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73-645: The ADA publishes a monthly journal of dental related articles named the Journal of the American Dental Association . As part of its lobbying efforts, the ADA has sought to restrict non-dentists (such as dental hygienists and dental therapists ) from providing basic dental care. The organization has played an important role in blocking the inclusion of dental coverage in Medicare . The ADA has expressed opposition to

146-523: A Department of the Division of Science. PRC scientists conduct basic and applied studies in clinical research, dental chemistry, polymer chemistry and cariology, and are used by of the ADA. Historically, the ADA has discriminated against minority dentists and sough to exclude them from its affiliates. This discrimination in part prompted the creation of the National Dental Association . In 2010,

219-438: A category for other conditions that may have an effect upon the health of the periodontium. The 2018 Disease Classification of Periodontal Disease and Conditions divides this category into four subcategories: The most effective prevention method is what can be achieved by the patient at home, for example, using the correct tooth brushing technique, interdental cleaning aids such as interdental brushes or floss and using

292-760: A clear goal. The non-surgical phase is the initial phase in the sequence of procedures required for periodontal treatment. This phase aims to reduce and eliminate any gingival inflammation by removing dental plaque and calculus, restoration from tooth decay and correction of defective restoration, as these all contribute to gingival inflammation, also known as gingivitis . Phase I consists of treatment of emergencies, antimicrobial therapy, diet control, patient education and motivation, correction of iatrogenic factors, deep caries , hopeless teeth, preliminary scaling, temporary splinting, occlusal adjustment, minor orthodontic tooth movement and debridement . During this phase, patients are seen 3–6 weeks after initial therapy; it

365-405: A disease. Risk factors can be genetic, environmental, behavioural, psychological, and demographic in nature. There are many risk factors that contribute to placing an individual at higher risk for developing gingival and periodontal diseases. However, the only aetiological factor for periodontal disease is bacterial plaque, or biofilm. Identification of one's risk factors plays an important role in

438-400: A few appointments, depending on time and clinician skills, for effective removal of supragingival and subgingival calculus, when periodontal pockets are involved. It can assist in periodontal healing and reduce periodontal pocketing by changing the subgingival ecological environment. Prevention of periodontal disease and maintenance of the periodontal tissues following initial treatment requires

511-512: A fluoridated toothpaste . It is also advised that patients receive bi-annual check ups from their dental health provider along with thorough cleaning. Along with specialist periodontist treatment, a general dentist or dental hygienist can perform routine scale and cleans using either hand instruments or an ultrasonic scaler (or a combination of both). The practitioner can also prescribe specialized plaque-removal techniques (tooth brushing, interdental cleaning). The practitioner can also perform

584-631: A minimum of three years in length and usually culminate with a master (MSc or MDent) degree. Graduates are then eligible to sit for the fellowship exams with the Royal College of Dentists of Canada . Dentistry is a regulated profession. To become a licensed dentist in Canada one must have a BDS, DDS, or DMD degree and be certified by the National Dental Examining Board of Canada . The American Dental Association (ADA)-accredited programs are

657-544: A minimum of three years in length. According to the American Academy of Periodontology, U.S.-trained periodontists are specialists in the prevention, diagnosis and treatment of periodontal diseases and oral inflammation, and in the placement and maintenance of dental implants. Many periodontists also diagnose and treat oral pathology. Historically, periodontics served as the basis for the speciality of oral medicine . Following successful completion of post-graduate training

730-498: A plaque index to indicate to the patient areas of plaque they are not removing on their own. This can be removed through the procedure of a dental prophylaxis. The primary aetiological factor for periodontal disease is plaque biofilm of dental biofilm. A dental biofilm is a community of microorganisms attached to a hard, non-shedding surface. In the oral cavity, hard non-shedding surfaces include teeth, dental restorative materials and fixed or removable dental appliance such dentures. It

