CHICAGO – November 23, 1999 – It’s been “drilled” into our minds by family members and friends and experiences from long ago: our fear of dental treatments. However, according to a recent online poll of periodontists conducted by the American Academy of Periodontology (AAP), many more patients indicate they have a fear about receiving periodontal treatment prior to treatment than mention they felt extreme discomfort or pain following treatment.

Of the 164 periodontists polled, almost half said that more than 50 percent of their patients indicate they are fearful about receiving periodontal treatment. However, more than three-quarters said less than 10 percent of their patients say periodontal treatments actually cause them any extreme discomfort or pain.

Many respondents said establishing trust with patients goes a long way in alleviating fear. “I try to address the issues of anxiety and comfort right from the start. People like knowing that their comfort is a priority,” said Richard Kaplan, D.D.S., a periodontist in New Jersey. “One of the things I most like hearing a patient say is ‘that wasn’t bad at all.’”

Periodontists report that it’s men and middle-aged adults who are most likely to fear periodontal procedures.

While 47 percent of those surveyed said that male patients are more often fearful, only 11 percent find their female patients to be the more fearful gender. And, more than half chose adults in their 40s and 50s as the most fearful age group, compared to younger and older age groups. Specifically, they said their patients are most likely to be afraid of feeling pain and needles.

In addition, the survey revealed that the top origins of that fear are family and friends or a personal bad experience more than 10 years ago.

“In recent years, we have seen wonderful advances in our ability to treat periodontal conditions in a comfortable way,” said Vincent Linz, D.D.S., a periodontist from Ohio.

In fact, the vast majority (84 percent) of respondents said that they have implemented specific procedures to help patients deal with their fear during treatment, and 59 percent said they’d implemented procedures in the past three years that actually make periodontal treatment less painful. In addition, some periodontists mentioned that improvements in local anesthesia, pain and anxiety medications, and in some cases, conscious sedation, have made many procedures virtually pain-free.

• Click here for detailed survey results

A referral to a periodontist in your area and free brochure samples including one titled Periodontal Surgery: What Can I Expect? 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

CHICAGO – August 30, 1999 – Postmenopausal women weighing the pros and cons of hormone replacement therapy may be able to add another benefit to their list – protecting their teeth. A study published in the current issue of The Journal of Periodontology released today suggests that estrogen supplementation in women within five years of menopause may slow the progression of periodontal disease. Study Abstract *

Studies show that at least half of Americans older than age 55 have periodontitis (an advanced stage of periodontal disease). Researchers have suspected that estrogen deficiency and osteopenia/osteoporosis speed the progression of oral bone loss following menopause, which could lead to tooth loss. The newly released study concluded that estrogen supplementation may lower gingival inflammation and the frequency of attachment loss (destruction of the fibers and bone that support the teeth) in women with signs of osteoporosis, thus helping to protect the teeth.

“For women at risk for osteoporosis, which likely makes them more vulnerable to rapid periodontal bone loss, this may be yet one more reason to be on estrogen,” said the study’s lead researcher Dr. Richard Reinhardt, professor, University of Nebraska Medical Center, College of Dentistry. “However, female smokers should note that the study found that smoking had a greater impact on speeding the progression of periodontal disease than estrogen deficiency.”

About 25 million of this country’s older women suffer bone loss due to osteoporosis. Estrogen supplementation is credited with helping to prevent bone loss, alleviating common menopause symptoms (such as hot flashes and irritability) and reducing the risk for coronary artery disease.

“While the study points to another possible benefit of hormone replacement therapy, women also need to consider the risks,” said Dr. Robert Schoor, president of the American Academy of Periodontology (AAP). “Women should speak to their physicians and their periodontists to help determine if estrogen supplementation is a good option for them.”

