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prevention International magazine for oral health No. 1, 2017

opinion | understanding prevention Maurizio Tonetti: “Prevention makes excellent economic sense for the dentist” Lack of compliance from patients cannot remain an excuse for giving up, says Prof. Tonetti, editor of the Journal of Clinical Periodontology and co- author of a Perio Focus green paper on periodontal diseases. It is up to the dentist to adequately motivate his patient. If the dentist and patient have shared goals, then the failure to achieve them is shared too. AUTHOR: DENTAL TRIBUNE INTERNATIONAL / PROF. MAURIZIO TONETTI Prof. Maurizio Tonetti In your Perio Focus green paper, “Im- pact of the global burden of periodontal diseases on health, nutrition and well- being of mankind: A call for global ac- tion”, you call for prevention, diagnosis and treatment. Why do you recommend this threefold approach to periodontal diseases? More than 750 million people suffer from severe forms of periodontitis, while another 3 billion have a milder form of it. With such a widespread prevalence of this disease, we need a multi-pronged approach to treat it, which includes: a) Prevention, to ensure that fewer people develop the disease. We sug- gest that we need to work on the com- mon risk factor approach for the pre- vention of chronic non-communicable diseases, as suggested by the World Health Organization (WHO), with one critical addition: we must include oral hygiene as one of the virtuous behav- iours (along with not smoking, eating well, controlling weight and exercise). Prevention requires the implementa- tion of appropriate oral hygiene prac- tices and the effective management of gingivitis, which dental professionals need to play a critical role in providing. In addition, more needs to be done by governments in this regard. b) Diagnosis, since we think that early detection and early management will lessen the economic burden of treat- ing periodontal disease. We suggest an alliance with the patient to aid early detection with self-assessment, fol- lowed by professional screening and a full periodontal diagnosis. In addition, it is critical that dental professionals communicate the message that gingi- val bleeding is not normal and requires attention. c) Treatment, which for dentists is the obvious step. The problem is that we know how to treat this disease and we have all been trained in dental or hygiene school on how to do it, but for- midable barriers are making access to the best evidence-based treatment dif- ficult—and I am not only talking about money! A complex mix of misunder- standings, incorrect health messages derived from the advertisement of oral 12 issue #1

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