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Primary prevention of periodontitis: managing gingivitis
- Source :
- Journal of Clinical Periodontology, 42(S16), S71-S76. Blackwell Munksgaard, Journal of Clinical Periodontology, 42(suppl. 16), S71-S76. Wiley, Chapple, I L C, van der Weijden, F, Doerfer, C, Herrera, D, Shapira, L, Polak, D, Madianos, P, Louropoulou, A, Machtei, E, Donos, N, Greenwell, H, van Winkelhoff, A J, Eren Kuru, B, Arweiler, N, Teughels, W, Aimetti, M, Molina, A, Montero, E & Graziani, F 2015, ' Primary prevention of periodontitis: managing gingivitis ', Journal of Clinical Periodontology, vol. 42, no. S16, pp. S71-S76 . https://doi.org/10.1111/jcpe.12366
- Publication Year :
- 2015
- Publisher :
- Blackwell Munksgaard, 2015.
-
Abstract
- Periodontitis is a ubiquitous and irreversible inflammatory condition and represents a significant public health burden. Severe periodontitis affects over 11% of adults, is a major cause of tooth loss impacting negatively upon speech, nutrition, quality of life and self-esteem, and has systemic inflammatory consequences. Periodontitis is preventable and treatment leads to reduced rates of tooth loss and improved quality of life. However, successful treatment necessitates behaviour change in patients to address lifestyle risk factors (e.g. smoking) and, most importantly, to attain and sustain high standards of daily plaque removal, lifelong. While mechanical plaque removal remains the bedrock of successful periodontal disease management, in high-risk patients it appears that the critical threshold for plaque accumulation to trigger periodontitis is low, and such patients may benefit from adjunctive agents for primary prevention of periodontitis.AimThe aims of this working group were to systematically review the evidence for primary prevention of periodontitis by preventing gingivitis via four approaches: 1) the efficacy of mechanical self-administered plaque control regimes; 2) the efficacy of self-administered inter-dental mechanical plaque control; 3) the efficacy of adjunctive chemical plaque control; and 4) anti-inflammatory (sole or adjunctive) approaches.MethodsTwo meta-reviews (mechanical plaque removal) and two traditional systematic reviews (chemical plaque control/anti-inflammatory agents) formed the basis of this consensus.ResultsData support the belief that professionally administered plaque control significantly improves gingival inflammation and lowers plaque scores, with some evidence that reinforcement of oral hygiene provides further benefit. Re-chargeable power toothbrushes provide small but statistically significant additional reductions in gingival inflammation and plaque levels. Flossing cannot be recommended other than for sites of gingival and periodontal health, where inter-dental brushes (IDBs) will not pass through the interproximal area without trauma. Otherwise, IDBs are the device of choice for interproximal plaque removal. Use of local or systemic anti-inflammatory agents in the management of gingivitis has no robust evidence base. We support the almost universal recommendations that all people should brush their teeth twice a day for at least 2 min. with fluoridated dentifrice. Expert opinion is that for periodontitis patients 2 min. is likely to be insufficient, especially when considering the need for additional use of inter-dental cleaning devices. In patients with gingivitis once daily inter-dental cleaning is recommended and the adjunctive use of chemical plaque control agents offers advantages in this group.
- Subjects :
- Toothbrushing
safety
NSAIDs
primary prevention
Dental Plaque
Dentistry
inter-dental cleaning
Dental plaque
Severe periodontitis
Oral hygiene
anti-inflammatory agents
Dental Devices, Home Care
Gingivitis
systematic review
SDG 3 - Good Health and Well-being
chemical plaque control
medicine
Dentifrice
Tooth loss
Humans
inter-dental brushes
wood sticks
Adverse effect
meta-review
periodontitis
Dentifrices
floss
Periodontitis
power toothbrushes
business.industry
oral hygiene instruction
GLOBAL BURDEN
Oral Hygiene
medicine.disease
manual toothbrushes
adverse effects
gingivitis
mechanical plaque control
meta-analysis
secondary prevention
self-administered care regimes
water irrigator
Self Care
Periodontics
medicine.symptom
business
Subjects
Details
- Language :
- English
- ISSN :
- 1600051X and 03036979
- Volume :
- 42
- Issue :
- S16
- Database :
- OpenAIRE
- Journal :
- Journal of Clinical Periodontology
- Accession number :
- edsair.doi.dedup.....31498b1a9f76e22546e66638c8b875b2