CHICAGO —February 6, 2007—Smoking can harm the integrity of dental implants and cause them to fail more often than in a nonsmoker, according to a new study that appeared in the February issue of the Journal of Periodontology (JOP). Study Abstract

Researchers from University of Murcia in Spain investigated if smoking impacts the ability of a dental implant to succeed. They found that smoking is a risk factor with regard to tooth loss and dental implant failure.

“People who smoke are at a greater risk of infection following surgery, and may heal more slowly,” said Dr. Arturo Sanchez Perez, Department of Periodontology at the University of Murcia. “When an implant is placed in a smoker, it is more likely to fail. This means a patient’s smile may be negatively affected, and the potential for more bone loss in the areas surrounding the gums and teeth.”

Smoking negatively affects blood flow to the bone and tissues surrounding the gums and teeth, which impairs bone healing. Implants fail because of a failure to integrate with the surrounding bone tissues. The study followed 66 patients over 5 years, who received 165 implants. They found that 15.8% of implants failed in smokers, versus 1.4% of implants in non-smokers.

“Tobacco use has been shown to be a risk factor for periodontal diseases, which is the main cause of tooth loss in adults,” said Dr. Preston D. Miller, DDS, President of the American Academy of Periodontology, “This research shows that if you want your dental implant to last, you should not smoke. Also, the treating dentist should make sure their patients are aware of this before placing an implant, and emphasize the importance of quitting smoking.”

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for

CHICAGO–May 15, 2007–– There are many lifestyle factors that can impact a person’s health, such as nutrition, amount of sleep, mental stress, tobacco use, and exercise. A study in the May issue of the Journal of Periodontology identifies lifestyle factors that have the most impact on periodontal health. Study Abstract

The study followed a group of 219 factory workers in Japan from 1999 to 2003 in an attempt to evaluate the effect of different lifestyle factors on the progression of periodontal diseases. Each worker was evaluated on a list of the following lifestyle factors: physical exercise, alcohol consumption, tobacco use, hours of sleep, nutritional balance, mental stress, hours worked and eating breakfast. The study found that the number one lifestyle factor that independently impacted the progression of periodontal disease was smoking; hours of sleep closely followed. Over 41% of study participants who showed periodontal disease progression from 1999 to 2003 were current smokers. In addition, lack of sleep was identified as a significant lifestyle factor that may play a role in the progression of periodontal disease. The participants who received seven to eight hours of sleep exhibited less periodontal disease progression than those who received six hours of sleep or less. High stress levels and daily alcohol consumption also demonstrated a significant impact on periodontal disease progression.

“Our findings are in line with other studies that have identified smoking as a strong lifestyle factor affecting oral health,” said study author Muneo Tanaka, DDS. “However, studies that have looked at hours of sleep as an independent factor affecting periodontal health are limited. From this study, we can speculate that shortage of sleep can impair the body’s immune response which may lead to the progression of diseases such as periodontal disease.”

“This study points out to patients that there are lifestyle factors other than brushing and flossing that may affect their oral health. Simple lifestyle changes, such as getting more sleep, may help patients improve or protect their oral health,” explained Dr. Preston D. Miller, DDS, and AAP president. “It is also important to keep these in mind as the body of evidence linking oral disease with systemic diseases continues to grow because ultimately these lifestyle factors might impact a patient’s overall health.”

To find out if you are at risk for periodontal diseases, please visit the AAP’s Web site and take a free risk assessment test. A referral to a periodontist in your area and brochure samples including one titled Tobacco & Gum Disease are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for periodontists—specialists in the prevention, diagnosis, and treatment of diseases affecting the gums and supporting structures of the teeth, and in the placement of dental implants. Periodontists are also dentistry’s experts in the treatment of oral inflammation. They receive three additional years of specialized training following dental school, and periodontics is one of the nine dental specialties recognized by the American Dental Association. The AAP has 8,000 members worldwide.

