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21Dental Tribune United Kingdom Edition | 1/2015 The UK is gearing up to host the largest conference in Periodontology and Implant Dentistry ever held with EuroPerio8 taking placeon3 -6JuneatLondonExCel. Over100 speakers will contribute to the main scien- tific programme and there are many addi- tional sponsor sessions. Over 1,500 ab- stracts have been accepted. Already over 7,000 periodontists, implantologists, gen- eral dentists and dental hygienists from 96 differentcountrieshaveconfirmedtheirat- tendance. We expect to have nearly 10,000 people at the conference in total, a new record for a conference in this field, and it is till not too late to register. Giventhehugepopularityofthisevent,it is perhaps a perfect time to reflect on the state of periodontology in the UK. It is clear that periodontal disease is not going to go awayanytimesoon.Althoughthereisalack of detailed epidemiology of the disease in the UK, the Adult Dental Health Survey pro- vides a useful indicator of trends in the epi- demiologyofthedisease,evenifitprobably seriously underestimates true prevalence rates, owing to the limited methodology used in this survey. The good news is that there has been sig- nificantreductionsinthenumberofpeople with visible plaque and calculus present, (but this is still reported as 45 % of the pop- ulation) and concomitant reductions in the amount of mild periodontal disease, con- sisting of gingivitis and those with low lev- els of attachment loss. However, perhaps unexpectedly, this has not been associated with similar reductions in moderate and se- vere periodontitis. In fact, the number of adults with severe periodontitis (pocketing of 6mm+) has increased from 6 % in 1998 to 9 % in 2009. The reasons for this may be complex but are likely to include the fact that we have an increasingly aging popula- tion, and that dentists are (rightly) taking out fewer teeth even when judged to have poor long term prognoses. This disconnection between trends in plaque control to more severe destructive periodontitis is a common finding in a number of recent epidemiological surveys in different populations and underlines the complexityofaetiologicalfactorswhichde- termine susceptibility to destructive peri- odontitis. Although plaque tends to corre- latedirectlywithgingivaldisease,inthema- jority of people this may not necessarily re- sult in the progression to more severe periodontitis. The major risk factors which are implicated in this process including smoking, genetic factors, and medical fac- tors, particularly diabetes and medications such as calcium channel blocker antihyper- tensive drugs. Theimpactofthewelldocumentedrisein the numbers of older people may be partic- ularly important for future treatment needs.Theover65-yearoldsareoftenfitand well and have high expectations for their continued health needs, even though they mayalsosufferfromcommonmedicalcon- ditions such as type 2 diabetes and hyper- tension and may take multiple medica- tions. Impact of periodontal disease Periodontal disease has typically been seen as a “silent disease” which might have few consequences unless resulting in tooth loss. However, there is now lots of evidence to refute this concept. Patients with peri- odontitis consistently report significant impacts of the condition on their quality of life, particularly impacting on function, aesthetics, comfort and self esteem. Fur- thermore, even mild disease resulting in gingival bleeding and perhaps halitosis im- pact on social acceptability and remain highly legitimate reasons for treatment need. Prevention of more severe disease is of course best achieved by primary preven- tion and early disease control by achieve- ment of high levels of plaque control to- getherwithmanagementofmodifiablerisk factors, particularly smoking cessation. Periodontal disease has now been associ- atedwithriskofanumberofothersystemic conditions, most notably cardiovascular and cerebrovascular disease, among many other conditions. It has been clearly shown that periodontal disease causes a measura- ble systemic inflammatory response but it is not at all clear that periodontal treatment actually reduces the risk of these condi- tions, or whether the conditions are associ- ated through common factors such as ge- netic predisposition. Nevertheless, given the importance of these systemic condi- tions it is recommended that periodontal health should be regarded as part of general health. Manpower Clearly there remains a major, often un- met,periodontaltreatmentneedwithinthe UK population, which represent a signifi- cant challenge for dental health profession- als. There are currently over 30,000 regis- tered dentists and over 6,000 dental hy- gienists in the country. In addition, there areapproximately300periodontistsonthe specialist list, who work mainly in private specialist practices or in the hospital and university services. Given that there are an estimated five million cases of moderate to severe periodontitis, and perhaps 20 to 30 million with some signs of periodontal dis- ease,itwouldappearthattheserelativepro- portions of dental manpower are not cur- rentlyideallysuitedfortheprovisionofpri- mary and secondary periodontal care ac- cordingtoactualclinicalneeds. Thereareof course a significant but unknown number of general dentists who provide a degree of periodontal treatments that might other- wise considered to be at secondary care level. The number of specialist periodontists in training is small (certainly less than 20 every year), which is probably insufficient tomaintainthetotalnumberonthespecial- ist list over time. There is considerable in- terest and some commitment to providing a group of dentists with additional skills in specific restorative specialties including periodontology, who could potentially A mixed national picture The current state of periodontology in the UK and why there needs a lot to be done By Prof.Francis Hughes,London TRENDS & APPLICATIONS © Lighthunter / shutterstock.com Access to specialist treatment services within the NHS remain very patchy. ADI Team Congress 2015 Implant Dentistry Moving Forward: Experience – Evidence – Excellence 14 – 16 May 2015 SECC Glasgow The key dental implant industry event in 2015 For all members of the dental team Earn up to 20 hours verifiable CPD BOOK ONLINE: www.adi.org.uk/congress2015 AD DTUK0115_21-22_Hughes 09.04.15 15:36 Seite 21 DTUK0115_21-22_Hughes 09.04.1515:36 Seite 21