Practical periodontics. Awareness of periodontal disease--the patient.

This paper looks at awareness by the public and our patients' knowledge of the health of their gums and the tooth supporting tissues, what it means to them, how they interpret this information and whether they seek care as a result of such knowledge. The way a dentist and a patient interact with and without such knowledge is considered. It is contended that knowledge of the periodontal disease processes and of how to treat, manage, control, and even prevent must be accompanied by an awareness by the patient, the profession and industry. This recognises that the dentist and patient are in a partnership, especially in management of periodontal diseases.

Periodontal health: CPITN as a promotional strategy.

Community and individual involvement are essential needs in preventive programmes for periodontal health. Campaigns should be directed towards a better individual understanding of the importance of healthy gum tissues if a functional healthy dentition is to be retained over a lifetime. Effective awareness campaigns require not only participation and education of the general public, but also all levels of health care professionals. Awareness programmes need to be carefully planned and their messages clear, non-conflicting and regularly reinforced. The complete programme should be based on, and include, specific aims, goals, strategies, monitoring and evaluation. Oral health and hygiene promotion campaigns need careful coordination between the relevant agencies or institutions involved in their implementation, such as government agencies, professional associations, industry, aid groups and education organisations.

Periodontal awareness: the key to periodontal health.

The maintenance of periodontal health requires an informed public and patient. Treatments will fail, and in fact will not ever start, if individuals are not aware of the differences between periodontal health and disease, the significance of these differences and the part they can play in prevention and control. Self awareness begins the process, with self care and professional assistance following. A periodontal awareness programme was started in New Zealand in 1986 aimed at improving periodontal health, through increasing the knowledge of both the public and the profession. It is on such a knowledge base that self care and assisted care programmes can be developed. This paper presents the New Zealand programme, the public and professional messages and the way these were linked. Patient self assessment and self care are emphasised. The new basic periodontal examination for the dentist and auxiliary staff begins a stepped and structured programme of assisted care. An examination of this awareness programme is presented together with future directions. Chronic inflammatory periodontal diseases are universal but the profession knows it is possible to prevent, manage and control almost all of these diseases. Awareness of the need for the right actions by patients and dental professionals is seen as the key to improving periodontal health.

A simplified periodontal screening examination: the Community Periodontal Index of Treatment Needs (WHO) in general practice.

Chronic periodontal disease presents a unique challenge to the dental profession, not only in its recognition, diagnosis and treatment, but also in public and patient education. Epidemiologic surveys may place the prevalence of the chronic gum diseases at the highest levels but the public has accepted the most obvious sign, bleeding, as 'normal' and only in the later stages of the disease is treatment demanded. Thus dental practitioners must be the first to recognize periodontal disease and then must persuade the patient to take personal action and to seek professional assistance. In the past decade there have been many changes in periodontal concepts. A more conservative basis to treatment and to general management is now well accepted, with disease control rather than cure as the major objective, and regular maintenance a necessity. Disease activity is the primary criterion by which both dentist and patient should recognize and monitor periodontal treatment needs. The use of current concepts to introduce a simple specific and realistic screening and monitoring examination is introduced. It utilizes the Community Periodontal Index of Treatment Needs (CPITN) developed by the Oral Health Unit of WHO in 1981. This index, designed for population surveys, has been adapted for use in general practice. Examples drawn from a 1-year trial are presented and it will be seen that the Index provides meaningful information to both dentist and patient, an immediate indication of treatment needs and a method of monitoring progress.