Wednesday, Jul 1, 2015

Dentists treating patients with chronic periodontitis, a severe form of gum 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 (ADA). 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).

According to the authors, chronic periodontitis is a prevalent condition, affecting 47.2 percent of the adult U.S. 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 percent and 8.5 percent, respectively, among adults.

In 2011, the ADA resolved to develop a clinical practice guideline on nonsurgical treatments including SRP. SRP is the process by which dentists 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. Other treatments combined with SRP were examined, including systemic subantimicrobial-dose doxycycline (SDD), systemic antimicrobials and lasers. The sub-antimicrobial dose doxycycline (Periostat) was a stronger recommendation than other systemic antimicrobials/antibiotics because of concerns of side effects and overprescribing.

For more information, read the guideline and the systematic review.