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The purpose of this study is to discuss the current understanding of periodontitis causation. The understanding of periodontitis as a monocausal infection has hindered the investigation of other potential causes that influence periodontitis morbidity and does not reflect the complexity of periodontitis etiology. Still today, the periodontal literature frequently defines periodontitis as an infection, whereas other potential causes of periodontitis, like smoking, which seems to be causally related to periodontitis, are typically called modifying or susceptibility factors. Instead of addressing the complexity of periodontitis, the field has narrowed its focus trying to find the most important bacteria or gene. Distal causes of periodontitis and interaction between constellations of causes at multiple levels have been commonly neglected. Understanding periodontitis as a group of signs and symptoms characterized by inflammatory destruction of the periodontium would provide a better frame for future etiological research.

Several decades of research of the interrelationships between diabetes and periodontitis have evolved into a significant body of knowledge that should be incorporated into dental practice. However, there may be a delay in implementing this important information into everyday patient care. Oral healthcare providers (i.e., dentists and dental hygienists) should be progressively engaged in changing the trajectory of the epidemics of diabetes and periodontitis. This article synthesizes the cumulative evidence on the diabetes-periodontitis link, proposes ideas for risk stratification of dental patients with diabetes and periodontitis, and builds a case for the development of a risk-prediction model that provides for the earliest identification of dental patients who have dysglycemia.

A new therapy for the management of early caries lesions and caries prevention was established for clinical use. This therapy was named the Dental Drug Delivery System (3DS), and its effectiveness was confirmed by clinical evaluations. The 3DS method involves the application of either antimicrobial drugs or fluoride gels, with individual trays at the chair-side and also for home care program. By using the individual trays, only the cariogenic bacteria “Streptococcus mutans” that adheres to the tooth surface is controlled without changing the core composition of oral microflora. Therefore, we recommend the use of this method in dental clinics for caries management. The 3DS method should be used especially by pregnant women and mothers raising small children because children most often receive the S. mutans from their mothers via saliva. Patients with dental implants also should be treated by 3DS in order to prevent peri-implantitis. Perioperative patients and bed-ridden people who find it physically challenging to take care of their teeth would also benefit from the 3DS. Patients with severe halitosis are also candidates for 3DS treatment. The scientific rationale of 3DS and the clinical procedure involved are introduced in this article.

The purpose of this paper is to review current evidence for a concomitant relationship between oral diseases and malnutrition in the elderly. A narrative overview of current literature was undertaken to combine the context for research with critical elaboration and commentary. Oral disease is one of the most common public health issues worldwide with significant socio-economic impacts, and yet it is frequently neglected in public health policy. Epidemiologic studies show that oral disease frequently causes malnutrition in the elderly. In particular, malnutrition is associated with poor quality of life and poor efficacy of oncologic therapy in oral cancer patients. As oral disease remains a major public health burden worldwide, it is of great importance to integrate oral health into the nutrition agenda via the Common Risk Factor Approach. As such the long-term sustainable strategy for global oral health should focus on health promotion and malnutrition prevention in the elderly.

The demand for root coverage in multiple gingival recession defects has increased in recent years. Compared to isolated recession, multiple gingival recession defects are much more challenging due to various limiting factors and require more sophisticated surgical techniques. This review aims to address recent progress in the management of multiple recession defects. The subepithelial connective tissue graft (SCTG) procedure, while effective, is limited due to tissue availability and patient preference to avoid a donor harvest site. Different surgical techniques and biological materials have been studied in an attempt to find ideal alternatives. Based on the studies reviewed, the SCTG procedure still remains the gold standard in terms of percent root coverage. Acellular dermal matrix allograft in conjunction with different flap designs has shown comparable, satisfactory results up to 1 year postoperatively. Other materials such as porcine collagen matrix and enamel matrix derivative also show some promise. Well-designed studies with long-term outcomes are still needed.