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Tooth loss significantly reduced with non-surgical therapy.

The goal of periodontal therapy is to maintain the natural teeth in health, comfort, and function during the patient’s lifetime. The majority of clinical periodontal studies focus on the effectiveness of periodontal procedures in reducing clinical probing depth, and the maintenance or gain of clinical attachment levels. Most of these studies are short-term and do not address the essential issue ‐ do these procedures increase the longevity of the dentition? Over the past 50 years, several papers have been identified as classics. These papers represent major breakthroughs in the art and science of periodontics. They have been instrumental in creating a change in dentistry and the specialty. The paper by Loe and colleagues established the relationship between bacterial plaque and gingivitis. 1 In 1986, Loe and colleagues reported significant clinical attachment loss and tooth loss in Sri Lankan laborers who did not have access to dental care. 2 The Hirschfeld and Wasserman study provided retrospective evidence that curettage and maintenance were successful in maintaining teeth over prolonged periods. 3 In this issue, the research by Hujoel and colleagues represents another landmark study. The paper is important because it represents a cooperative effort of periodontal researchers and the insurance industry, and the significance of their results is that they are based on more than 1,000 patients. This paper provides the first controlled evidence to demonstrate that the basic procedures of periodontal scaling and maintenance decrease tooth loss. Further, as clinical probing depth increased, tooth loss increased. The results appear to demonstrate that shallow sulci with decreased probing depths provide patients with the long-term benefits of decreased tooth loss. These two findings clearly provide the profession with clear, objective evidence that periodontal therapy reduces tooth loss; and, thus, these basic procedures meet one of the most important objectives of treatment ‐ maintenance of the natural dentition. This paper will impact the profession and public health.