D. Douglas Miley

Purpose: To evaluate the efficacy of SmartMouth Clinical DDS compared with 0.12% chlorhexidine and placebo mouthrinses. Materials and Methods: Seventy-six subjects with gingivitis or chronic periodontitis were enrolled in a double-blind, placebo-controlled, clinical study. Examinations included Gingival Index (GI), Bleeding Score (BS), Plaque Index (PI), Tooth Stain Index (TSI), and Calculus Index (CI). Subjects were given a prophylaxis and oral hygiene instructions at the time of enrolment. Subjects were assigned to one of three groups: SmartMouth Clinical DDS (SM), 0.12% chlorhexidine (CHX), or placebo (PL). Subjects were examined at 3 and 6 weeks. Data were evaluated as differences from baseline for each group. Analysis of variance (ANOVA), t tests or non-parametric altematives were used to analyse data. Results: The GI, BS and PI decreases from baseline were statistically significant at both 3 and 6 weeks for all three groups (p s 0.025). Differences between groups were not statistically significant, except that the PI decrease for CHX was significantly greater than PL at 6 weeks (p = 0.048). At 6 weeks there was a statistically significant increase in TSI for CHX (p s 0.001). CI decreased significantly for all groups at 3 weeks (p s 0.004) and for PL at 6 weeks (p < 0.001). At 3 weeks and 6 weeks, the percentages for compliance were significantly higher for SM and PL than for CHX (p < 0.001). SM had less taste alteration reported than CHX (p = 0.003). Conclusion: While all three groups were shown to improve GI, BS and PI scores; non-prescription SM resulted in less taste alteration, less tooth stain and better compliance than CHX.

Background: Reports from studies of twins, disease aggregation in families, animal models for periodontal disease, and various genetic‐analysis studies have determined that genetics plays a role in the susceptibility to periodontal disease. The purpose of this pilot study is to evaluate the effect of genetics on periodontal disease by evaluating the heritability of alveolar bone loss in a captive baboon population.Methods: A collection of baboon skulls from a pedigreed colony (for which scientists and veterinarians maintain complete genealogic and veterinary records) was obtained from the Southwest National Primate Research Center, San Antonio, Texas and used in this pilot study. Measurements of alveolar bone loss were performed on 390 dry baboon skulls. A periodontal probe was used to measure alveolar bone loss. Maximum likelihood methods (designed to handle complex genealogies) were used to determine the heritability of alveolar bone loss. This software used known pedigrees in the captive baboon sample and tested the relationship between pairwise kinship and alveolar bone loss data to determine the heritability of alveolar bone loss from periodontal disease.Results: Genetic data were available for 347 of the 390 specimens. Using age and sex as covariates, genetic analysis indicated a heritability of 35% (standard error = 20%; P = 0.01). Although gender was not a significant factor in periodontal disease (P = 0.96), age was highly significantly associated with periodontal disease (P Conclusions: In this pilot study, analysis of alveolar bone loss measurements from captive baboons indicates that bone loss increases with age and that a portion of periodontal disease risk may be caused by genetic variance. These findings provide evidence that periodontal disease is heritable in captive baboons and indicate that a larger, more‐detailed study is warranted.

Background: A low dietary intake of vitamin D and calcium hastens bone loss and osteoporosis. Because vitamin D metabolites may also alter the inflammatory response and have antimicrobial effects, we studied whether the use of vitamin D and calcium supplements affects periodontal disease status.Methods: A cohort of 51 subjects receiving periodontal maintenance therapy was recruited from two dental clinics; 23 were taking vitamin D (≥400 IU/day) and calcium (≥1,000 mg/day) supplementation, and 28 were not taking such supplementation. All subjects had at least two interproximal sites with ≥3 mm clinical attachment loss. Daily calcium and vitamin D intake (from food and supplements) were estimated by nutritional analysis. The following clinical parameters of periodontal disease were recorded for the mandibular posterior teeth: gingival index, probing depth, cemento‐enamel junction–gingival margin distance (attachment loss), bleeding on probing, and furcation involvement. Posterior photostimulable‐phosphor bitewing radiographs were taken to determine cemento‐enamel junction–alveolar crest distances (alveolar crest height loss). Data were analyzed with a repeated‐measures multivariate analysis of variance.Results: Compared to subjects who did not take vitamin D and calcium supplementation, supplement takers had shallower probing depths, fewer bleeding sites, lower gingival index values, fewer furcation involvements, less attachment loss, and less alveolar crest height loss. The repeated‐measures analysis indicated that collectively these differences were borderline significant (P = 0.08).Conclusions: In these subjects receiving periodontal maintenance therapy, there was a trend for better periodontal health with vitamin D and calcium supplementation. More expanded longitudinal studies are required to determine the potential of this relationship.

Optimal intake of vitamin D and calcium slows bone resorption and ensures adequate calcium for bone mineralisation. Optimal levels of vitamin D should have an immunosuppressive effect on periodontal disease. Older adults, particularly those with dark skin colour and/or those who live in northern latitudes, should consider oral vitamin D supplementation.