A referral to a periodontist in your area and free brochure samples including one titled Women and Periodontal 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—June 5, 2007—Melatonin could be the latest supplement to join the fight against periodontal diseases. According to a literature review in the June issue of the Journal of Periodontology, melatonin may promote bone formation and stimulate the body’s immune response, which are two factors that can affect a person’s periodontal health. Review Abstract

Since its discovery in 1917, melatonin has been found to be involved in many biological functions such as setting the body’s sleep rhythms and fighting off free radicals that may lead to cancer and other autoimmune diseases. The authors of this study conducted an extensive review of the literature (e.g., PubMed, Science Direct, Web of Knowledge, etc.) to evaluate the potential effects of melatonin on the oral cavity, including: melatonin as an antioxidant and free radical scavenger; melatonin as a host modulation agent; melatonin as a promoter of bone formation; and melatonin and periodontal disease. This review found strong evidence that melatonin may play a key role in periodontal health by helping to maintain bone levels in the oral cavity through suppressing the cells that work during bone resorption, and enhancing the body’s host response to the periodontal bacteria. One of the most devastating effects of periodontal disease is bone loss in the jaw which often leads to tooth loss.

“Although the review did not directly look at melatonin as a treatment option for periodontal diseases, this is an area that might be worth investigating in the future,” said review author Antonio Cutando, DDS. “Melatonin has important physiological functions that have not yet been explored in dentistry or in the treatment of periodontal diseases.”

Melatonin also has strong antioxidant and anti-inflammatory effects that help to improve the body’s immune response to infection. Recent studies have shown that salivary melatonin levels may actually vary according to the degree of periodontal disease, indicating that melatonin may act to protect the body from periodontal bacteria and inflammation.

“While natural supplements such as vitamin D, calcium, and vitamins E and C have been shown to have possible effects on periodontal diseases patients should be aware that supplements alone are not a substitute for periodontal care,” explained Preston D. Miller, DDS, and AAP president. “Patients should make an effort to know their pocket probing depths, which are the key to understanding their periodontal disease. A healthy probing depth of one to two millimeters with no bleeding represents a healthy mouth. Probing depths of three to four, that bleed, generally need more than a simple cleaning- they may require a procedure called scaling and root planing. When probing depths reach five millimeters or greater the patient has reached a level which may require surgical treatment to restore lost bone. Patients should keep this pocket size guide to their oral health in mind and should not hesitate to ask their dental professionals about their probing depths if this information is not volunteered.”

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 Protecting Your Oral Health 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.

The following letter was sent by Dr. Gordon Douglass, D.D.S., president of the American Academy of Periodontology.

January 24, 2003

Ms. Cornelia Dean
Medical/Health Editor
New York Times
229 W 43rd St.
New York, NY 10036-3959

Dear Ms. Dean,

I am writing to you with great concern regarding the article titled “Experts Debate the Best Way to Fix Ailing Gums” in the January 21, 2003, issue of the New York Times. The March 2002 clinical study referenced in the article further supports knowledge we have had for years that scaling and root planing with the use of adjunctive antibiotics, when needed, can help stabilize periodontal disease. However, neither this study nor any other has demonstrated bone growth from use of antibiotics. The article calls attention to a very important issue facing many dental practitioners today: what is the most cost-effective, minimally invasive means to keep periodontal diseases at-bay for each individual patient?

The American Academy of Periodontology (AAP) treatment guidelines have always stressed that periodontal health should be achieved in the least invasive and most cost-effective manner. This is often accomplished through non-surgical periodontal treatment, including scaling and root planing (a careful cleaning of the root surfaces to remove plaque and tartar from deep periodontal pockets and to smooth the tooth root to remove bacterial toxins), followed by adjunctive therapy such as systemic and local delivery antimicrobials and host modulation, as needed and on a case-by-case basis. Most periodontists would agree that after scaling and root planing, many patients do not require any further active treatment, including surgical therapy. Most periodontists also agree that determining surgical needs before assessing a patient’s response to non-surgical therapies is putting the cart before the horse. In fact, surgery is reserved for those situations when non-surgical therapies have failed to achieve the desirable clinical outcome of periodontal health, and to repair damage to gum tissue and bone as a result of periodontal disease.