CHICAGO – November 11, 2003 – Swedish researchers may have found why tobacco smoking impairs the outcome of surgical and non-surgical periodontal therapy. According to the findings published in the Journal of Periodontology, smokers will want to quit before oral surgery in preparation for a prompt recovery. Study Abstract *

“In this study we investigated the relationship between tobacco smoking and the inflammatory response in smokers who consumed 10 to 20 cigarettes per day,” said Michael P. Rethman, D.D.S., M.S., and president of the American Academy of Periodontology (AAP). “What we found in tobacco smokers is that the body’s defense mechanism was weakened, whereas the defense mechanism in non-smokers promoted a more favorable healing response.”

Research also shows that tobacco smoking releases enzymes that could increase the development of periodontitis, a bacterial infection of the gums, bone and attachment fibers that support the teeth and hold them in the jaw. Once smokers quit, oral health begins to improve.

“Patients who want to quit smoking are urged to increase brushing and flossing their teeth and gums,” said Rethman. “It’s suggested that the fresh clean feeling a person feels in the mouth after brushing and flossing may curb the urge to smoke. Ironically, these simple tips also help to prevent periodontal diseases.”

In conjunction with the Great American Smokeout in November, the AAP has launched a special section on its Web site at www.perio.org to educate people about tobacco’s effects on periodontal health.

A referral to a periodontist in your area and free brochure samples including one titled Tobacco and Gum Disease are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for periodontists—specialists in the prevention, diagnosis, and treatment of diseases affecting the gums and supporting structures of the teeth, and in the placement of dental implants. Periodontists are also dentistry’s experts in the treatment of oral inflammation. They receive three additional years of specialized training following dental school, and periodontics is one of the nine dental specialties recognized by the American Dental Association. The AAP has 8,000 members worldwide.

CHICAGO – October 18, 1999 – Not only are smokers more likely to develop periodontal disease and have more severe cases of the disease than nonsmokers are, they are also more susceptible to treatment failure. According to a study published in the current issue of the Journal of Periodontology, smoking impairs healing after non-surgical periodontal treatment, which typically consists of oral hygiene instruction and scaling and root planing to remove plaque and bacteria from below the gum line.

After six to 10 periodontal appointments in which the goal was to reduce inflammation and probing depths (the amount of space between the teeth and gums), nearly 43 percent of smokers in the study required further periodontal treatment, while only about 11 percent of nonsmokers did. The study included 35 smokers and 35 nonsmokers with periodontal disease. Study Abstract *

“Smoking impairs the body’s defense mechanisms and interferes with the healing process,” explained Robert Genco, D.D.S., Ph.D., editor-in-chief of the Journal of Periodontology. “Smokers should understand that they are at increased risk for treatment failure, treatment complications and increased time to treat periodontal disease. Periodontal treatment of smokers should include serious attempts at smoking cessation.”

“The good news is your oral health will begin to improve once you quit smoking,” said Jack Caton, D.D.S., M.S., president of the American Academy of Periodontology (AAP). “In addition to reducing such serious threats as heart disease and cancer, quitting will help ensure you keep your teeth for a lifetime.”

In conjunction with the Great American Smokeout in November, the AAP has launched a special section on its Web site at www.perio.org to educate people about tobacco’s effects on periodontal health. The smoking section provides information on how tobacco use affects oral health and provides links to the following:

• Other AAP news releases on smoking and periodontal disease
• Research studies on tobacco use and oral health
• Web sites with smoking cessation information

A referral to a periodontist in your area and free brochure samples including one titled Tobacco and Gum Disease are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for periodontists—specialists in the prevention, diagnosis, and treatment of diseases affecting the gums and supporting structures of the teeth, and in the placement of dental implants. Periodontists are also dentistry’s experts in the treatment of oral inflammation. They receive three additional years of specialized training following dental school, and periodontics is one of the nine dental specialties recognized by the American Dental Association. The AAP has 8,000 members worldwide.

