Article: Volume 43 Number 8 Page 734 - October 2016

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  Dent Update 2016; 43: 734-744

Restorative dentistry:  Periodontal Disease- Breaking the Downward Spiral of the Disease Process

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Abstract: Periodontal disease is a common disease affecting more than 50% of the world’s adult population. It presents a diagnostic and treatment challenge for the dental clinician. A successful treatment outcome can be achieved by early and repeated intervention when signs of disease are evident in the mouth. Gingival bleeding is one of the early signs of gum disease and one which should not be overlooked by the patient or his/her dental care professional. This is usually indicative of the presence of gingivitis, which can lead to periodontitis in susceptible patients.

Clinical relevance: A high standard of plaque control is essential throughout treatment for a favourable periodontal outcome and yet it is unfortunate that sometimes, despite the best endeavour of both patients and clinicians, this is not possible. As a consequence of the failure to establish high levels of plaque control, some patients do not respond fully to traditional periodontal therapy and, for some patients, an ongoing deterioration or ‘downward spiral’ continues and adjuncts to non-surgical periodontal therapy are indicated to improve periodontal outcomes.

Author notes: Elaine Kehily, Clinical Fellow in Restorative Dentistry ( and Anthony Roberts, Professor and Consultant in Restorative Dentistry (Periodontology), Cork University Dental School and Hospital, Wilton, Cork, Ireland.

Objective: To understand the aetiology and management of periodontal disease and when adjunctive therapies may be appropriate.

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