803-563: A recategorization of various forms of periodontitis, and the inaugural classification for peri-implant diseases and conditions. The 2018 Disease Classification for periodontal health, gingivitis, and gingival diseases and conditions are outlined in detail below: The 2018 Disease Classification of Periodontal Diseases and Conditions breaks down the category of periodontitis into three forms and each of these forms are further broken down into two or more subcategories. The 2018 Disease Classification of Periodontal Disease and Conditions contains

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876-457: A system of classification is necessary to enable dental professionals to give a label to a patient's condition and make a periodontal diagnosis. A diagnosis is reached by firstly undertaking thorough examination of the patient's medical, dental and social histories, to note any predisposing risk factors (see above) or underlying systemic conditions. Then, this is combined with findings from a thorough intra and extra oral examination. Indices such as

949-461: A wide range of treatments including root scaling and planing, periodontal surgery , implant surgery and other complex periodontal procedures. List of procedures performed by a periodontist: Before applying to any postgraduate training program in periodontology, one must first complete a dental degree . Canadian programs are accredited by the Commission on Dental Accreditation of Canada and are

1022-428: Is a form of periodontal disease; however, it is the least devastating, in that it does not involve irreversible damage or changes to the periodontium (gingiva, periodontal ligament, cementum or alveolar bone). It is commonly detected by patients when gingival bleeding occurs spontaneously during brushing or eating. It is also characterized by generalized inflammation, swelling, and redness of the mucosal tissues. Gingivitis

1095-538: Is a member of the dental team who is dual-qualified as a dental hygienist and dental therapist . They work closely with dentists and a number of dental specialists including periodontists. It is common for the oral health therapist to be involved in the treatment of gingival and periodontal diseases for patients. Their scope of practice in this area includes oral health assessment, diagnosis, treatment and maintenance and referral where necessary. They also have expertise in providing oral health education and promotion to support

1168-403: Is a specialist dentist who treats patients for periodontal-related diseases and conditions. They are involved in the prevention, diagnosis and treatment of periodontal disease. Periodontists receive further specialist training in periodontics after completing a dental degree. Periodontists provide treatments for patients with severe gingival diseases or complex medical histories. Periodontists offer

1241-419: Is a valley-like or concave depression that lies directly beneath the contact point, between the facial and lingual papilla. However, the col may be absent if there is gingival recession or if the teeth are not contacting. The main purpose of the interdental gingiva is to prevent food impaction during routine mastication. This area of tissue is non-keratinized and is located beyond the mucogingival junction. It

1314-447: Is an antiseptic such as chlorhexidine mouth-rinse or antibiotics. Thus, antibiotics are not generally used in the treatment of periodontal disease, unlike other bacterial infections around the body. The most effective way to control the plaque biofilm is via mechanical removal such as toothbrushing, interdental cleaning or periodontal debridement performed by a dental professional. An individual's host response plays an important role in

1387-470: Is composed mostly of collagen fibres, however it also houses blood vessels and nerves within loose connective tissue. Mechanical loads that are placed on the teeth during mastication and other external forces are absorbed by the periodontal ligament, which therefore protects the teeth within their sockets. In periodontal health, the alveolar bone surrounds the teeth and forms the bony socket that supports each tooth. The buccal and lingual plates and lining of

1460-490: Is composed of 460 delegates representing 53 constituent societies, five federal dental services and the American Student Dental Association . The house meets once a year during the association's annual session. The association's 11 councils serve as policy recommending agencies. Each council is assigned to study issues relating to its special area of interest and to make recommendations on those matters to

1533-410: Is irreversible. A risk factor is a variable that in health can be defined as "a characteristic associated with an increased rate of a subsequently occurring disease". Risk factors are variables that contribute to disease, rather than being factors that induce disease. Risk factors may be seen as modifiable and non-modifiable. Modifiable risk factors are often behavioural in nature and can be changed by