CHICAGO –April 3, 2007 –A study published in this month’s issue of the Journal of Periodontology found that subjects with periodontitis who were exposed to secondhand smoke were more likely to develop bone loss, the number one cause of tooth loss. Study Abstract

Researchers studied rats that were induced with periodontal disease. One group was not exposed to any cigarette smoke while the other two groups were exposed to either 30 days of smoke inhalation produced by non-light cigarettes (cigarettes containing higher tar, nicotine and carbon monoxide levels) or light cigarettes (cigarettes containing lower tar, nicotine and carbon monoxide levels). Results showed that bone loss was greater in the subjects exposed to secondhand smoke regardless of if it was smoke from light or non-light cigarettes than those who were exposed to no smoke at all.

“Previous clinical research has proven a strong positive correlation between smoking and gum disease. However, this study is unique in that it evaluated the impact of secondhand smoke on periodontitis,” explained study author Getulio da R. Nogueira-Filho, D.D.S.

“This study really drives home the fact that even if you don’t smoke the effects of secondhand smoke can be devastating. Part of maintaining a healthy lifestyle should include avoiding smoke-filled places such as night clubs, bars and even some restaurants,” said Dr. Preston D. Miller, DDS, and AAP president. “The Academy applauds the cities that are taking steps to make their hospitality industries smoke-free so all patrons can enjoy not only a good time but also good overall health.”

Cigarette smoking may well be the major preventable risk factor for periodontal disease. To find out if you are at risk for periodontal diseases, please visit the AAP’s Web site and take a free risk assessment test. A referral to a periodontist in your area and brochure samples including one titled Tobacco & Gum Disease are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for periodontists—specialists in the prevention, diagnosis, and treatment of diseases affecting the gums and supporting structures of the teeth, and in the placement of dental implants. Periodontists are also dentistry’s experts in the treatment of oral inflammation. They receive three additional years of specialized training following dental school, and periodontics is one of the nine dental specialties recognized by the American Dental Association. The AAP has 8,000 members worldwide.

CHICAGO – July 18, 2002 – Researchers from the Eastman Dental Institute at the University College in London identified severe periodontitis in a person with Marfan’s syndrome, a rare heredity disorder that causes connective tissues to be weaker than normal. The case report is published in the July issue of the Journal of Periodontology. Case Report Abstract *

“Reports of oral findings in Marfan’s syndrome patients have focused mainly on skeletal abnormalities. This case is notable since the detected periodontal breakdown was severe and could be only partly explained by known risk factors, such as cigarette smoking and inadequate oral hygiene,” said Maurizio Tonetti, D.M.D., PhD, professor and chair of the department of periodontology at the University College London. “It also supports our hypothesis that a variety of connective tissue disorders may increase susceptibility to periodontal tissue breakdown.”

Severe periodontitis is an advanced form of a chronic bacterial infection (periodontal disease) that inflames the supporting tissues of the teeth and destroys attachment fibers (periodontal ligaments) and supporting bone that hold teeth in the mouth. The main cause of periodontal diseases are bacterial plaque, sticky, colorless film that constantly forms on the teeth. Other factors that contribute to the disease include the following: smoking/tobacco use; genetics; hormonal changes; stress; certain medications; clenching or grinding your teeth; poor nutrition; systemic diseases; and notably, diabetes.

An oral examination determined the 41-year-old patient had swollen and receding gums, severe periodontal ligament attachment loss on all teeth and bleeding gums at 76 percent of the areas examined. The patient had no family history of periodontitis.

“It is important to note that this case report does not show a causal relationship between Marfan’s syndrome and periodontal diseases,” said Kenneth Bueltmann, D.D.S., president of the American Academy of Periodontology. “More research needs to be conducted to determine if there is an association between the diseases.”

However, Dr. Tonetti recommends that Marfan patients follow a preventive oral program based on professional tooth cleaning and daily brushing and flossing. And that they receive regular periodontal screenings by a periodontist.

Marfan’s syndrome is a heritable disorder of the connective tissue that affects many organ systems, including the skeleton, lungs, eyes, heart and blood vessels. The condition affects both men and women of any race or ethnic group. Scientists estimate that as many as 1 million people in the United States may have a heritable disorder of connective tissue, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases.

