers an inflammatory response, termed the acute-phase response, by the liver. As a result, the blood levels of C-reactive protein are increased and circulating leukocytes such as the neutrophils related to oxygen radicals are released. These inflammatory markers raise blood
Results of Improving Periodontal Health
The research has shown that successful periodontal treatment improves tooth retention and positively affects general health and well-being. Periodontal inflammation is now ranked as one of the top six most important chronic noncommunicable diseases (NCDs) in humans. Resolving periodontal inflammation may offer a cost-effective, achievable primary prevention strategy in managing chronic systemic diseases associated with aging. Therefore it follows that the dental team can contribute
Discussion
To better address periodontal inflammation and its effects, the scope of practice of dentistry and the educational processes supporting it should be reviewed to ensure that they meet the needs and expectations of patients. Dentists need to have a skill set and function much like physicians. Leaders of dentistry and regulatory bodies need to provide the relevant regulation, training, guidance, and vision to meet the challenges of patients with and/or susceptible to chronic NCDs.
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Chapple I, Wilson N: Chronic non-communicable diseases. Br Dent J 216:487, 2014
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