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1606-437: Is less firmly attached and is redder than attached gingiva. It provides for the movement of cheek and lips. The periodontal ligament is the connective tissue that joins the outer layer of the tooth root, being the cementum, to the surrounding alveolar bone. It is composed of several complex fibre groups that run in different directions and which insert into the cementum and bone via Sharpey's fibres . The periodontal ligament

1679-550: Is multifactorial, requiring dental and oral health professionals to have a clear and thorough understanding of the risk factors and their mechanisms in order to implement effective disease management in clinical practice. Periodontitis and associated conditions are recognised as a wide range of inflammatory diseases that have unique symptoms and varying consequences. In order to identify disease, classification systems have been used to categorize periodontal and gingival diseases based on their severity, aetiology and treatments. Having

1752-685: Is necessary to evaluate the requirement of periodontium for surgery. Factors identifying if the surgical phase is required are: periodontal pocket management in specific situations, irregular bony contours or deep craters, areas of suspected incomplete removal of local deposits, degree II and III furcation involvements, distal areas of last molars with expected mucogingival junction problems, persistent inflammation, root coverage and removal of gingival enlargement. During this phase, any defects need to be restored with removable or fixed through dental prosthesis , prosthodontics , or other restoration processes. The last phase of periodontal therapy requires

1825-442: Is required to re-evaluate the steps carried out after the phase I therapy. Usually 3–6 week re-evaluation is crucial in severe cases of periodontal disease. The elements which are required to be re-evaluated are the results of initial therapy (phase I therapy), oral hygiene and status, bleeding and plaque scores and a review of diagnosis and prognosis and modification of the whole treatment plan if necessary. After post-phase I, it

1898-407: Is the specialty of dentistry that studies supporting structures of teeth , as well as diseases and conditions that affect them. The supporting tissues are known as the periodontium , which includes the gingiva (gums), alveolar bone , cementum , and the periodontal ligament . A periodontist is a dentist that specializes in the prevention, diagnosis and treatment of periodontal disease and in

1971-536: Is the best solution for the patient." The ADA established rigorous guidelines for testing and advertising of dental products, and the first ADA Seal of Acceptance was awarded in 1931. Today, about 350 manufacturers participate in the voluntary program and more than 1,300 products have received the Seal of Acceptance. Product manufacturers are charged $ 14,500 for each product the ADA evaluates. For products that are approved, manufacturers pay an annual fee of $ 3,500. According to

2044-461: Is the charitable arm of the association. The ADA opposes the opening of new dental schools and increases in the number of dental students. The organization has questioned federal data showing a dentist shortage in the United States. In the 1980s, dental schools graduated nearly twice as many students relative to total population as they did in the 2000s. The ADA has a history of trying to restrict

2117-698: Is the largest and oldest national dental association in the world. The association has more than 400 employees at its headquarters in Chicago and its office in Washington, D.C. The Paffenbarger Research Center (PRC), located on the campus of the National Institute of Standards and Technology (NIST) in Gaithersburg, Maryland, an agency of the American Dental Association Foundation (ADAF) and

2190-401: Is this adherence to non-shedding surfaces that allows bacteria in a dental biofilm to have unique characteristics of clinical significance. The stages of biofilm formation: Bacteria contained within the biofilm are protected by a slimy extracellular polysaccharide matrix which helps to protect them from the outside environment and chemotherapeutics agents. An example of a chemotherapeutic agent

2263-466: Is typically painless and is most commonly a result of plaque biofilm accumulation, in association with reduced or poor oral hygiene . Other factors may increase a person's risk of gingivitis, including but not limited to systemic conditions such as uncontrolled diabetes mellitus and some medications. The signs and symptoms of gingivitis can be reversed through improved oral hygiene measures and increased plaque disruption. If left untreated, gingivitis has

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2336-523: The American Academy of Periodontology (AAP) and the European Federation of Periodontology (EFP) together collaborated to revise and adopt a new classification system for periodontal conditions to aid in a more personalized approach to patient care. In 2018 they released an updated classification system which includes a multi-dimensional staging and grading system for periodontitis classification,

