Success requires effective self-care and thorough subgingival debridement - including scaling and root planing (SRP) - that may need to be repeated over time. The traditional first step in periodontal therapy involves eliminating subgingival biofilm and calculus to resolve periodontal inflammation. Regardless of which hypothesis is correct, dysbiotic microbial communities coupled with the host’s inflammatory response can result in degradation of the periodontium. Hajishengallis 5 also discussed the concept that inflammation supports the growth of dysbiotic microbial communities.
2,3 Alternately Bartold and Van Dyke 4 proposed that inflammation itself is responsible for controlling the composition of biofilms. Dysbioses seem initiated by the interactions of certain microbes, such as Porphyromonas gingivalis and Filifactor alocis. Figure 1 and Figure 2 are scanning electron micrographs depicting typical subgingival biofilm. Dysbioses are problematic disruptions of normal flora. Inflammation results from the interaction of a host’s immune system and dysbiotic subgingival biofilms. Oral inflammation can cause tooth loss and has been linked to numerous systemic health problems. The destructive effects and systemic impacts of periodontitis are the result of inflammation. 1 Undiagnosed, untreated or inappropriately treated periodontitis can have devastating effects on oral health, quality of life and overall health.
Periodontal diseases are a worldwide public health burden.
Identify determination criteria and approaches to therapy for sites that fail to adequately respond to traditional blind SRP.Discuss limitations to traditional blind scaling and root planing (SRP).Explain the roles of subgingival calculus and biofilm in persistent periodontal inflammation.This 2 credit hour self-study activity is electronically mediated.Īfter reading this course, the participant should be able to: The author has no commercial conflicts of interest to disclose. This course was published in the September 2021 issue and expires September 2024.
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