The Periodontal Screening Index is a good test for gingivitis

Dr. Fuhrmann says diseases that compromise the immune system, such as diabetes and rheumatic diseases, cause micro-inflammation that increases the risk of periodontitis. He says the Periodontal Screening Index, which is often paid for by health insurance, helps dentists monitor a patient's level of gum inflammation. The Periodontal Screening Index is graded on a scale of 0 to 4 - patients with a PSI of 3 or 4 need to be informed of their options and the consequences of untreated inflammation.

Dr. Fuhrmann says that 0 is the optimal value for PSI tests - it indicates that there is no bleeding and the gums are pink and firm. However, such perfect conditions are usually only theoretical and rarely found in reality. Most patients are inflamed to some degree, so it is necessary to examine patients individually. What is considered inflamed in one patient may be considered tolerable in another. Therefore, after studying the PSI, the dentist should make an individual assessment of the patient.

Dr. Fuhrmann says his dental clinic routinely performs the PSI test on all new patients and periodically on existing patients. However, if the dentist does not offer a PSI test voluntarily, the patient can request it. If action is required, the patient must be informed of the reason for the action, i.e., why certain treatments and recommendations are necessary.

The relationship between periodontitis and general well-being

In periodontology, Dr. Fuhrmann said, numerous studies have shown the link between overall health and bacterial infections. In some cases, bacterial germs increase the risk of heart problems and premature birth. That doesn't mean all people with severe periodontitis will have a preterm birth or suffer a heart attack, but it's a risk factor that can't be ignored. And the bacterial infections from the mouth can spread through the bloodstream to the rest of the body, so periodontal disease can really manifest itself in numerous general health problems outside the mouth.

The relationship between periodontitis and implantology

According to Dr. Fuhrmann, it makes sense for periodontology and implantology to work together. Because you have to create a good foundation for the implant. Even if the patient has no teeth and there is no risk of dental inflammation, the dentist must ensure the stability of the keratinized gums. This is because stable gums in an edentulous jaw have a positive effect on the long-term survival rates of implants. Therefore, dentists should also consider periodontology when providing implants to ensure the long-term success of the implant.

How patients can ensure a stable periodontal level

Dr. Fuhrmann provides patients with the following tips to ensure a stable periodontal level:

• See your dentist for dental cleanings as often as needed, depending on your dental health.
  

• Brush regularly, preferably with an electric toothbrush.

• Floss regularly, preferably with perfectly fitting interdental brushes.
  

• Apply Chlorhexamed gel between the teeth.

• Use mouthwash sparingly - excessive use can alter the bacterial flora in the mouth and even kill beneficial bacteria.
  

Advice for dentists who want to get involved in periodontology

• Enquire about continuing education courses offered by suitable organizations, such as the German Society for Periodontology
  

• Learn from dentists who are leaders in periodontology via books, Zoom Calls, and videos

• Learn from dentists outside your country - international dentistry allows you to learn about other perspectives that are not common in your specialty or training.
  

• Exploration of in-service training

Dr. Fuhrmann says all dentists should continue their education throughout their lives. "The more you learn, the more you realize you don't know that much," he says. His long-term goal is to stay current in all areas of dentistry, including technology and basic science. He concludes, "If you stay curious and enjoy your work, there are no limits. 

You can find Dr. Fuhrmann offline in his dental practice at Hauptstraße 6 in Achern, Germany, and online via LinkedIn, Twitter, Instagram or YouTube. You can also listen to him on our Zircon Medical podcast.