2409-417: The dentine layer of the tooth and provides attachment for the collagen fibres of the periodontal ligament. It also protects the dentine and provides a seal for the otherwise exposed ends of the dentinal tubules . It is not as hard as enamel or dentine and is typically a light yellow colour. Gingivitis is a common condition that affects the gingiva or mucosal tissues that surround the teeth. The condition

2482-454: The gingival margin is the fibrous tissue that encompasses the cemento-enamel junction , a line around the circumference of the tooth where the enamel surface of the crown meets the outer cementum layer of the root. A natural space called the gingival sulcus lies apically to the gingival margin, between the tooth and the free gingiva. A non-diseased, healthy gingival sulcus is typically 0.5-3mm in depth, however, this measurement can increase in

2555-482: The pathogenesis of periodontal disease. Even in a mouth where the gingiva appear healthy, there is constant low-level inflammatory response facilitated by the host to manage the constant bacterial load of plaque micro-organisms. Leukocytes and neutrophils are the main cells that phagocytose bacteria found in the gingival crevice or pocket. They migrate from the tissues in a specialized exudate called gingival crevicular fluid also known as GCF. Neutrophils are recruited to

2628-419: The red complex bacteria (e.g. P. gingivalis , T. forsythia , and T. denticola ) of the gingiva and teeth, combined with host immuno-inflammatory mechanisms and other risk factors that can lead to destruction of the supporting bone around natural teeth. Untreated, these diseases can lead to alveolar bone loss and tooth loss . As of 2013 , periodontal disease accounted for 70.8% of teeth lost in patients with

2701-434: The ADA apologized for its history of racial discrimination. After a Reader's Digest investigation revealed that dentists provided drastically different evaluations of the same patients and suggested drastically different treatments, ADA President Leslie Seldin said, "Dentistry is an art based on scientific knowledge, and what's most important to all of us is that we each use our professional judgment to design what we believe

2774-399: The ADA, it does not make a profit from the program. The Board of Trustees, the administrative body of the association, is composed of the president, the president-elect, two vice presidents and 17 trustees from each of the 17 trustee districts in the United States. The treasurer and executive director serve as ex officio members. The House of Delegates, the legislative body of the association,

2847-454: The American Dental Association in 1939. This article about a medical journal is a stub . You can help Misplaced Pages by expanding it . See tips for writing articles about academic journals . Further suggestions might be found on the article's talk page . Periodontics Periodontology or periodontics (from Ancient Greek περί , perí – 'around'; and ὀδούς , odoús – 'tooth', genitive ὀδόντος , odóntos )

2920-667: The Board of Trustees and the House of Delegates. The association's official publication is the Journal of the American Dental Association . Other publications include the ADA News and the ADA Guide to Dental Therapeutics. The Commission on Dental Accreditation, which operates under the auspices of the ADA, is recognized by the U.S. Department of Education as the national accrediting body for dental, advanced dental and allied dental education programs in

2993-558: The National Dental Association . It was renamed The Journal of the National Dental Association in 1915, and Journal of the American Dental Association in 1922. It merged with Dental Cosmos in 1936. Marjorie Jeffcoat became the first female editor of the journal in 2001. The editor is Dr. Jeffrey Platt of the Indiana University School of Dentistry. JADA absorbed Dental Cosmos in 1936. Dental Cosmos

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3066-578: The National Dental Association, which has advocated for universal dental coverage for Medicare recipients. In 2021, ADA president Cesar R. Sabates credited the exclusion of Medicare dental coverage in the Build Back Better Plan to the ADA's advocacy. Critics of the ADA argue that the organization undermines competition in dental services and makes dental care in the United States less affordable. The ADA has also been described as an "old boys club" where licensed dentists, 70% of whom are male, restrict

