The American Academy of Periodontology (AAP), in collaboration with the European Federation of Periodontology (EFP), recently published a series of consensus reports that analyze the scientific evidence linking periodontal disease, specifically periodontitis, to other systemic diseases, including diabetes, cardiovascular disease and adverse pregnancy outcomes. The consensus reports, which appear in both the *Journal of Periodontology *and the *Journal of Clinical Periodontology*, also outline clinical recommendations for dental professionals to use when treating patients at risk for, or presenting with, certain medical conditions.Specifically, the
consensus reports conclude:

– There is strong epidemiologic evidence that periodontitis provides an increased risk for future cardiovascular disease. Dental professionals should discuss other risk factors for cardiovascular disease with their patients, including hypertension, obesity, and tobacco use. The treatment of periodontitis in patients with a history of cardiovascular disease should follow the American Heart Association guidelines for elective procedures.

– There is an independent association between moderate to severe periodontitis and an increased risk for the development or progression of diabetes. Periodontal interventions may provide beneficial effects on diabetes outcomes in some patients, so regular comprehensive periodontal evaluations should be part of an ongoing diabetes management program.

– While some studies suggest a modest association between maternal periodontitis and adverse pregnancy outcomes, there is currently insufficient evidence that periodontal therapy can be recommended as a means to improve pregnancy outcomes. Periodontal therapy is considered safe in pregnant women and can result in improved periodontal health, but dental professionals are urged to adhere to general obstetric guidelines that suggest elective procedures should be avoided in the first trimester.

– Evidence suggests a relationship between periodontitis and other systemic diseases, including chronic obstructive pulmonary disease,
pneumonia, chronic kidney disease, rheumatoid arthritis, cognitive impairment, obesity, metabolic syndrome and cancer. However, additional
studies are needed to better understand these associations.

The consensus reports also identified recommendations for future research, such as well-designed interventional studies and randomized clinical
trials, to enhance understanding of the impact of periodontitis and periodontal treatment on overall health. The complete consensus reports are
freely available online <http://www.joponline.org/toc/jop/84/4-s>.

The consensus reports were developed at a joint workshop held in Segovia, Spain in November 2012. More than 70 international experts met to conduct an intense review of the available evidence supporting the association between periodontitis and other systemic diseases.

A recent study published by the Journal of the American Dental Association (JADA) concluded  that patients that have a strong social support system and that enjoy from other socioeconomic factors such as financial stability, improve their chances of  making more dental visits in their lifetime, thus enhancing their oral health. The authors analyzed data pertaining to adults 40 years and older from a sample of 2,500 people.

Interesting findings about the study:

1. Only about 49% of the population above 40 years old visit the dentist regularly (once every three years max)

2. Compared to patients 54 years or younger, those older than 75 years of age visit the dentist more often. Of that age group, females tend to go to the dentist more often than men.

3. The presence of an extensive social network is not a guarantee of better oral health. Frequency and type of available support from those social networks may be more important for dental visits than the quantity of the relationships.

4. Along these lines, the presence of a spouse does not influence self care, but it is the quality of the relationship and the functional support provided by the spouse or partner that matters.

5. Socioeconomic factors, such as education, income or ethnicity play an important role in patient’s ability to come to see their dentist often.

In conclusion, a strong social network, comprised  of quality relationships where patients feel supported and can discuss their dental issues, encourage health promoting activities. Socioeconomic factors, especially financial stability, also play a big role in enhancing a person’s oral health.

Source: JADA 2013; 144(2):188-194