Should our focus on inflammation change the way we practice?
Some scientists say, "Forget about bacteria; treat, or even better yet, prevent inflammation." We understand that periodontal diseases originate as bacterial assaults, but some two-thirds of the destruction comes from the inflammatory response to the bacterial invasion. There is growing evidence that inflammation can be transferred from the oral cavity to other parts of the body (and vice versa), explaining the possible association between periodontitis and other chronic inflammatory conditions. As a clinician, I find this intellectually interesting, but when I ask myself whether or not this shift from an infection model to an inflammation model changes the way I treat my patients, the answer is, "not really." But should it? Have I been so busy in my daily practice that I missed something important? Although I may not understand inflammation on the molecular level, I do know when my patients have inflammation, and when I do what I have been trained to do as a diagnostician and a clinician to eliminate it, most of my patients end up with a good clinical outcome. My job as a clinician is to translate what is going on in research and incorporate it into my practice to provide the best possible patient care. What I offer you in this commentary are the results of my journey to discover how or if our new emphasis on inflammation should affect how I care for my patients. My conclusion at this time is that I should err on the side of aggressive control of periodontal inflammation, since, until proven otherwise, the consequences of undertreatment could be more than the loss of a few teeth. It is your job to decide how this information influences the treatment of your patients.
McGuire
Michael K
MK
D002908:Chronic Disease; D006801:Humans; D007249:Inflammation / Q000150:complications* / Q000628:therapy; D010347:Patient Care Planning; D010510:Periodontal Diseases / Q000150:complications / Q000276:immunology* / Q000628:therapy; D019239:Practice Patterns, Dentists'; D018570:Risk Assessment