3139-405: The United States. It is also recognized by 47 individual states. The ADA formally recognizes nine specialty areas of dental practice: dental public health, endodontics , oral and maxillofacial pathology, oral and maxillofacial surgery , orthodontics and dentofacial orthopedics, pediatric dentistry, periodontics , prosthodontics , and oral and maxillofacial radiology . The ADA Foundation

3212-445: The areas of separation between the free and attached gingiva. The junctional epithelium provides a specialized protective barrier to microorganisms residing around the gingival sulcus. Collagen fibres bind the attached gingiva tightly to the underlying periodontium including the cementum and alveolar bone and vary in length and width, depending on the location in the oral cavity and on the individual. The attached gingiva lies between

3285-772: The dentists to review their work." In 2017, the Federal Trade Commission proposed to create a category of mid-level practitioners ( dental therapists ) to provide some routine dental services, which "could benefit consumers by increasing choice, competition, and access to care, especially for the underserved." The ADA lobbied against the proposal, arguing that the government should rather give more funding to dentists than allow "lesser trained" therapists to provide dental services. The ADA spent millions of dollars to block legislative proposals in various states to permit dental therapists to provide services. The ADA's own research has shown that when dentists work with dental therapists,

3358-873: The diagnosis, treatment and management of periodontal diseases. It was previously believed that each human being had the same risk of developing periodontal diseases, but through the identification and classification of risk factors, it has become well understood that each individual will have a differing array of risk factors that generate susceptibility and contribute to severity of periodontal disease. Individual, modifiable risk factors include: Non-modifiable risk factors include: Risk characteristics must be considered in conjunction with risk factors as variables that may also contribute to increasing or decreasing one's chances of developing periodontal disease. Numerous studies show that age, gender , race , socioeconomic status , education and genetics also have strong relationships on influencing periodontal disease. Periodontal disease

3431-585: The disease in South Korea. Periodontal disease is the second most common cause of tooth loss (second to dental caries) in Scotland. Twice-daily brushing and flossing are a way to help prevent periodontal diseases. Healthy gingiva can be described as stippled, pale or coral pink in Caucasian people, with various degrees of pigmentation in other races. The gingival margin is located at the cemento-enamel junction without

3504-405: The free gingival line or groove and the mucogingival junction . The attached gingiva dissipates functional and masticatory stresses placed on the gingival tissues during common activities such as mastication , tooth brushing and speaking. In health it is typically pale pink or coral pink in colour and may present with surface stippling or racial pigmentation. The interdental gingiva takes up

3577-832: The gingiva, a host-microbial interaction gets underway. This results in the imbalance between host and bacterial factors which can in turn result in a change from health to disease. Other local or systemic factors can result in or further progress the manifestation of periodontal disease. Other factors can include age, socio-economic status, oral hygiene education and diet. Systemic factors may include uncontrolled diabetes or tobacco smoking. Signs and symptoms of periodontal disease: bleeding gums, gingival recession , halitosis (bad breath), mobile teeth , ill-fitting dentures and buildup of plaque and calculus . Individual risk factors include: gender, smoking and alcohol consumption, diabetes, obesity and metabolic syndrome , osteoporosis and Vitamin D conditions, stress and genetic factors. In 2017,

3650-406: The gingivae. The gingivae are categorized into three anatomical groups: the free, attached and the interdental gingiva. Each of the gingival groups are considered biologically different; however, they are all specifically designed to help protect against mechanical and bacterial destruction. The tissues that sit above the alveolar bone crest are considered the free gingiva. In healthy periodontium,

3723-456: The gingival crevice area as they are signalled to by molecules released by plaque microorganisms. Damage to epithelial cells releases cytokines which attract leukocytes to assist with the inflammatory response. The balance between normal cell responses and the beginning of gingival disease is when there is too much plaque bacteria for the neutrophils to phagocytose and they degranulate, releasing toxic enzymes that cause tissue damage. This appears in

