Periodontal disease treatment: New guidelines from the American Dental Association

Dentists treating patients with chronic periodontitis, a severe form of periodontal disease that can lead to tooth loss, are advised to use scaling and root planing (SRP), deep cleaning of the teeth, as initial treatment, according to new guidelines from the American Dental Association. The guidelines, based on a systematic review and meta-analysis of treatment of periodontitis, were published in the July issue of the Journal of the American Dental Association (JADA).

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“This is the first time the various treatments of periodontitis have been compared side-by-side,” said ADA President and periodontist Maxine Feinberg, DDS. “Dentists are often challenged with managing gum disease of varying severity; these guidelines will assist practitioners in their decision-making and ultimately help patients receive the right treatment at the right time.”

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According to the authors, chronic periodontitis is a prevalent condition, affecting 47.2% of the adult US population aged 30 years or older. It is a major cause of tooth loss in adults. According to the Centers for Disease Control and Prevention and American Academy of Periodontology, the prevalence of moderate and severe periodontitis are estimated at 30% and 8.5%, respectively, among adults.

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In 2011, the ADA resolved to develop a clinical practice guideline on nonsurgical treatments including SRP. SRP is the process by which dentists and dental hygienists remove tartar and plaque that attach to the tooth surfaces. Based on a review of the evidence, the ADA concluded that clinicians should consider SRP as the initial treatment for patients with chronic periodontitis.

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Other treatments combined with SRP were examined, including systemic subantimicrobial-dose doxycycline (SDD), systemic antimicrobials, and lasers. The subantimicrobial-dose doxycycline (Periostat) was a stronger recommendation than other systemic antimicrobials/antibiotics because of concerns of side effects and overprescribing.