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Don Jayawardena : Specialty Registrar in Restorative Dentistry,
Royal London Dental Hospital

Association between periodontal diseases and cardiovascular diseases, diabetes and respiratory diseases

This paper is a consensus report, through a collaborative workshop between both medical and dental specialties, on the associations between periodontal disease and systemic conditions. The workshop considered the role of oral healthcare professionals (OHPs) and family doctors in reducing the disease burden on patients.

The following conditions were deemed to be independently linked to periodontal disease:
cardiovascular disease and periodontitis 
diabetes and periodontitis
chronic obstructive pulmonary disease
and periodontitis
obstructive sleep apnoea and periodontitis
COVID-19-associated complications and periodontitis

The mechanisms linking these diseases are predominantly linked to periodontal bacteria being able to enter the bloodstream. There is evidence of common inflammatory pathways and the presence of periodontal bacteria within these organs/tissues.

The paper recommends that OHPs should advise periodontitis patients of the increased risk for the above diseases, although the primary prevention of these diseases is not currently associated with periodontal treatment.

Herrera D, Sanz M, Shapira L, et al. J Clin Periodontol 2023; 50(6): 819–841

The UK public and healthcare professionals’ awareness of mouth cancer

This review paper considered the need to improve both public and professional awareness of oral cancer. The authors suggested early detection of oral cancer improves prognosis and quality of life, noting poor awareness among the general public of the risks factors of oral cancer.

The paper advocates educational campaigns to raise awareness, with recommendations of local media displayed in public spaces. The authors considered the use of mass media as well as social media through celebrity engagement as potential avenues for awareness campaigns.

These suggestions were based on previously effective campaigns for other health conditions, including smoking cessation.

Any campaign must target all groups who are disproportionately affected by oral cancer, including low socioeconomic groups, diverse ethnicities and different education/literacy levels.

Healthcare professionals have variable exposure levels to mouth cancer in their training. Potential healthcare groups who could undertake relevant professional development could be pharmacists, nurses, doctors and medical practitioners.

Barrett D, Dubal RL, Morgan C.

Br Dent J 2023; 235: 811–815

Survival of immediate implants replacing traumatised teeth in the anterior maxilla

This retrospective observational study considered the success rates for immediate implants placed in trauma patients in a single UK-based centre.

The study was performed by one operator placing 70 bone-level implants in the anterior maxilla. The study utilised a protocol of immediate implant placement with a conventional loading (Type 1C).

The implant success rate was 95.7%, with the reporting of three failures, which occurred within the first 12 months of follow-up. These success rates are in line with existing literature, including the International Team for Implantology consensus statement. The three failures were reported due to mobility (n=2) and the presence of a buccal fistula (n=1). The study reported four minor prosthetic complications within three years and four implants with probing depths of over 3.5mm, although no patient had peri-implant disease.

The authors conclude that, within the limitations of the study, immediate implant placement is a viable option in trauma patients.

Hirani M, Moshtofar Z, Devine M, Paolinelis G, Djemal S. Survival of immediate implants replacing traumatised teeth in the anterior maxilla. Br Dent J 2023; 234(10): 745

Guidelines for preventing and managing denture loss in hospitals and community residential settings

Denture loss has a detrimental effect on patients’ ability to function. These guidelines recommend protocols to minimise denture loss within care homes and hospital settings.

Oral care assessments are recommended for all patients on admission to care homes and hospitals, with the presence of dentures recorded on the patient’s property list.

Education of healthcare and social care professionals should include how to identify and clean dentures. The guidelines recommending denture storage pots or a personal belongings box that could hold commonly misplaced items, including glasses, hearing aids and dentures.

Denture labelling (with patient consent) is recommended to allow return of misplaced dentures. This can be done by the dentist for vulnerable patients at the point of denture construction or retrospectively with a denture-marking kit in care homes.

The guidelines note the importance of having a clear reporting/replacement pathway, which may support patients when dentures have been lost.

OCDO/NHS England 2023. Available at www.england.nhs.uk/primary-care/dentistry/management-and-prevention-of-denture-loss