Friday, 3 October 2014

#Tubuleslive event: The Well Elderly, a Major Challenge for the Periodontist with Professor Francis Hughes



Here's my summary of the latest #Tubuleslive Event, The Well Elderly, a Major Challenge for the Periodontist, which took place yesterday evening.

Yesterday's talk was hosted by Professor Francis Hughes, an world-leader in the field of periodontology.
His talk proved very popular with a full house attending the live audience!

Here are my main points from the evening:


  • 1 in 6 people will now live to their 100th birthday (The Guardian). People are keeping their teeth for longer and expectations among these more senior members of our society are increasing. This raises challenges for periodontists as well as dentists in general.
  • Although the incidence of severe periodontitis increases with age, age isn't necessarily a sole cause of periodontal disease
  • Incidence of plaque and mild periodontitis has decreased over the past 30 years, whilst the incidence of severe periodontitis has doubled to 9% of the population
  • This shows that plaque isn't the sole cause of severe periodontitis and other factors such as smoking, diabetes and possibly cardiovascular disease can contribute to periodontal disease. 
  • There is new research to support the idea that improving a patient's periodontal status can improve their diabetic control and certainly controlling their diabetes impacts positively on their periodontal health. 
  • In the future it could be considered for GDPs to screen for diabetes if they come across patients with severe periodontitis. 
  • Calcium channel blockers such as amlodipine or nifidipine can aggravate periodontal disease and cause gingival inflammation
  • 2 million people are taking these types of drugs in the UK to control their hypertension
  • GDPs should consider liasing with a patient's GMP to discuss switching anti-hypertensives if appropriate
  • A patient may not respond to different anti-hypertensives such as ACE inhibitors, or they may be taking combinations of the different classes of anti-hypertensives. In these cases it may not be possible to change their medication. 
  • Other drugs such as new cancer drugs, as well as polypharmacy, which is common in the elderly, can also negatively affect the periodontium. 
  • It has recently been suggested that statins help reduce inflammation and may therefore decrease the risk of periodontal disease.
  • Other health conditions such as neutrophil disorders can lead to periodontal disease as chronic inflammation can lead to bone loss. 


In summary, although this group of the population has a greater incidence of periodontal disease, they should not be separated out as a special group for treatment as they often respond well to conventional periodontal treatment.
Dentists however, should be aware that some factors such as diabetes and cardiovascular disease are more prevalent in the elderly and therefore may be one of the underlying causes of periodontal disease in this group.

The next #Tubuleslive Event will be on the 16th of October with Dr Neel Patel and Dr Vinit Gohil: Implants. Where do I start?


To see my other posts about previous #TubulesLive events see here

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