Biography
Biography: Raison Thomas
Abstract
The approach to the diagnosis and treatment of periodontal disease is changing. The disease has not changed, but dentistry's understanding of the pathogenesis and appreciation for the influence of host factors has improved. Initially, the link between systemic disease and periodontal diseases was thought to be unidirectional. Currently, there is increasing evidence that the relationship between these entities may be bidirectional. Various hypothesis, including common susceptibility, systemic inflammation, direct bacterial infection and cross-reactivity, or molecular mimicry, between bacterial antigens and self-antigens, have been postulated to explain these relationships. In this scenario, the association of periodontal disease with systemic diseases has set the stage for introducing the concept of periodontal medicine. Increasing evidence is available from many investigators to indicate periodontitis as a risk factor for cardiovascular diseases, diabetes mellitus, low birth weight infants, pulmonary diseases, rheumatoid arthritis and recently, osteoporosis, pancreatic cancer, metabolic syndrome, renal diseases and neurodegenerative diseases such as Alzheimer's disease. This has brought a shift in the perspective, with research being now focused on the potential impact of periodontal diseases on systemic health. General practitioners are at a more advantageous position to provide early patient counselling for preventing and improving prognosis of several systemic pathologic conditions. By identifying people who are at greater risk of developing severe adult periodontitis, we may be able to carry out earlier or more aggressive intervention for these patients. Close collaboration between physicians and dentists will help to treat patients with systemic diseases better. Strategies to deal with etiologically relevant systemic factors will provide predictable treatment regimens to save patient’s dentition.