Periodontal diseases are serious bacterial infections that destroy the attachment fibers and supporting bone that hold your teeth in your mouth. When the attachment fibers are destroyed, gums separate from the teeth, forming pockets that fill with plaque and even more infection. As the disease progresses, these pockets deepen even further, more gum tissue and bone are destroyed and the teeth eventually become loose. Approximately 15 percent of adults between 21 and 50 years old and 30 percent of adults over 50 have the disease.

A referral to a periodontist in your area and free brochure samples are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for periodontists—specialists in the prevention, diagnosis, and treatment of diseases affecting the gums and supporting structures of the teeth, and in the placement of dental implants. Periodontists are also dentistry’s experts in the treatment of oral inflammation. They receive three additional years of specialized training following dental school, and periodontics is one of the nine dental specialties recognized by the American Dental Association. The AAP has 8,000 members worldwide.

CHICAGO – June 2, 2003 – Researchers from Case Western Reserve University have found a significant association between obesity and prevalence of periodontal disease, especially among individuals aged 18 to 34 years. Study findings were published in the May issue of the Journal of Periodontology. Study Abstract *

The study looked at 13,665 people, and all participants underwent a periodontal examination. Body mass index and waist circumference were used to indicate obesity. The prevalence of periodontal disease amoung obese individuals aged 18-34 years was 76% higher than normal weight individuals in this age group.

No significant association was found between body weight and periodontal disease in the middle and older age groups.

Several explanations for the association between obesity and periodontal disease in younger adults and not older adults are plausible. The younger people in the study may have different dietary patterns than older study participants. Research in dietary trends in adolescents ages 11 to 18 reveal a significant decrease in raw fruit and non-potato vegetables, which are sources of vitamin C. In addition, adolescents have decreased their calcium intake, and increased their intake of soft drinks and non-citrus juices. This is important to oral health because low dietary intake of calcium and vitamin C have been associated with periodontal disease.

“Periodontists have known for awhile that people who consume less than the recommended dietary allowance (RDA) for calcium and vitamin C have slightly higher rates of periodontal disease. Young people are now drinking more soft drinks and non-citrus juices than milk and healthier beverages, decreasing their vitamin C and calcium intake” said Mohammad S. Al-Zahrani, D.M.D., Centers for Health Promotion Research, Case Western Reserve University. “Periodontitis has long been considered an ‘older person’s’ disease, as more than half of people aged 55 or older have it. We now know that widespread risk factors such as obesity may also compromise periodontal health in younger populations.”

“This is one more finding that shows healthy nutrition and adequate physical activity are necessary for overall health, and may also help to improve periodontal health by reducing the rate of progression of periodontal disease, said Gordon Douglass, D.D.S. and president of the American Academy of Periodontology.”

The study mentions other reasons for the association between obesity and periodontal disease including the social stigma associated with obesity in younger adults. Obesity for this age group may be a greater source of chronic stress than in older adults where increased body weight is considered more acceptable. Stress and how an individual copes with stress has been shown to increase a person’s risk for periodontal disease.

“These findings add one more health risk to the list, and further demonstrate the importance of preventing and managing obesity, said Douglass. “Like obesity, periodontal disease can take away a person’s confidence and smile.”

A referral to a periodontist in your area and free brochure samples including one titled Periodontal Diseases: What You Need to Know are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for periodontists—specialists in the prevention, diagnosis, and treatment of diseases affecting the gums and supporting structures of the teeth, and in the placement of dental implants. Periodontists are also dentistry’s experts in the treatment of oral inflammation. They receive three additional years of specialized training following dental school, and periodontics is one of the nine dental specialties recognized by the American Dental Association. The AAP has 8,000 members worldwide.

