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Loesche WJ, Grossman NS. Periodontal disease as a specific, albeit chronic, infection: diagnosis and treatment. Clin Microbiol Rev. 2001;14(4):727-52, table of contentsdoi: 10.1128/CMR.14.4.727-752.2001.
Loesche, W. J., & Grossman, N. S. (2001). Periodontal disease as a specific, albeit chronic, infection: diagnosis and treatment. Clinical microbiology reviews, 14(4), 727-52, table of contents. https://doi.org/10.1128/CMR.14.4.727-752.2001
Loesche, W J, and Grossman, N S. "Periodontal disease as a specific, albeit chronic, infection: diagnosis and treatment." Clinical microbiology reviews vol. 14,4 (2001): 727-52, table of contents. doi: https://doi.org/10.1128/CMR.14.4.727-752.2001
Loesche WJ, Grossman NS. Periodontal disease as a specific, albeit chronic, infection: diagnosis and treatment. Clin Microbiol Rev. 2001 Oct;14(4):727-52, table of contents. doi: 10.1128/CMR.14.4.727-752.2001. PMID: 11585783; PMCID: PMC89001.
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Clin Microbiol Rev. 2001 Oct;14(4):727-52, table of contents. doi: 10.1128/CMR.14.4.727-752.2001.

Periodontal disease as a specific, albeit chronic, infection: diagnosis and treatment.

Clinical microbiology reviews

W J Loesche, N S Grossman

Affiliations

  1. Department of Microbiology and Immunology, School of Medicine, University of Michigan, Ann Arbor, Michigan 48109, USA. [email protected]

PMID: 11585783 PMCID: PMC89001 DOI: 10.1128/CMR.14.4.727-752.2001

Abstract

Periodontal disease is perhaps the most common chronic infection in adults. Evidence has been accumulating for the past 30 years which indicates that almost all forms of periodontal disease are chronic but specific bacterial infections due to the overgrowth in the dental plaque of a finite number of mostly anaerobic species such as Porphyromonas gingivalis, Bacteroides forsythus, and Treponema denticola. The success of traditional debridement procedures and/or antimicrobial agents in improving periodontal health can be associated with the reduction in levels of these anaerobes in the dental plaque. These findings suggest that patients and clinicians have a choice in the treatment of this overgrowth, either a debridement and surgery approach or a debridement and antimicrobial treatment approach. However, the antimicrobial approach, while supported by a wealth of scientific evidence, goes contrary to centuries of dental teaching that states that periodontal disease results from a "dirty mouth." If periodontal disease is demonstrated to be a risk factor for cardiovascular disease and stroke, it will be a modifiable risk factor since periodontal disease can be prevented and treated. Since the antimicrobial approach may be as effective as a surgical approach in the restoration and maintenance of a periodontally healthy dentition, this would give a cardiac or stroke patient and his or her physician a choice in the implementation of treatment seeking to improve the patient's periodontal condition so as to reduce and/or delay future cardiovascular events.

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