Public Health Implications of Chronic Periodontal Infections in Adults

Proceedings of a Conference

April 8–9, 2003
Renaissance Atlanta Hotel
Atlanta, Georgia

The Centers for Disease Control and Prevention (CDC) plays a major role in assuring a strong science base for public health action. CDC’s mission focuses on detecting, assessing, and monitoring threats to public health; building the capacity of state and local health agencies; and supporting applied and community-based research and population-level efforts to prevent disease and promote health. Such efforts can include health policy changes at many levels (e.g., clean indoor air-laws, mandatory insurance coverage for specific health services, proof of immunization for school enrollment), and health communication designed for key groups.

In light of these responsibilities and recent professional and public interest in the expanding science base on the associations between periodontal infections and systemic diseases, on April 8–9, 2003, CDC convened a meeting of experts from multiple disciplines to address the “Public Health Implications of Chronic Periodontal Infections in Adults.” The experts presented research findings and provided insight regarding associations between periodontal infections and four categories of systemic disease (cardiovascular diseases, diabetes, reproductive health outcomes, and respiratory infections). The public health implications were then examined for each of these associations.

Those invited to hear the presentations and contribute to open discussions of issues raised included representatives from CDC and other federal agencies, academic health centers, state departments of health, the World Health Organization, the Association of State and Territorial Dental Directors, and dental professional associations including the American Dental Association, the American Academy of Periodontology, the American Dental Hygienists Association, and the American Dental Education Association.

A primary goal of this meeting was to determine whether the science behind these associations is of sufficient quality and strength to warrant population-based interventions to prevent and control periodontal infections as a risk factor for these systemic outcomes. A second goal of this meeting was to establish an expert work group to research and recommend pragmatic and valid population-based surveillance measures for periodontal disease. CDC and others have recognized that the development, implementation, and evaluation of public health interventions require an ability to monitor periodontal diseases in populations. Such monitoring should be ongoing and systematic. The data should then be analyzed and interpreted, and used to guide public health practice. Current measures of periodontal infections are extremely resource-intensive and often outside the reach for inclusion in state and local surveillance systems.

This Web site contains abstracts of the experts’ presentations* followed by a transcript of the conference question-and-answer sessions. Finally, summary remarks by William R. Maas, DDS, MPH, Director, CDC Division of Oral Health, provide a perspective on the information presented and the state of our knowledge regarding periodontal diseases and their associations with systemic diseases.

CDC Work Group on Periodontal Disease Surveillance

* These abstracts were written by the various authors in their private capacity. No official support or endorsement by the Centers for Disease Control and Prevention, Department of Health and Human Services, is intended, nor should be inferred.

Abstracts from Expert Presentations:

• Introduction to Periodontal Diseases: Clinical Presentations, Etiology, and Pathogenesis
• Population Aspects, Smoking, and Other Modifiable Risk Factors for Periodontal Disease
• Genetic Aspects of Periodontal Diseases
• Periodontal Diseases and Respiratory Infections
  
  Periodontis and Cardiovascular Disease
• The Inflammatory Link between Periodontitis and Cardiovascular Diseases
• Periodontitis and Cardiovascular Diseases – Comorbid Conditions?
• Difficulties in Evaluating the Relationships Between Periodontal Disease and Cardiovascular Diseases
• Potential Public Health Implications of Periodontal Disease and Cardiovascular Disease Relationships
  
  Diabetes and Periodontal Disease
• Diabetes and Periodontal Disease: Current Concepts
• Diabetes and Periodontal Disease: Important Gaps in Knowledge and Methodological Issues
• Diabetes and Its Complications: Designing New Therapies for this Epidemic
  
  Periodontal Disease and Reproductive Outcomes
• Potential Impact of Maternal Periodontitis on Reproductive Outcomes
• Periodontal Disease as a Risk Factor for Preterm Birth: Epidemiology and a Pilot Intervention Study
• Potential Public Health Implications of Associations Between Periodontitis and Reproductive Outcomes

Question and Answer Session: Day 1, April 8, 2003

Question and Answer Session: Day 2, April 9, 2003

Summary Remarks: The CDC Perspective – William R. Maas, DDS, MPH

This conference was initiated by the Division of Oral Health and supported by three other divisions of the National Center for Chronic Disease Prevention and Health Promotion, specifically, those responsible for reproductive health, cardiovascular health, and diabetes. The Center also has an office that addresses issues related to tobacco and health. Collectively, the Center and its divisions have many years of experience building public health programs in the states to prevent and control chronic diseases. That experience can help guide and foster future activities and efforts resulting from this meeting.

We are especially grateful to the American Academy of Periodontology (AAP) for its active role in collaborating with CDC to plan the content and format of this meeting and shape the goals and ongoing efforts of the surveillance work group. AAP’s partner, Sunstar Inc. (and the John O. Butler Company) generously underwrote the meeting hospitality and amenities.

Historical Document
Page last reviewed: November 21, 2005
Content source: Division of Oral Health, National Center for Chronic Disease Prevention and Health Promotion