CHICAGO – April 19, 2002 – Researchers found depressed patients have twice the odds of sub-optimal outcomes from periodontal treatment over one year compared to patients without depression, according to a recent study* in the April Journal of Periodontology. Study Abstract *

“There are many factors that could impact treatment outcomes in clinically depressed periodontal patients,” said John Elter, lead author of the study and a dentist and epidemiologist at the University of North Carolina Chapel Hill School of Dentistry. “For example, the patient’s attitude about the treatment process plays a significant role in treatment success. Depressed patients might view a course of periodontal treatment as an overwhelming ordeal, and might be more likely to not comply with all treatment recommendations.”

“In addition, depressed persons are more likely to continue to smoke, which has been linked to poor response to periodontal therapy,” said Elter. “Most importantly, it is possible that their immune system is impaired which may slow down the body’s reaction to fight off the infection, but more research needs to be conducted to verify this.”

He continued, “Future studies should focus on elucidating a possible mechanism for the negative effect of depression on the immune system and on wound healing.”

Previous research has found that depression has been associated with poor outcomes from cardiac surgery and reconstructive spinal surgery. In this study, the presence of preoperative fear, anxiety, or depression prior to surgery is associated with a negative postsurgical experience and with increased post-periodontal surgery pain response and impairment of quality of life.

“This is the first report of clinical depression and poor periodontal treatment outcome,” said Kenneth Bueltman, D.D.S., president of the American Academy of Periodontology. “As we are hearing a lot about the decrease of mental health lately, this new information is important for periodontists and patients to consider before periodontal treatment. Pretreatment assessment of depressive status may serve to improve the quality, accessibility and effectiveness of periodontal treatment for patients suffering from clinical depression.”

A total of 697 patients were given periodontal exams between January 1, 1996, and December 31, 1998; 85 of the patients had been diagnosed with some form of depression. Each patient had at least three diseased sites with probing depth (PD) greater than 5 mm between the gum tissue and teeth at the beginning of the study and was monitored from the date of the initial periodontal examination until the follow-up examination one year later. The level of periodontal diseases in the patients varied from moderate to severe. The median change score in the disease after treatment was 7.4 percent in mentally healthy patients and only 4.7 percent in depressed patients.

In any given 1-year period, 9.5 percent of the population, or about 18.8 million American adults, suffer from a depressive illness, according to the National Institute of Mental Health. Women tend to experience depression about twice as often as men due to many hormonal factors such as menstrual cycle changes, pregnancy, pre-menopause, and menopause. While the exact cause is not known, some types of depression run in families, suggesting that a biological vulnerability can be inherited. Additional factors, possibly stresses at home, work, or school, are involved in its onset.

“In light of recent economic events, more Americans may have additional stresses that may put them at a high risk of becoming clinically depressed. Therefore, periodontists needs to be aware of the signs and symptoms of depression so they can adjust their treatment procedures to obtain the best possible outcomes,” said Bueltmann.

A July 1999 article in the Journal of Periodontology reported that high levels of financial stress and poor coping abilities increase twofold the likelihood of developing periodontal (gum) disease. More about this article

After accounting for other risk factors – such as age, gender, smoking, poor dental care and diabetes – those who reported high levels of financial strain and poor coping behaviors had higher levels of attachment loss and alveolar bone loss (signs of periodontal disease) than those with low levels of financial strain. However, people who dealt with their financial strain in an active and practical way (problem-focused) rather than with avoidance techniques (emotion-focused) had no more risk of severe periodontal disease than those without money problems.

Periodontal diseases are serious bacterial infections that destroy the attachment fibers and supporting bone that hold your teeth in your mouth. When this happens, gums separate from the teeth, forming pockets that fill with plaque and even more infection. As the disease progresses, these pockets deepen even further, more gum tissue and bone are destroyed and the teeth eventually become loose. Approximately 15 percent of adults between 21 and 50 years old and 30 percent of adults over 50 have the disease.

A referral to a periodontist in your area and free brochure samples are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for periodontists—specialists in the prevention, diagnosis, and treatment of diseases affecting the gums and supporting structures of the teeth, and in the placement of dental implants. Periodontists are also dentistry’s experts in the treatment of oral inflammation. They receive three additional years of specialized training following dental school, and periodontics is one of the nine dental specialties recognized by the American Dental Association. The AAP has 8,000 members worldwide.