Prescribing antibiotics as a first line of defense is not only unnecessary as most patients respond well without antibiotics, but it also disregards the Centers for Disease Control recommendations for appropriate antibiotic use for health care providers. As health care providers, it is important for all dentists to consider antibiotic usage guidelines in treatment planning, so that the effectiveness of their use is preserved for patients who do not initially respond to therapy; and to avoid contributing to one of the world’s most pressing public health problems namely, antibiotic resistance of bacteria.

The AAP continually monitors emerging research to identify therapies that further its members’ understanding of cost-effective, minimally invasive procedures in the treatment of periodontal diseases. Unfortunately, when the overly simplistic dispute over non-surgical versus surgical procedures arises, it often misleads patients and the dental community into thinking it’s an “either-or” debate. In fact, the procedures are complementary, with each having their place in treatment, and each having their limitations.

Sincerely,

Gordon Douglass, DDS
President

About the AAP

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

CHICAGO – November 27, 2002 – Austrian researchers found that learning about a patient’s stress coping strategies could help physicians with proper diagnosis and treatment of some medical conditions.

The study, published in the Journal of Periodontology (JOP), found that patients with defensive coping skills are more likely to refuse all responsibility and downplay their conditions in comparison with others, thus making it difficult for physicians to determine the severity of the medical condition and inhibiting their ability to counsel patients on possible prevention methods. Study Abstract *

“Should these results be confirmed, they would constitute an important means of enhancing the patient’s compliance during medical examinations and treatment,” said Gernot Wimmer, D.M.D, study author and lector at the Karl Franzens University of Graz in Austria. “In such cases, care should be taken to ensure that patients receive information in such a way that it does not cause them to become defensive, and that proper access to the disease is established.”

He continued, “Either consciously or unconsciously, individuals use coping measures as a response to stress, in order to reduce its intensity or to overcome stress altogether. Thus, the individual’s concept of stress coping appears to be particularly an important determinant of the general tenor on his/her health.”

The study looked at coping behavior in 89 men and women with periodontitis, an inflammatory gum infection at its most aggressive and destructive form, and 63 healthy persons. All study participants underwent a periodontal examination and took one of the most comprehensive stress questionnaires in German-speaking countries to determine their coping behavior. Results showed that those with periodontal disease were less likely to use active coping strategies, such as situation control, than those in the control group. They were also more likely to cope with stress situations by means of averting blame.

“This Investigation further demonstrates a correlation between emotional and psychosocial stress factors and medical treatment success,” said Gordon Douglass, D.D.S., and president of the American Academy of Periodontology. “It is important that both patients and their therapists understand ways to improve their stress coping ability.”

In terms of differentiating the various stressors, earlier reports indicate that work-related issues are coped with in a rather problem-oriented fashion, whereas disease-related situations are handled emotionally. Concerning family issues, no specific style is given preference; both patterns are used to an equal extent.

Problem-oriented coping is practiced in those situations that are considered changeable. For example, previous research in the JOP found that people with financial worries were at a higher risk of periodontal disease. However, authors recommended problem-based coping behaviors, such as taking charge and tackling the situation head first, to reduce the stress-associated risk. Emotional coping is more common in situations that have to be accepted and in which the individual feels helpless.

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

CHICAGO – April 4, 2006 – The American Academy of Periodontology (AAP) commissioned a review of the literature on the use of lasers in periodontics to help clinicians better understand the clinical applications of this emerging technology. Lasers in Periodontics: A Review of the Literature appears in this month’s issue of the Journal of Periodontology.

“The increase in promotion of the use of lasers in periodontics has prompted many questions from periodontists, general practitioners and patients,” said Kenneth A. Krebs DMD and AAP president. “This paper will help clinicians sort through the hype and identify the appropriate use of this technology in providing periodontal care.”

