Guest Editorial: Team Work

Twenty-five years ago, most periodontal therapy in the United States

was delivered by 2,500 trained periodontists whereas today there are 4,500 periodontists who perform almost all surgical periodontal treatment, according to surveys performed by the American Academy of Periodontology (AAP). However, 90% of scaling and root planing is performed in general dental practices—primarily by dental hygienists.1,2

This shift and expansion of care, which further integrated the general practice dental hygienist into the periodontal team, occurred gradually throughout the 1980s and 1990s and greatly increased the number of patients who received periodontal therapy. The AAP recognizes the importance of dental hygiene in the periodontal continuum of care and, as a result, is dedicated to furthering knowledge sharing between periodontists, general dentists, and dental hygienists.

Supply and Demand

Changes in the delivery of periodontal services continue today. The demand for periodontal services has remained relatively unchanged since 1990 but the patterns of services have changed. The total number of scaling and root planing procedures performed annually by general dental and periodontal practices declined from 14 million in 1990 to 10.8 million in 1999.^1,2 The 3.2 million decrease represents several factors, eg, there was a back-log of untreated patients in the 1970s and ’80s, many patients with early disease were treated and freed of periodontal disease, and prevention education by dental professionals—particularly dental hygienists—improved the periodontal health of most patients.

Periodontal maintenance today represents the greatest area of growth for both periodontal and general practices. These procedures increased from 9.5 million in 1990 to 12.5 million in 1999.^1,2 This increase illustrates the success of all our efforts in treating and managing periodontal diseases.

Working Together

The AAP is committed to sharing knowledge on the changing management of the periodontal patient with general dentists and dental hygienists through both formal and informal educational programs. As periodontal therapy and disease profiles evolve, our knowledge and skills must change. The goal of the AAP is that by all of us working together as a knowledgeable, interactive team of therapists, we can not only continue the progress we have made, but greatly improve the periodontal health of the American public.

References

1. American Dental Association Survey Center. 1990 Survey of Dental Services Rendered and Distribution of Dentists in the US by Region and State. Chicago: American Dental Association; 1991.
2. American Dental Association Survey Center. 1999 Survey of Dental Services Rendered and Distribution of Dentists in the US by Region and State. Chicago: American Dental Association; 1999.