PreViser Blog

What happens to the periodontal (gum) health of 10 people if you put them in a Stone Age environment for 4 weeks with no toothbrushes?!    This interesting, if small scale, study was undertaken by Baumgartner et al in 2009.  The subjects’ periodontal health was measured at baseline using four indicators: bleeding on probing (BOP), gingival (GI) and plaque indices (PI) and probing depths (PD).  The subjects who were participating in a Swiss TV documentary:

Four weeks later their periodontal health was re-assessed using the same measures.  In the absence of modern oral hygiene you might have expected that their gums would have suffered.  This is the case when similar studies are conducted without dietary changes.

In fact what was found was that only the level of plaque increased.  With this diet, rich in antioxidants and and anti-inflammatory components and with no refined sugar, there was no clinical evidence of increased gingival inflammation and PD and BOP decreased over time.   

The authors concluded:   Diet matters in the control or development of gingivitis in the absence of oral hygiene measures over a 4 week period. 

We’ll examine the relationship between nutrition and periodontal disease in future posts.  For the moment it is sufficient to say that evidence for nutrition as a risk factor is growing but not yet sufficiently robust.

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Age is not thought to be a risk factor for periodontitis.  That said, age is a difficult risk factor to test.  It is not possible to make patients younger and so we can’t do intervention studies!

Experts believe that as we get older, our lifetime exposure to risk factors increases, and this is why we see more periodontitis in older people.  86% of the UK population >65 have some periodontitis (Morris et al 2001) and 60% of the US population >60 do.  However, we know that our immune clearance of bacteria decreases as we get older (“immunoscenesence”) and blood nutrients also decrease with age.  As both are associated with an increased risk of periodontitis, maybe this will help clarify the link with ageing?

As we note on the front page of our website, the WHO’s target is to retain 20 teeth for life.  The chart to the left which is based on US data shows the potential for achieving this.  We see few patients at the age of 30 with severe periodontitis, but up to 60% may get it by the age of 60.  If we can identify those patients at risk (remember risk changes over time: this is not a one off assessment) and motivate them to work with their dentist / hygienist, then Axelsson has shown that periodontitis and the consequential tooth loss is preventable.

PreViser offers a simple, scientifically verified tool for assessing your patients’ risk of perio disease, converting both risk and disease into scores which also motivate your patient to work with you to improve their oral health.  If you would like to find out more, call us on 07725125291 or download our free one month trial at www.previser.co.uk.