A new role for periodontists in the 21st century

The 20th century brought major advances in dentistry. Fluoridation of the water supply has been identified as one of the top 10 public health initiatives of the 20th century and has resulted in a 30 to 50% reduction in dental caries. Dental implants have changed the rules of the game by offering patients an expanded range of options for replacement. Advances in dentistry have been so dramatic that dentists are now isolating stem cells from dental tissues and manipulating them for tissue reconstruction. However, in spite of these dramatic improvements in general dentistry and several other dental specializations, for decades, the role of periodontists has been somewhat stationary. During that time, the profession has only focused on the treatment and prevention of periodontitis, or placing dental implants. However, periodontists are more than " gum doctors, " and there are at least 3 reasons to emphasize the new more central role periodontists will play in 21st century dentistry. First, many diseases and disorders can have important effects on oral health. For instance, periodontitis is more prevalent in patients with poorly controlled diabetes. Linear gingival erythema is a prominent part of the presentation of human immunodeficiency virus infection. Periodontists can detect and prevent the oral diseases associated with these other conditions. Second, the reverse is also true. Periodontal disease has been identified as a risk factor for diseases and disorders at distant sites, including cardiovascular and cerebrovascular disease, diabetes, adverse obstetric outcomes, and respira