Guidelines for the Management of Patients With Periodontal Diseases

I n 2005, the American Academy of Periodontology undertook the development of guidelines for the management of patients with periodontitis. The development process took into consideration the latest research in the field of periodontics, comments from Academy members, and input from other dental organizations. The final product – Guidelines for the Management of Patients With Periodontal Diseases – is published in this issue of the Journal. Today, there is greater public awareness about periodontal diseases and more treatment options for patients than ever before. However, as advancements in periodontal therapy continue to develop at a record-breaking pace, periodontal diseases remain the most common cause of adult tooth loss. In addition, accumulating research is further defining the links between periodontal diseases and other systemic conditions such as diabetes, adverse pregnancy outcomes, and cardiovascular diseases. Patients are beginning to understand that good periodontal health is more important than ever before. It is the Academy’s hope that these Guidelines will help to improve the periodontal health of all patients with periodontitis. Evidence suggests that an increasing number of patients would benefit from periodontal specialty care. Clearly, there has been some confusion regarding periodontal treatment and continued reevaluation of its effectiveness and when a periodontist should be consulted as a member of the patient’s treatment team. These Guidelines can help the entire dental team in the timely identification of patients with periodontal diseases and those most appropriate for specialty care. Patients at risk for periodontal diseases can often be overlooked during a routine dental examination because they appear to be in a state of periodontal health, yet there can be underlying risk factors that could increase the probability of periodontitis in the future. Many practitioners are aware that the concept of risk in the treatment of chronic diseases is rapidly becoming an important component of patient care and will ultimately drive treatment decisions and appropriate referrals in the healthcare community. For example, we know that a patient in excellent cardiovascular health today may be at high risk for developing the disease at some point in the future based on certain genetic or behavioral factors. The same is true for periodontal diseases. These Guidelines are meant to help identify patients who are at greatest risk early and, therefore, would benefit from specialty care. The Guidelines are in no way meant to replace a practitioner’s knowledge, skills, or abilities; a ‘‘one-size-fits-all’’ treatment plan for periodontal diseases does not exist. The diagnosis and treatment of periodontal diseases continue to present significant challenges to all practitioners regardless of experience level. We encourage periodontists to take these Guidelines and incorporate them into their daily routine and share them with their referring colleagues. These Guidelines provide a basis for strengthening existing relationships and building new ones. Periodontists have a unique relationship with general dentists because they are the only specialists who work with the restorative community throughout a patient’s life. There are many times that we hear from our referring colleagues that they have referred patients for specialty care, but, for one reason or another, the patient never follows through. We urge you to take the time to develop protocols with your referring colleagues for periodontal specialty care and to help optimize the health of your patients. This is an exciting time in periodontics. We encourage you to share these Guidelines with all members of your dental team and work to incorporate them into the management of your periodontal patients. The Academy hopes that the adoption of the Guidelines into everyday practice will help to provide guidance and perspective to the dental community. Together, we can work to enhance and ensure the periodontal health of all.