After rather devastating negative conclusions made in a systematic review (SR) of the literature regarding the long claimed, possibly causal, relationship between periodontitis and atherosclerotic vascular disease by Lockhart et al. (2012), a highly alerted group of members of our specialty organizations, the Amercian Academy of Periodontology and the European Federation of Periodontology, had hastily organized a joint workshop, in the end of 2012, to fix unwelcome results of a number of large intervention studies by creating new systematic reviews on the Perio-Systemic link. The clear aim was to cement, once and forever, the claim of the number one clinical problem: periodontal disease and general health are closely related.
While the proceedings had been published, open access, in special issues of our main professional journals, the Journal of Clinical Periodontology and the Journal of Periodontology, workshop participants of the EFP presumptuously condensed the 209 pages of the 16, mostly valuable, papers in a nutshell, strangely called Manifesto.
It is remarkable that the prestigious Journal of Clinical Periodontology, founded by Hans Mühlemann and edited for decades by Jan Lindhe, is going to publish a commercial for a Quintessence Publishing and Sunstar production, part of a Quintpub series of DVDs (all called Cell-to-Cell Communication) of short (each runs for about 15 minutes) animated (“3D”) movies. The first installations in this series had been about inflammatory reactions in the periodontium (I had critically reported on its educational value here), periodontal regeneration and osseointegration.
Any dental student in Germany would certainly fail his/her final exam if carelessly talking about the role of “fluor” in preventive dentistry. An assumed power of environmentalist pressure groups is very much feared among cariologists who want to make sure that it is fluoride, not fluorine, which has its most important part in the prevention and early treatment of dental caries. One possible accident of a child ingesting several fluoride tablets would suffice to provide environmentalists with further arguments. Elemental fluorine is highly toxic, in contrast to fluoride which is not so toxic, and environmentalist propagandists have used the public’s lack of knowledge to differentiate for manipulating public opinion against water fluoridation and further application and wide distribution of fluorides which have certaily resulted in most of the observed post WWII caries decline in all industrialized countries. So, dental students are advised to be precise. Fluorides are used in preventive dentistry, not highly toxic fluorine (“fluor”). As table salt is not chlorine!
The frenzy about fluorides in cariology appears to be based on the concept that dental caries is a result of fluoride deficiency. While it is undisputed that modern oral hygiene includes daily toothbrushing with fluoridated toothpaste (1450 ppm), additional application of, for instance, fluoride mouthwash may be restricted, based on current evidence, to caries-active individuals, in particular between 6 and 18 years. Most recently, 0.5% to 1% chlorhexidine gel alone or in combination with fluoride or 0.12% chlorhexidine mouthwash alone or with fluoride for prevention of coronal caries was not recommended, based on expert opinion in the former and strong experimental evidence in the latter case. Continue reading