Updated Guidelines for Periodontal Screening & Management of Children and Adolescents Under 18 years of age
We wish to thank Professor Valerie Clerehugh [1] and Dr Susan Kindelan [2] for their excellent work in updating the Guidelines for Periodontal Screening and Management of Under 18s, plus Executive Summary.
The focus of these guidelines is on the periodontal diseases and conditions of relevance to children and adolescents under 18 years of age and to set out the updated joint recommendations of the British Society of Periodontology and Implant Dentistry (BSP) and the British Society of Paediatric Dentistry (BSPD) for periodontal screening and management in the primary dental care setting. It takes account of the introduction of the 2017 World Workshop Classification system for periodontal and peri-implant diseases and conditions (Caton et al., 2018) and its impact on the younger age groups.
Gingivitis (gingival ‘gum’ disease) is common in children and adolescents and is preventable and reversible. This reversible gingival inflammation can progress to the initial stages of irreversible periodontitis (periodontal destruction of the supporting periodontal attachment and bone) in adolescents. The use of e-cigarettes and the rise in childhood and early adult obesity are factors which may lead to increases in levels of periodontal problems within a population.
Most periodontal disease in these younger age groups is not severe. However, there are a subgroup of young patients who will be susceptible to more severe, destructive forms of periodontal disease, which can have various consequences during childhood, adolescence and/or into adulthood (tooth loss, pain, aesthetics, function and bad breath etc.). By careful periodontal screening in childhood and adolescence, they can be identified early and managed before major problems develop.
Therefore, dental practitioners have an important role to play in the early recognition and diagnosis of gingival and periodontal diseases. This will ensure the greatest chance for successful treatment, either in clinical practice within the primary dental care setting or by referral to appropriate specialist services.
Management needs to incorporate effective oral hygiene practices in childhood and adolescence which should extend into early adulthood and beyond as part of an evidence-based but pragmatic treatment approach for the various periodontal diseases diagnosed.
The aims of these guidelines are twofold:
- To outline a method of screening children and adolescents under 18 years of age for periodontal diseases during the routine clinical dental examination using a simplified Basic Periodontal Examination (sBPE) to detect the presence of gingivitis or periodontitis or other periodontal problems at the earliest opportunity.
- To provide guidance on periodontal management and when it is appropriate to treat in practice or refer to specialist services, thus optimizing periodontal outcomes for children and young adolescents.
Both documents are available to download from the BSP website, Professional/Publications page:
[1] Professor Valerie Clerehugh, Emeritus Professor of Periodontology, Department of Restorative Dentistry, School of Dentistry, University of Leeds, on behalf of British Society of Periodontology and Implant Dentistry.
[2] Dr Susan Kindelan, Consultant in Paediatric Dentistry, Leeds Dental Institute, Leeds Teaching Hospitals Trust, on behalf of British Society of Paediatric Dentistry.