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3796-402: The gingival tissues and further escalate inflammation, which impacts the progression of chronic systemic inflammation and disease. The result is collagen breakdown, infiltrate accumulation as well as collagen breakdown in the periodontal ligament and alveolar bone resorption. At this stage, the disease has progressed from gingivitis to periodontitis and the loss of supporting periodontium structure

3869-470: The individual or environmental circumstances, whereas non-modifiable factors are usually intrinsic to an individual's genetics and cannot be changed. To determine risk factors for a disease, evidence-based research and studies are needed for evidence, with longitudinal studies giving the most statistically significant outcomes and the best reliability for determining risk factors. Risk factors often coexist with other variables, rarely acting alone to contribute to

3942-452: The kind of care that dental hygienists and dental therapists are allowed to provide. In many states, dental hygienists are required to be closely supervised by dentists when they provide care. In 1991, the Director of the ADA's Council on Dental Practice expressed opposition to permit dental hygienists to work unsupervised, arguing that this would harm patients and that dental hygienists "need

4015-586: The kinds of services that dental hygienists (more than 95% of whom are female) can provide. Journal of the American Dental Association The Journal of the American Dental Association is a monthly peer-reviewed medical journal on dentistry published by the American Dental Association . It is freely available to the public after a one-year embargo. The journal was first published in 1913 as Official Bulletin of

4088-432: The level of disease. Radiographs may also be performed to assess alveolar bone levels and levels of destruction. Contemporary periodontal treatment is designed based on the trimeric model, and is performed in four phases. These phases are structured to ensure that periodontal therapy is conducted in a logical sequence, consequently improving the prognosis of the patient, in comparison to indecisive treatment plan without

4161-479: The microbial flora to a favourable environment to stabilize periodontal disease. Debridement is thorough mechanical removal of calculus and dental biofilm from the root surfaces of the tooth. Debridement is the basis of treatment for inflammatory periodontal diseases and remains the golden standard for surgical and non-surgical treatment in the initial therapy. It is conducted by hand instrumentation such as curettes or scalers and ultrasonic instrumentation. It requires

4234-438: The motivation of the patient behaviour changes that have originated from the patient. Patients must want to improve their oral hygiene and feel confident that they have the skills to do so. It is crucial for the clinician to encourage patient changes and to educate the patient appropriately. Motivational interviewing is a good technique to ask open-ended questions and express empathy towards the patient. An oral health therapist

4307-532: The mouth as red, swollen and inflamed gingiva which may bleed when probed clinically or during tooth brushing. These changes are due to increased capillary permeability and an influx of inflammatory cells into the gingival tissues. When gingival disease remains established and the aetiology is not removed, there is further recruitment of cells such as macrophages, which assist with the phagocytic digestion of bacteria, and lymphocytes, which begin to initiate an immune response. Pro-inflammatory cytokines are produced inside

4380-411: The opening of new dental schools or to increasing the number of dentists in the United States, even as the United States trains almost half as many dental students (relative to population) in the 2000s as it did in the 1980s. The American Dental Association was founded August 3, 1859, at Niagara Falls , New York , by twenty-six dentists who represented various dental societies in the United States. It

4453-455: The patient to maintain their at-home oral care. Oral health therapists are employed by the dental team to share the responsibilities of care. They are an important asset as they have been uniquely and specifically trained in preventative dentistry and risk minimization. This allows the dental team to work more competently and effectively as dentists can manage more complex treatments or significantly medically compromised patients. A periodontist

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4526-425: The patient's ability to perform and maintain effective dental plaque removal. This requires the patient to be motivated in improving their oral hygiene and requires behaviour change in terms of tooth brushing, interdental cleaning, and other oral hygiene techniques. Personal oral hygiene is often considered an essential aspect of controlling chronic periodontitis . Research has shown that it is important to appreciate

