Periodontal lesions associated with deep traumatic overbite.

Certain aspects of malocclusion, particularly deep overbite, can be related to periodontal pathology, especially in the presence of poor oral hygiene. The authors have noted an association between deep overbite and unusual periodontal lesions. These lesions often appear on radiographs as circumscribed radiolucencies, remote from the alveolar crest and sometimes close to the apex. Gingival surface injury and food impaction may be important aetiological factors. This is illustrated in this article by a number of case studies.

Smoking cessation advice for patients with chronic periodontitis.

BACKGROUND: There are limited data on the utility of dental professionals in providing smoking cessation counselling in the UK. OBJECTIVES: The purpose of this study was to determine quit rates for smokers with chronic periodontitis who were referred to a dental hospital for treatment. MATERIALS AND METHODS: Forty-nine subjects with chronic periodontitis who smoked cigarettes were recruited. All subjects received periodontal treatment and smoking cessation advice as part of an individual, patient-based programme provided by dental hygienists trained in smoking cessation counselling. Smoking cessation interventions included counselling (all patients), and some patients also received nicotine replacement therapy (NRT) and/or Zyban medication. Smoking cessation advice was given at each visit at which periodontal treatment was undertaken (typically four to six visits) over a period of 10-12 weeks. Smoking cessation advice was also given monthly during the programme of supportive periodontal care over the following nine months. Smoking status was recorded at three, six and 12 months and was confirmed with carbon monoxide (CO) monitors and salivary cotinine assays. RESULTS: Forty-one per cent, 33%, 29% and 25% of patients had stopped smoking at week four, months three, six and 12, respectively. Gender, age, the presence of another smoker in the household, and baseline smoking status (determined using subject-reported pack years of smoking) were not significant predictors of quit success (P < 0.05). Baseline CO levels were significantly associated with quit success, however, and were significantly higher in those subjects who continued to smoke compared to those subjects who were quitters at week four, month three and month six (P < 0.05). CONCLUSION: Success rates in quitting smoking following smoking cessation advice given as part of a periodontal treatment compared very favourably to national quit rates achieved in specialist smoking cessation clinics. The dental profession has a crucial role to play in smoking cessation counselling, particularly for patients with chronic periodontitis.