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Periodontal treatment in patients with learning disabilities part 2: professional mechanical intervention Shazia Kaka Chris Dickinson Dental Update 2024 44:3, 707-709.
Authors
ShaziaKaka
BDS, MJDF, RCSEng, MSc M Spec Care Dent, BDS MJDF RCS (Ed), MSc, MSCD RCS(Ed), FHEA
Specialty Registrar (STR) in Sedation and Special Care Dentistry, Oxfordshire Healthcare Foundation Trust, UK (shazia.kaka@kcl.ac.uk)
The first part of this two part series discussed the potential barriers and risk factors that may lead to an increased incidence and severity of periodontal disease amongst patients with learning disabilities. Additionally, preventive strategies and tools that can be used by general dental practitioners, oral health promotion teams as well as specialists within the field to control and prevent disease progression were explored. To prevent periodontal disease progression and attain optimal periodontal health, a combination of prevention and professional mechanical instrumentation is usually required. The second part of the series concentrates on the role of the dental professional in implementing professional mechanical instrumentation to attempt to reduce the burden of disease further in this patient group.
CPD/Clinical Relevance: Although research continues into which professional techniques for instrumentation are the most successful amongst patients with periodontal disease, very little data specifically explore the needs of patients with learning disabilities, despite their high unmet needs. This paper aims to report on any available data present to produce suggestions for care.
Article
In the European Workshop of Periodontology 2008, Sanz et al quoted ‘the performance of oral hygiene practices is an inseparable principle that must be observed with any protocol of mechanical debridement.’ 1 This concept cannot be disputed. Page and Rams reported significant improvements in BOP, PPD and periodontal pathogens in chronic periodontitis patients with the sole use of improved oral hygiene.2 Although this study sample was small (11 patients), the changes observed were statistically very significant. Lindhe et al, with much larger study samples, demonstrated suboptimal oral hygiene to result in continued attachment loss whatever professional treatment was provided,3,4 whils a recent systematic review suggested that routine scaling and polishing without oral hygiene instruction (OHI) may provide no benefit at all.5
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