CHICAGO – November 11, 2004 – As the scientific community is seeking alternatives to antibiotic treatment, periodontal researchers found that photodynamic therapy (PDT) is advantageous for suppressing anaerobic bacteria that lead to periodontal diseases according to a recent study in the Journal of Periodontology.

“Although this study is still in its early phase, with the recent number of reports about bacterial strains becoming resistant to frequent doses of antibiotics, PDT could be an alternative to conventional periodontal therapeutic methods,” said Dr. Michael P. Rethman, DDS, MS, and president of the American Academy of Periodontology. “Antibiotics may be used as an adjunctive therapy for periodontal diseases, so there is a pronounced interest in the development of alternative antimicrobial concepts.

PDT involves two stages. In the first stage, a light-sensitive drug is applied. The second stage involves shining a light or laser directly on the area treated with the drug. When the light is combined with the drug, phototoxic reactions are induced which destroy bacterial cells. PDT was first approved by the Food and Drug Administration in 1999 to treat pre-cancerous skin lesions of the face or scalp.

In this study, researchers investigated anaerobic bacterial strains (bacteria that can only survive and grow in the absence of molecular oxygen) and facultative anaerobic bacteria (bacteria that can survive without oxygen).

“The photosensitizers we investigated were able to completely suppress the anaerobic key pathogens leading to periodontal diseases; however, facultative anaerobic bacteria tested responded to a lesser extent to PDT,” said Dr. Bernd W. Sigusch, Friedrich Schiller University of Jena, Conservative Dentistry, Germany.

To specifically address the periodontal pockets in the body, the test tube results are presently being verified in several animal and human experiments.

A referral to a periodontist in your area and free brochure samples including one titled Periodontal Therapy: Where Do I Start are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for periodontists—specialists in the prevention, diagnosis, and treatment of diseases affecting the gums and supporting structures of the teeth, and in the placement of dental implants. Periodontists are also dentistry’s experts in the treatment of oral inflammation. They receive three additional years of specialized training following dental school, and periodontics is one of the nine dental specialties recognized by the American Dental Association. The AAP has 8,000 members worldwide.

CHICAGO—July 10, 2007—The American Academy of Periodontology (AAP) published a supplement today in the Journal of Periodontology (JOP), that is the result of a collaboration between the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, and the AAP to examine the feasibility of using alternative non-clinical measures for population-based surveillance of periodontal diseases. Participants in this workgroup include representatives from the CDC and AAP, and other leading oral epidemiologists, statisticians, academicians and public health experts. The supplement titled Development of Self-Reported Measures for Population-Based Surveillance of Periodontitis accompanied this month’s JOP issue.

The supplement reports on the current challenges in public health surveillance of periodontal diseases, and focuses on the potential use of self-report measures for population-based surveillance. The efforts of this workgroup include identifying and assessing the validity of self-report measures for surveillance of periodontal diseases in multiple datasets, and field testing of promising questions in a national survey. Eleven papers are presented in this supplement, covering the following issues:

• Background and perspectives on surveillance of periodontal disease
• Case definitions for population-based surveillance of periodontal disease
• Analytical methods and assessments of self-report measures for surveillance in multiple datasets
• Field testing of promising self-report questions.

“The issue of periodontal surveillance has been important for both the AAP and the CDC,” explained William Giannobile, DDS, Associate Editor of the JOP. “These papers provide valuable information about the current status of periodontal surveillance and future directions on the monitoring of periodontal disease. With the use of new salivary proteomic and genomic biomarkers of disease and rapid identification procedures to classify patients, the future is sure to be exciting.”

“We are excited about this information,” said Preston D. Miller, DDS and AAP president. “Epidemiologists, dental researchers, clinicians, and the public are eager to assess the prevalence of periodontal disease in the U.S. population. The papers in this supplement highlight the diversity and complexity of the issue of periodontal surveillance.”

About the AAP

The American Academy of Periodontology (AAP) is the professional organization for