Periodontics: Oral Health and Wellness I. Understanding Periodontal Health, Recognizing Disease States and Choices in Treatment Strategies

This course provides information to assist clinicians in promoting the goals of oral health by first understanding periodontal health, recognizing disease states and providing choices in treatment strategies. The course reviews basic periodontal anatomy (to include connective tissue, bone, periodontal ligament and cementum) and physiology, periodontal disease classification, as well as the challenges, manifestations and implications of attachment loss. Evaluation of periodontal therapeutic strategies is best accomplished through a review of the scientific evidence on the topic. The objective of the therapeutic strategies reviewed is to improve the health and function of all periodontal attachment structures rather than only bone in isolation.

Periodontal health depends on several factors, such as the periodontal microflora, oral hygiene, host response and other periodontal risk factors. Currently, we have yet to consistently and predictably restore periodontal attachment lost due to periodontal disease. The most frequently occurring periodontal disease is chronic periodontitis (formerly termed adult periodontitis). As the name implies, chronic periodontitis is often a slowly progressing disease which responds favorably to treatment and can be managed adequately; however, disease sequellae may not always be predictably restored.

Before one can recognize disease, one must understand periodontal health. The healthy periodontium is a strong yet flexible structure which attaches the teeth to the bones of the maxilla and mandible. In health, the periodontal attachment includes cementum, periodontal ligament, connective tissue and alveolar bone. The attachment bone plays a crucial role in maintaining the health and survival of the dentition.