Maurizio S. Tonetti, Peter Eickholz, Bruno G. Loos, Panos Papapanou,Ubele van der Velden, Gary Armitage et al.
J Clin Periodontol. 2015 Apr;42 Suppl 16:S5-11
Aims: In spite of the remarkable success of current preventive efforts, periodontitis
remains one of the most prevalent diseases of mankind. The objective of this
workshop was to review critical scientific evidence and develop recommendations
to improve: (i) plaque control at the individual and population level (oral
hygiene), (ii) control of risk factors, and (iii) delivery of preventive professional
interventions.
Methods: Discussions were informed by four systematic reviews covering aspects
of professional mechanical plaque control, behavioural change interventions to
improve self-performed oral hygiene and to control risk factors, and assessment
of the risk profile of the individual patient. Recommendations were developed
and graded using a modification of the GRADE system using evidence from the
systematic reviews and expert opinion
Results: Key messages included: (i) an appropriate periodontal diagnosis is
needed before submission of individuals to professional preventive measures and
determines the selection of the type of preventive care; (ii) preventive measures
are not sufficient for treatment of periodontitis; (iii) repeated and individualized
oral hygiene instruction and professional mechanical plaque (and calculus)
removal are important components of preventive programs; (iv) behavioural
interventions to improve individual oral hygiene need to set specific Goals, incorporate
Planning and Self monitoring (GPS approach); (v) brief interventions for
risk factor control are key components of primary and secondary periodontal
prevention; (vi) the Ask, Advise, Refer (AAR) approach is the minimum standard
to be used in dental settings for all subjects consuming tobacco; (vii) validated
periodontal risk assessment tools stratify patients in terms of risk of disease progression
and tooth loss.
Conclusion: Consensus was reached on specific recommendations for the public,
individual dental patients and oral health care professionals with regard to best
action to improve efficacy of primary and secondary preventive measures. Some
have implications for public health officials, payers and educators.