A group of oral health professionals met with a team from Johnson & Johnson in Dublin last year to advise on the topic of ‘Improving the periodontal health of the Irish population – prevention and treatment’. The Journal reports and obtained Professor Finbarr Allen’s comments on the meeting.

Professor Finbarr Allen

Professor Finbarr Allen, former Professor of Prosthodontics
and Oral Rehabilitation at University College Cork

At the meeting, held in Dublin, the following oral health professionals were in attendance: Professor Finbarr Allen, former Professor of Prosthodontics and Oral Rehabilitation at University College Cork; Professor Noel Claffey, Professor of Periodontology at Dublin Dental School and Hospital; Professor Anthony Roberts, Professor of Restorative Dentistry (Periodontology) at Cork University Dental School and Hospital; Dr Rory Maguire, Principal of Clarendon Periodontics and Implant Dentistry in Dublin; Dr Mark Condon, Principal of the Leeson Dental Clinic in Dublin, specialising in restorative (prosthodontics) and implant dentistry; and Louise Fleming RDH, President of the Irish Dental Hygienists Association.

Agreed statement
All present agreed on the following periodontal health consensus statement:

  • effective plaque and calculus removal is key to oral health;
  • dental healthcare professionals have a responsibility to educate patients on their disease status and to direct patients appropriately;
  • patients should receive tailored oral hygiene instruction and demonstration;
  • patients have a responsibility to act upon the advice given by dental healthcare professionals;
  • for effective management, optimal patient home care and professional debridement are both essential;
  • long-term periodontal maintenance with continuity of care is critical for successful treatment; and,
  • clinically proven mouthwashes, gels and pastes should be considered for recommendation to those individuals who are not achieving optimal levels of plaque control in their home care routine.

Johnson & Johnson has stated that it will use this consensus statement as it continues to work in partnership with dental professionals.

Practical ideas
Professor Finbarr Allen spoke to the Journal about his role in the event. “I think that innovation in healthcare is important and best achieved when clinical academic experts and industrial partners work together to develop ideas that might ultimately be implemented in clinical practice. Johnson & Johnson has been active in developing products for preventing disease, and this fits with my own interest in a preventive approach to healthcare.

“If implemented effectively, we should see a marked reduction in disease, improved tooth retention, less replacement of tooth restorations, fewer dentures and a better oral health-related quality of life.”

Oral disease is highly prevalent, and the treatment costs are spiralling. We have to change the way we look at oral healthcare, and we cannot continue with the old surgical model of disease management that we have been using for decades. We need to find a way to deliver quality preventive care and remunerate providers appropriately. Patients have a major role in this, and we have to promote our message in a more effective way than we are currently doing. If we can achieve this goal, then I believe our healthcare will be more effective and costs of oral healthcare can be contained.

Spreading the message
“Most, if not all, oral healthcare professionals understand that caries and periodontal diseases are preventable. However, our understanding of the recovery powers of teeth and periodontal tissues is continually evolving. Oral healthcare professionals need to keep up to date with advances in the field, and the consensus statement can guide them on what we know about gingival and periodontal diseases and their response to treatment at the present time. I think the statement can also be used to advocate for appropriate funding mechanisms for prevention-focused healthcare.
Patient motivation can be a problem, and regular dental attendance is not the norm. We do need to use other means of getting oral healthcare messages across rather than solely relying on patients visiting a dentist. We should look to other means of promoting the message, e.g., general medical practice and pharmacies.

It works – it can reduce disease
I think dentists need to be convinced home care works, and shown the evidence that it does. However, they need to be remunerated appropriately for this approach. Patients will also need to be educated that paying for such advice is in their interests, and this will require effective communication. Their expectation that they should only be paying dentists for surgical intervention (e.g., drilling a cavity) needs to be moderated, and this can be achieved via effective communication about the role of prevention in disease management.
If the statement was embraced by our profession, I would hope to see a reduction in disease and greater levels of tooth retention in the Irish population over time. It will require us to develop a new approach to undergraduate dental student training and continuing education courses to promote the concept of prevention-focused oral healthcare. This will keep me busy!
If implemented effectively, we should see a marked reduction in disease, improved tooth retention, less replacement of tooth restorations, fewer dentures and a better oral health-related quality of life.”