Joan Otomo-Corgel

State of the Science: Chronic Periodontitis and Systemic Health

CONTEXT Inflammatory periodontal diseases exhibit an association with multiple systemic conditions. Currently, there is a lack of consensus among experts on the nature of these associations and confusion among health care providers and the public on how to interpret this rapidly growing body of science. This article overviews the current evidence linking periodontal diseases to diabetes, cardiovascular disease, osteoporosis, preterm low birth weight babies, respiratory diseases, and rheumatoid arthritis. EVIDENCE ACQUISITION Evidence was taken from systematic reviews, clinical trials, and mechanistic studies retrieved in searches of the PubMed electronic database. The available data provide the basis for applied practical clinical recommendations. EVIDENCE SYNTHESIS Evidence is summarized and critically reviewed from systematic reviews, primary clinical trials, and mechanistic studies CONCLUSIONS Surrogate markers for chronic periodontitis, such as tooth loss, show relatively consistent but weak associations with multiple systemic conditions. Despite biological plausibility, shorter-term interventional trials have generally not supported unambiguous cause-and-effect relationships. Nevertheless, the effective treatment of periodontal infections is important to achieve oral health goals, as well as to reduce the systemic risks of chronic local inflammation and bacteremias. Inflammatory periodontal diseases exhibit an association with multiple systemic conditions. With pregnancy as a possible exception, the local and systemic effects of periodontal infections and inflammation are usually exerted for many years, typically among those who are middle-aged or older. It follows that numerous epidemiological associations linking chronic periodontitis to age-associated and biologically complex conditions such as diabetes, cardiovascular disease, osteoporosis, respiratory diseases, rheumatoid arthritis, certain cancers, erectile dysfunction, kidney disease and dementia, have been reported. In the coming years, it seems likely that additional associations will be reported, despite adjustments for known genetic, behavioral and environmental confounders. Determining cause-and-effect mechanisms is more complicated, especially in circumstances where systemic effects may be subtle. Currently, however, there is a lack of consensus among experts on the nature of these associations and confusion among health care providers and the public on how to interpret this rapidly growing body of science. This article overviews the current evidence linking periodontal diseases to diabetes, cardiovascular disease, osteoporosis, preterm/low birth weight babies, respiratory diseases, and rheumatoid arthritis.

The North American Menopause Society recommendations for clinical care of midlife women

In celebration of the 25th anniversary of The North American Menopause Society (NAMS), the Society has compiled a set of key points and clinical recommendations for the care of midlife women. NAMS has always been a premier source of information about menopause for both healthcare providers and midli

AAP President’s Address*

Welcome to the 2015 Annual Meeting of the American Academy of Periodontology. This year marked a period of new beginnings, the start of a fresh vision and a new legacy. In 1914, the American Academy of Oral Prophylaxis and Periodontology was founded by Drs. Gillette Hayden andGrace Rogers Spalding. In 1919, the name of the organization was changed to the American Academyof Periodontology. So, last year, we celebrated the 100th anniversary of our organization’s origins and the 95th year as the AAP. As the Academy’s past presidents leaned in to blow out the candles on our Academy’s centennial birthday cake, we toasted an organization that has directed and defined the legacy of the specialty of periodontics for the past century—the specialty that, number one, saves teeth; number two, regenerates bone and soft tissues, laying the foundation for beautiful and healthy smiles; and number three, reduces the risk of systemic diseases. We are the true deliverers of oral health care. After taking the helm of the presidency for the AAP’s 101st year, I thought of what our legacy could be. This is a time when the hows and the whys in the practice and study of periodontics are constantly shifting. I wondered this: 99 years from now, what will this specialty look like? So the theme for this, our 101st year and guiding us into our next century, has been ‘‘New Beginnings.’’ New beginnings come in many forms, with opportunities to start anew in our personal and professional lives. For our Academy, this is an opportunity to refresh and modernize our mission, vision, and brand. New beginnings may be fraught with uncertainty and fear of the future, but if we commit to the core values that define us—a foundation in science, innovation, and the highest level of patient care—we will succeed. You will succeed if you pretend you are the patient in the chair. So what were our new beginnings in 2015? Invigorating our commitment to science is among the many things that make us unique. In the DNA of every periodontist is an inquisitive scientist and a skilled clinician, so as an Academy, we’ve spent the last 12 months reinvigorating the science that drives our daily work. The AAP has repositioned itself as the go-to source for evidence-based data that drive dentistry forward: world-class research was published in the Journal of Periodontology (JOP) and Clinical Advances in Periodontics, which is designed to show our colleagues what is possible. The Compendium of Continuing Education in Dentistry highlighted the Academy’s 2014 Regeneration Workshop in its November 2015 issue. We are poised to continue our push to advance the science in 2016, particularly with the upcoming bestevidence conferences on cone beam computed tomography, lasers, and dental implants. Our plans also include the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions, designed to reassess the existing types of periodontal diseases and conditions. This follow-up to the1999World Workshop will unite thinkers from the AAP, European Federation of Periodontology, and similar groups from Asia, South America, and Canada. The findings from this workshop will make disease classification more applicable to clinical practice, especially for dental students. Students and young, emerging members are groups that the Academy is working to embrace and elevate. These individuals will one day sit at the helm of our board, committees, and task forces. I challenge everyone to reach out, educate, mentor, and serve those who comprise our posterity. For the first time, the AAP has provided educational grants that enable third-year residents to attend the annual meeting festivities, which included yesterday’s symposiumon current regenerative technologies presented by the American Academy of Periodontology Foundation and Osteology Foundation. The symposium was held as a part of the young professionals fast track, which is another first for the Academy’s annual meeting and a specially designed series of sessions geared to those who are the faces of our future. As part of an Academy-wide effort to prioritize its engagement with new members, we are currently exploring the opportunity to allow students and emerging members to have a stand-alone meeting. This would allow each yearly class of attendees to establish its own identity while learning among peers and solidifying a relationship with the Academy. To our periodontal residents and those who have been in practice for 10 years and under: you are our future. Stickwith us. You are important to ourAcademy, and we will stand by you in your careers. At tomorrownight’s general assemblymeeting, voting members will have the opportunity to chime in on two critical votes affecting students and emerging members. One will grant students the benefits of full-fledged AAP membership upon graduation, with a tiered pricing