“The topic of lasers has been condensed to a ‘to-use’ or ‘not-to-use’ debate,” explained paper author Charles M. Cobb, DDS, and AAP member. “The issue is really more complicated than that. Each laser has a different wavelength. These various wavelengths can accomplish different things, however, damage to periodontal tissues can result depending on the wavelength and power, and the periodontal procedure that the laser was used to perform. This paper will help clinicians develop an evidence-based approach to the use of lasers in periodontal treatment.”

A referral to a local periodontist and free brochure samples including one titled Periodontal Surgery: What Can I Expect? 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

CHICAGO – November 13, 2006 – Patients who visit the AAP Web site (www.perio.org) now have an interactive tool to help them identify their individual risk for developing periodontal disease. “Millions of Americans have periodontal disease and don’t know it,” said Preston D. Miller, DDS and AAP president. “This tool will help patients test to see if they are at risk for having or developing periodontal disease.”

The tool, which is linked from www.perio.org/consumer/4a.html, includes a short questionnaire for patients to complete. Once submitted, a calculation based on the PreViser forumla, determines whether the patient is at low, medium, or high risk for developing periodontal diseases. An individualized profile report appears, including referral recommendations, and all patients have an opportunity to visit the Academy’s patient referral service to locate a periodontist in their area.

“There is a possibility that periodontal treatment may significantly improve general health outcomes,” Miller continued. “Given the potential impact on diabetes, prematurity, cardiovascular disease and other conditions, we believe it is important for patients to understand their risk for periodontal diseases and the current state of their periodontal health. In addition to the potential link to these general health conditions, periodontal diseases remain the most common cause of tooth loss in adults and can compromise a patient’s ability to smile, speak and eat with comfort and confidence.”

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

CHICAGO – February 8, 2001 – Daily brushing and flossing using the proper technique is fundamental to good oral health. But beyond that, the rules aren’t hard and fast.

For example, nearly 39 percent of periodontists believe it is best to floss before brushing your teeth, while about 35 percent say after is better, according to an online survey of 195 periodontists conducted recently by the American Academy of Periodontology (AAP). In addition, about half of those surveyed said people should spend about two minutes brushing. However, another 43 percent recommend about three minutes or more.

“Patients often ask how long they should spend brushing,” said Ravi Smith, D.D.S., a periodontist in San Francisco. “I do not recommend a timed regimen. Rather, I tell them however long it takes for them to properly brush all surfaces of their teeth.”

As for oral care products that promote fresh breath, nearly 44 percent of respondents said using a tongue scraper is an important part of an oral care routine while about 56 percent said it’s not. In addition, about 63 percent recommend mouthwash to patients concerned about fresh breath, while nearly 37 percent do not. For a quick breath refresher, 43 percent say sugarless gum is the best option; about 28 percent said a breath mint; and nearly 18 percent said breath spray.

More agreement exists on how many times a day brushing and flossing is necessary. About 82 percent of periodontists said they recommend brushing two or three times a day, and nearly 74 percent recommend flossing once per day. About 82 percent of periodontists say they personally floss daily, a much larger percentage than in the general population.

“The answer to many of the common questions dental professionals hear from their patients is that really it depends on the individual,” said Michael McGuire, D.D.S., president of the AAP. “Therefore, I advise people to ask their dental professional to talk with them about oral care products and to teach them how to properly brush and floss.”

Many periodontitsts wrote in that teaching patients about proper oral care regimens can have dramatic effects. “I recently had a 65-year-old patient who said he had only flossed once in his life,” wrote one periodontist. I explained to him the importance of cleaning between his teeth. He came back for an evaluation two months after treatment and said he was now flossing five days a week. Needless to say, his periodontal health has improved significantly.”

A referral to a periodontist in your area and free brochure samples including one titled Who Is a Periodontist and Why Do I Need One? are available by calling 800-FLOSS-EM or visiting the AAP’s Web site at www.perio.org.

