Valerie Clerehugh - Periodontal Management of Children, Adolescents and Young Adults

Quintessentials of Dental Practice 17
Periodontology 4

Quintessence Publishing Co. Ltd.

British Library Cataloguing in Publication Data

Clerehugh, Valerie
Periodontal management of children, adolescents and young adults.
(Quintessentials of dental practice. Periodontology; 4)
1. Pediatric periodontics
I. Title II. Tugnait, Aradhna III. Chapple, Iain L. (Iain Leslie) IV. Wilson, Nairn H. F.
617.6320083

ISBN 1850973105

Copyright 2004 Quintessence Publishing Co. Ltd., London

Age icons and Fig 10-4 by Laura Andrew.

All rights reserved. This book or any part thereof may not be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, or otherwise, without the written permission of the publisher.

ISBN 1-85097-310-5

This book is dedicated to Tony and Mary with my love.
Val Clerehugh

Many young people have periodontal problems which if overlooked or inappropriately managed may adversely influence the prognosis of the dentition. This latest addition to the Quintessentials of Dental Practice series provides a practical, well-illustrated guide to the aetiology, screening and diagnosis of periodontal diseases which may affect children, adolescents and young adults.

The values of teamwork, effective communication and knowing when to treat and when to refer to a specialist periodontist are rightfully stressed as important elements of the take-home message of this expertly crafted book. Owning and reading this Quintessentials book will be a pleasure, and then to go on to apply the enormous amount of evidence-based advice captured between the covers of this volume will, in all probability, transform the periodontal management of the children, adolescents and young adults you treat in your clinical practice.

As you would expect of a book in the Quintessentials of Dental Practice series, Periodontal Management of Children, Adolescents and Young Adults is an attractive publication written in a style aimed to appeal to busy practitioners and students. This book is an important volume in the series, and a valuable addition to dental literature in general. This is a book you will be very pleased to have read and to have available for ready reference.

Nairn Wilson
Editor-in-Chief

This is the fourth of five books in a series designed to provide the general dental practitioner with a contemporary, practical, illustrated guide for the management of patients with gingival and periodontal diseases. Our aim is to make the reader aware of the many and varied periodontal problems that can affect the young patient from childhood through to young adulthood and to provide a simple step-by-step approach to periodontal diagnosis and management in this group of patients. The need to look actively, and routinely, for periodontal disorders in these patients underpins our philosophy for their overall periodontal care. The role of the general dental practitioner in reaching an accurate diagnosis based on current disease classifications, in particular, is crucial to arranging appropriate treatment. Furthermore, the value of teamwork and good communication cannot be overemphasised, including an awareness of when to treat or when to refer to a specialist periodontist. The take-home message is that many young people really do have periodontal problems that can be easily missed unless appropriate screening is routinely undertaken to detect them and that the general dental practitioner has an important role in their management.

It is hoped that having read this book the reader will:

• Appreciate that a variety of periodontal problems can affect children, adolescents and young adults.

• Understand the key features of the periodontium in health and disease in the younger patient.

• Become familiar with the current classification of the periodontal diseases and be aware of how common or uncommon the various periodontal problems are in the younger patient.

• Appreciate that chronic periodontal destruction can begin in adolescence and that severe, aggressive forms of periodontal disease can affect children, adolescents and young adults.

• Understand the aetiology of the periodontal diseases and the interplay between the host defence systems and microbial plaque.

• Be aware of the nature of the local and systemic risk factors for periodontal diseases in the younger age groups.

• Be aware of the concept of periodontal risk at four levels: the patient, the mouth, the tooth and the specific site.

• Be knowledgeable about the rationale and methods of screening young patients quickly and simply for periodontal problems.

• Know how to reach a periodontal diagnosis in the younger age groups.

• Understand the principles of treatment planning and the three key stages of periodontal care.

• Appreciate the role of the dental team and the value of effective communication in periodontal patient management of children, adolescents and young adults.

• Appreciate the key stages in making a decision on whether to treat or refer a young patient for specialist periodontal care.

Valerie Clerehugh
Aradhna Tugnait
Iain LC Chapple

This book was written with the help and support of a number of people to whom we extend our grateful thanks: the Photography Department at Leeds Dental Institute for their photographic expertise; Multimedia Services at Birminghams Dental School; Dr Simon Wood and colleagues in Oral Biology for kind permission to use Fig 2-3, and the Journal of Dental Research for permission to reprint it.

We would like to thank Stephen Fayle for Fig 5-5; Jack Toumba for Fig 10-5; Lesley Bensley for Fig 8-6; and Mike, Katy and Chloe Ehrlich for Fig 8-5; George Warman Publications (UK) Ltd for kindly granting us permission to reprint Figs 1-15, 5-5, 5-10 5-12, 6-10, 6-29, 7-7, 7-8, 9-1 9-3; Don Glenwright for Figs 6-1, 6-2, 6-4, 6-7, 6-25, 6-26; and Mosby Year Book for Figs 6-7, 6-11 and 6-13. We would also like to thank Maggie Jackson who devised the interdental brushes and kindly supplied Fig 8-9 and Professor Andy Blinkhorn for the oral health promotion leaflets that he so graciously provided for Chapter 9.

Dr Val Clerehugh wishes to say a huge thank you to her husband Tony and daughter Mary for their love, support and forbearance during the preparation of this book, and always. She also wishes to thank her mum, dad and her family for their unconditional support and guidance.

Dr Aradhna Tugnait wishes to thank her husband Keith for his loving support and his encouragement in the writing of this text and Mum, Anuja and Carl for always being there.

Professor Iain Chapple wishes to thank his wife Liz for her patience and unconditional support and little Jessica for giving up her valuable play time during the preparation of this fourth book.