Periodontal disease was once thought to be only due to plaque and plaque by products. Now, other risk factors such as opportunistic pathogens, environmental influences, genetics, host responses, connective tissue and bone metabolisms all factor in to the disease progression.
Periodontal disease is truly multifactorial and therapy is now trying to address these issues. Plaque now accounts for only 20% of the risk factors associated with this disease. The remaining 80% is now being assessed and treated as personalized periodontal medicine and dentistry.
The future of periodontal therapy will become personalized by utilizing the field of genomics, epigenetics (the study of what turns on and off genes) and host-pathogen relationships. Periodontal medicine will also be a significant factor since systemic inflammation is an important factor in the progression of this disease. The association of periodontal disease, heart disease, diabetes, rheumatoid arthritis and metabolic syndrome are well established. The combined medical and dental approach to therapy is critical to overall well-being.