Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Clinical
  • Published:

A modern approach to periodontal management

BDJ Student volume 28, pages 60–62 (2021)Cite this article

Access through your institution
Buy or subscribe

By William Thorley

In the same way that a house is only as strong as its foundations, a tooth is only as strong as its periodontium. Periodontal tissues form a specialised system which interfaces multiple hard and soft tissue components and plays an essential role in tooth prognosis. With an ageing population and an increasing desire to retain rather than remove teeth, periodontology becomes more imperative. As a dental student on the periodontal clinic, you would be forgiven for thinking that periodontal care consists of endless cycles of root surface debridement (RSD) supplemented with generic oral hygiene education. This article endeavours to broaden the reader's awareness of a modern approach to periodontal management.

This is a preview of subscription content, access via your institution

Access options

Access through your institution

References

  1. Stenman J. Attitudes and communicative factors related to oral health and periodontal treatment. 2012. Online information available at https://gupea.ub.gu.se/bitstream/2077/29212/5/gupea_2077_29212_5.pdf (Accessed June 2020).

  2. Beals D, Ngo T, Feng Y, Cook D, Grau D G, Weber D A. Development and laboratory evaluation of a new toothbrush with a novel brush head design. Am J Dent 2000; 13: 5A-14A.

  3. Gallagher A, Sowinski J, Bowman J, et al. The effect of brushing time and dentifrice on dental plaque removal in vivo. J Dent Hyg 2009; 83: 111-116.

  4. Public Health England. Delivering better oral health: an evidence-based toolkit for prevention. 2014. Online information available at: www.gov.uk/government/publications/delivering-better-oral-health-an-evidence-based-toolkit-for-prevention (Accessed June 2020).

  5. Chadwick B, White D, Lader D, Pitts N. Preventive behaviour and risks to oral health - a report from the Adult Dental Health Survey 2009. 2011. Online information available at: www.dhsspsni.gov.uk/theme5_preventivebehaviourandriskstooralhealth.pdf (Accessed June 2020).

  6. British Dental Health Foundation. Nearly half skip brushing teeth at bedtime. 2011. Online information available at: www.dentalhealth.org/news/details/483 (Accessed June 2020).

  7. Underwood B, Birdsall J, Kay E. The use of a mobile app to motivate evidence-based oral hygiene behaviour. Br Dent J 2015; 219: E2.

  8. Yaacob M, Worthington H V, Deacon S A et al. Powered versus manual toothbrushing for oral health. Cochrane Database of Syst Rev. 2014.

  9. Sälzer S, Slot D E, Van der Weijden F A, Dörfer C E. Efficacy of inter-dental mechanical plaque control in managing gingivitis-a meta-review. J Clin Periodontol 2015; 42: S92-105.

  10. Page L R, Rams T E. Subgingival root brushing in deep human periodontal pockets. J Int Acad Periodontol 2013; 15: 55-63.

  11. Salvi G E, Lawrence H P, Offenbacher S, Beck J D. Influence of risk factors on the pathogenesis of periodontitis. Periodontol 2000 1997; 14: 173-201.

  12. Lang N P, Lindhe J. Clinical Periodontology and Implant Dentistry. John Wiley & Sons, 2015.

  13. Preshaw P M, Heasman L, Stacey F, Steen N, McCracken G I, Heasman P A. The effect of quitting smoking on chronic periodontitis. J Clin Periodontol 2005; 32: 869-879.

  14. Ramseier C A, Suvan J E. Behaviour change counselling for tobacco use cessation and promotion of healthy lifestyles: a systematic review. J Clin Periodontol 2015; 42: S47-58.

  15. Monnier L, Mas E, Ginet C et al. Activation of oxidative stress by acute glucose fluctuations compared with sustained chronic hyperglycemia in patients with type 2 diabetes. Jama 2006; 295: 1681-1687.

  16. Chapple I L, Milward M R, Ling-Mountford N et al. Adjunctive daily supplementation with encapsulated fruit, vegetable and berry juice powder concentrates and clinical periodontal outcomes: a double-blind RCT. J Clin Periodontol 2012; 39: 62-72.

  17. Chapple I L, Milward M R, Dietrich T. The prevalence of inflammatory periodontitis is negatively associated with serum antioxidant concentrations. J Nutr 2007; 137: 657-664.

  18. Preeja C, Ambili R, Nisha K J, Seba A, Archana V. Unveiling the role of stress in periodontal etiopathogenesis: an evidence-based review. J Investig Clin Dent 2013; 4: 78-83.

  19. Jeffcoat M K, Jeffcoat R L, Gladowski P A, Bramson J B, Blum J J. Impact of periodontal therapy on general health: evidence from insurance data for five systemic conditions. Am J Prev Med 2014; 47: 166-174.

  20. Casanova L, Hughes F J, Preshaw P M. Diabetes and Periodontal Disease: A Two-Way Relationship. Br Dent J 2014; 217: 433-437.

  21. Wright D, Muirhead V, Weston-Price S, Fortune F. Type 2 diabetes risk screening in dental practice settings: a pilot study. Br Dent J 2014; 216: E15.

  22. Gursoy M, Graziani, F. 2017. Biological mechanisms between periodontal diseases and pregnancy complications. Online information available at: www.efp.org/publications/projects/oralhealthandpregnancy/reports/review-biologicalmechanisms-8-6.pdf (Accessed June 2020).

  23. Tunkel J, Heinecke A, Flemming T F. A systematic review of efficacy of machine-driven and manual subgingival debridement in the treatment of chronic periodontitis. J Clin Periodontol 2002; 29: 72-81.

  24. Ioannou I, Dimitriadis N, Papadimitriou K, Sakellari D, Vouros I, Konstantinidis A. Hand instrumentation versus ultrasonic debridement in the treatment of chronic periodontitis: a randomized clinical and microbiological trial. J Clin Periodontol 2009; 36: 132-141.

  25. Wennström J L, Tomasi C, Bertelle A, Dellasega E. Full-mouth ultrasonic debridement versus quadrant scaling and root planing as an initial approach in the treatment of chronic periodontitis. J Clin Periodontol 2005; 32: 851-859.

  26. Zanatta G M, Bittencourt S, Nociti Jr F H, Sallum E A, Sallum A W, Casati M Z. Periodontal debridement with povidone-iodine in periodontal treatment: Short-term clinical and biochemical observations. J Periodontol 2006; 77: 498-505.

  27. Del Peloso Ribeiro É, Bittencourt S, Sallum E A, Nociti Jr F H, Gonçalves R B, Casati M Z. Periodontal debridement as a therapeutic approach for severe chronic periodontitis: a clinical, microbiological and immunological study. J Clin Periodontol 2008; 35: 789-798.

  28. George M D, Donley T G, Preshaw P M. Ultrasonic periodontal debridement: theory and technique. John Wiley & Sons, 2014.

  29. Petridis H, Hempton T J. Periodontal considerations in removable partial denture treatment: a review of the literature. Int J Prosthodont 2001; 14: 164-172.

Download references

Author information

Authors and Affiliations

  1. Charles Clifford Dental Hospital, Sheffield, UK

    William Thornley

Authors
  1. William Thornley
    View author publications

    Search author on:PubMed Google Scholar

Corresponding author

Correspondence to William Thornley.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Thornley, W. A modern approach to periodontal management. BDJ Student 28, 60–62 (2021). https://doi.org/10.1038/s41406-021-0244-0

Download citation

  • Published:

  • Issue date:

  • DOI: https://doi.org/10.1038/s41406-021-0244-0

Search

Advanced search

Quick links