"This white paper provides oral health professionals with a comprehensive yet succinct summary of the main issues related to the global prevalence and impacts, aetiology and pathogenesis, prevention, diagnosis and treatment of periodontal diseases.
It also identifies the key challenges in tackling the burden of periodontal diseases and provides an action plan for oral health professionals, policymakers, and other related actors.
The Introduction defines periodontal diseases, including specific definitions and descriptions of the signs and symptoms of plaque-induced gingivitis, being evidence of gingival inflammation without clinical attachment loss, and periodontitis, being inflammation accompanied by loss of clinical attachment and alveolar bone resorption.
Notably, periodontitis is the major cause of severe tooth loss and edentulism in the adult population worldwide. It also describes the current classification of periodontal diseases (1999), gives a brief note on the forthcoming 2018 update from the World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions in November 2017, and emphasizes the screening and diagnostic procedures that dental professionals should follow to assess all patients’ periodontal status.
These procedures include medical and dental history/risk factor questions, extra- and intraoral examinations, radiographic assessment, and specific periodontal investigations. Section 2 goes on to detail the aetiology and pathogenesis of periodontal diseases, describing the process of inflammatory response to pathogenic oral biofilms.
It also considers risk factors for periodontal diseases, addressing both modifiable (lifestyle, metabolic, dietary, socioeconomic and stress factors) and nonmodifiable (genetic profile, gender, age, and certain systemic conditions) risk factors.
Sections 3 to 5 address the importance of periodontal diseases. A summary of the epidemiology and global burden of periodontal diseases is provided, recognizing severe periodontitis as the sixth most prevalent disease or condition worldwide.
Increasing disease prevalence with age, variations between global regions, and significant global socio-economic impacts are also highlighted (Section 3).
Section 4 describes the process by which periodontitis can result in bacteraemia and increased levels of systemic inflammation, and its shared unhealthy lifestyle (e.g. tobacco smoking), metabolic and dietary risk factors with other chronic noncommunicable diseases (NCDs).
Section 5 addresses the consequences and impacts of periodontitis, building on the information in Section 4 to describe the evidence for systemic diseases and conditions associated with periodontal infection and inflammation such as diabetes and cardiovascular diseases. It also describes the significant impact that periodontitis can exert on patients’ quality of life and self-esteem, through social, functional and aesthetic impairments."