4599-716: The periodontal screening record (PSR) and the Community Periodontal Index of Treatment Needs (CPITN) are also used in making a diagnosis and to order or classify the severity of disease. If disease is identified through this process, then a full periodontal analysis is performed, often by dental hygienists, oral health therapists, or specialist periodontists . This involves full mouth periodontal probing and taking measurements of pocket depths, clinical attachment loss and recession. Along with this other relevant parameters such as plaque, bleeding, furcation involvement and mobility are measured to gain an overall understanding of

4672-466: The placement of dental implants . The term periodontium is used to describe the group of structures that directly surround, support and protect the teeth. The periodontium is composed largely of the gingival tissue and the supporting bone. Normal gingiva may range in color from light coral pink to heavily pigmented. The soft tissues and connective fibres that cover and protect the underlying cementum, periodontal ligament and alveolar bone are known as

4745-417: The potential to progress to periodontitis and other related diseases that are more detrimental to periodontal and general health. Periodontal disease encompasses a number of diseases of the periodontal tissues that result in attachment loss and destruction of alveolar bone. Periodontal diseases take on many different forms but are usually a result of a coalescence of bacterial plaque biofilm accumulation of

4818-433: The presence of pathology. The gingival pocket between the tooth and the gingival should be no deeper than 1–3mm to be considered healthy. There is also the absence of bleeding on gentle probing. Periodontal diseases can be caused by a variety of factors, the most prominent being dental plaque. Dental plaque forms a bacterial biofilm on the tooth surface; if not adequately removed from the tooth surface in close proximity to

4891-399: The presence of periodontal disease. The gingival sulcus is lined by a non-keratinised layer called the oral sulcular epithelium ; it begins at the gingival margin and ends at the base of the sulcus where the junctional epithelium and attached gingiva begins. The junctional epithelium is a collar-like band that lies at the base of the gingival sulcus and surrounds the tooth; it demarcates

4964-409: The preservation of periodontal health. In this phase, patients are required to re-visit through a scheduled plan for maintenance care to prevent any re-occurrence of the disease. The maintenance phase constitutes the long-term success for periodontal treatment, thus contributing to a long relationship between the oral health therapist , dentist , or periodontist and the patient . The prognosis of

5037-443: The rate of untreated caries was lower than in dentist-only teams. The ADA has a long history of advocating against dental coverage under national health insurance plans. In 1965, the ADA lobbied against the inclusion of dental coverage in the original Medicare program. In 2021, the ADA launched a well-funded lobbying effort against proposal to provide dental insurance coverage for all Medicare recipients. The ADA stands in contrast to

5110-418: The restorative treatment is determined by the periodontal health. The goals for establishing periodontal health prior to restorative treatment are as follows: Non-surgical therapy is the golden standard of periodontal therapy which consists of debridement with a combination of oral-hygiene instructions and patient motivation. It mainly focuses on the elimination and reduction of putative pathogens and shifting

5183-402: The sockets are composed of thin, yet dense compact or cortical bone. Within the cortical plates and dental sockets lies cancellous bone, a spongy or trabecular-type bone which is less dense than compact bone. The anatomic landmarks of the alveolar process includes the lamina dura, the alveolar crest, and the periodontal ligament space. Cementum is the outer layer of the tooth root; it overlies

5256-400: The space beneath a tooth contact point, between two adjacent teeth. It is normally triangular or pyramidal in shape and is formed by two interdental papillae (lingual and facial). The middle or centre part of the interdental papilla is made up of attached gingiva, whereas the borders and tip are formed by the free gingiva. The central point between the interdental papillae is called the col. It

5329-645: Was the first monthly record of dental sciences in the United States. It was founded in 1859 in Philadelphia . The journal published articles related to dentistry from 1859 until 1936, when it merged with the Journal of the American Dental Association . The archived articles are hosted in the University of Michigan's online library. The merged journal was published as Journal of the American Dental Association and The Dental Cosmos for two years, and then reverted to Journal of

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