The American Academy of Periodontology is a 7,900-member association of dental professionals specializing in the prevention, diagnosis and treatment of diseases affecting the gums and supporting structures of the teeth and in the placement and maintenance of dental implants. Periodontics is one of nine dental specialties recognized by the American Dental Association.

For more information, contact the AAP Public Affairs Department at 312/573-3243 or 312/573-3242.

Find Out More

• Detailed Survey Results

Chicago – February 18, 2010 – The American Academy of Periodontology (AAP) estimates that approximately three out of four Americans suffer from some form of gum disease – from mild cases of gingivitis, to the more severe form known as periodontitis. However, despite this prevalence, approximately only three percent seek treatment for their gum disease. With increasingly more research indicating that gum disease may be linked to several other diseases, including diabetes, heart disease and certain forms of cancer, maintaining healthy teeth and gums has become more important than ever.

According to Samuel Low, DDS, MS, Associate Dean and professor of periodontology at the University of Florida College of Dentistry, and President of the American Academy of Periodontology, the discrepancy between the prevalence of gum disease and the lack of treatment can likely be blamed on a lack of understanding of the effect periodontal disease can have on overall health. “Patients do not always seek the periodontal care they require because they are not aware of the long-term and potentially dangerous implications of untreated gum disease,” says Dr. Low. “Unfortunately, there are a variety of myths surrounding periodontal disease and its repercussions.”

In order to help distinguish between fact and fallacy regarding periodontal disease, the AAP has identified and addressed below some common misconceptions about oral health.

1. Bleeding gums are not that big of a deal.
Red, swollen and bleeding gums are an important sign of periodontal disease. If you notice bleeding while brushing or flossing, or when eating certain foods, you should schedule a visit with your dental professional to be evaluated for periodontal disease. Studies have shown that in addition to tooth loss, gum disease may contribute to the progression of other diseases, including heart disease and diabetes, so it is important that you begin treating periodontal disease as soon as possible.

2. You don’t need to floss every day.
Routine oral care, which includes brushing after every meal and before bedtime, and flossing at least once a day, is the best way to prevent gum disease. However, a recent survey estimates that only 13.5 percent of Americans floss each day. It is vital that you keep up with your daily oral care, and see a dental professional for a thorough check-up twice a year. If gum disease is diagnosed, a consultation with a periodontist, a dentist who specializes in treating periodontal disease, may be beneficial.

3. A visit to the periodontist will be scary.
Periodontists are gum disease experts. They have received three or more years of specialized training following dental school centered on the diagnosis, treatment and prevention of periodontal disease. Periodontists are equipped with the latest treatments and technologies, using innovative tools such as digital radiography, ultrasound technology, biomarker measurement and laser therapy to help make your visit more comfortable.

4. A tooth lost to gum disease is a tooth lost forever.
Gum disease is a major cause of tooth loss in adults. However, in addition to treating gum disease, periodontists are also experts in placing dental implants – a convenient and comfortable way to permanently replace missing teeth. A dental implant is an artificial tooth root that is placed into the jaw to hold a replacement tooth. Studies have shown that dental implants have a 98 percent success rate, and with proper care, allow you to speak, eat and smile with confidence. In fact, a survey conducted by the American Academy of Periodontology found that over 70 percent of respondents reported being “pleased” or “extremely satisfied” with the results of their dental implants.

5. Poor oral hygiene is the only way to develop gum disease.
Forgoing good oral hygiene can certainly contribute to the progression of gum disease, but there are a variety of other factors that can also impact your risk. For instance, tobacco use has been shown to greatly increase your chance of developing gum disease. Stress, poor diet, and even genetics, can also play a role in the health of your gums. To determine your risk of developing gum disease, the AAP offers a free online risk assessment test.

To learn more about periodontal disease, visit perio.org.

About the American Academy of Periodontology
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 world-wide.

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