Perio health

Curved interdental brush facilitate interdental plaque removal.

In late October I attended a Proctor & Gamble lecture on periodontology held at the Hilton Metropole near the NEC in Birmingham. The hotel was a good venue for the evening, the hosts were hospitable and the food was hearty. There was a very good turn out; a mixture of dentists, hygienists, nurses and receptionists.The first lecturer to present was Prof Peter Heasman from Newcastle University. He covered the topic of gingival recession with a very apt title in view of the current economic climate Emerging from recession without the need for ‘cuts’. Prof Heasman discussed the aetiological factors that may cause gingival recession and he emphasized that it is no single cause but a multifactorial one.He explained that there are relatively few cohort studies and almost no longitudinal studies to show natural historical data linking toothbrushing as a single causative factor with gingival recession. There has also been a suggestion that gingival recession tends to be associated with a high standard of plaque control as well as a low standard of plaque control. The high standard groups tended to have buccal lesions and, unsurprisingly, the low standard groups with chronic inflammatory diseases tend to have lingual lesions. He said there is very little concrete evidence to associate toothbrushing with recession as there are many variables involved, such as how often people brushed their teeth, brushing duration, bristle size, bristle hardness and type of toothpaste used.One important aetiological factor that was touched on was patient induced trauma either due to habits or an underlying psychiatric condition. He demonstrated this with a very interesting case he treated over a period of years, where the patient was suffering from Munchausen Syndrome.  Prof Heasman concluded that when treating gingival recession defects it is essential to identify the aetiology and to control this before intervening surgically if need be. He also emphasized the importance of reassuring the patient that the tooth will not be lost as long there is a high standard of oral hygiene.