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Prof. Mariano Sanz, EFP Eminence in Periodontology Award

Our guest

09 Jun 2021

What does winning the EFP Eminence in Periodontology Award mean to you?

It means a lot, as I have been very active in the EFP since it was established in 1992. In fact, I was one of the founders, representing the Spanish Society of Periodontology (SEPA), and I have since held positions on its executive committee, until last year. That is why this award is a priceless pinnacle to my contribution to European Periodontology, and I feel fully supported by my SEPA society and the rest of the societies that have endorsed my nomination. And recognizing the award-winners that have preceded me, I am very flat-tered, since they represent fundamental figures in the modern history of periodontology.

Regarding the latest studies published, what would you highlight about periodontitis as a risk factor in patients with COVID-19? Do you think this could be extrapolated to other infectious diseases?

Studies published recently, especially the one I participated in together with the research team at the University of Doha in Qatar, indicate that periodontitis may be a risk factor in the severity of COVID-19 infections, although not so much in the initiation of the disease. In other words, the presence of a chronic inflammatory process, such as periodontitis, may aggravate the progression of this infectious disease. This has also been shown possible in processes of pulmonary infection, especially in pneumonia affecting individuals with weak-ened immune systems or those who are intubated. The presence of untreated periodontal pockets may be an important source of bacteria that are able to gain access to the blood-stream or by aspiration contaminate the lung parenchyma, thereby aggravating the underly-ing infectious process.

What do you consider key to the future of periodontal research, clini-cal practice and periodontal medicine?

As in any other branch of medicine, I believe that research in periodontology must transfer results in basic research to clinical practice so as to improve the health and quality of life of our patients. In addition, over the last 30 years we have advanced considerably in what we know about the impact of an oral disease such as periodontitis on the rest of the body, and now the relationship between this periodontal disease and important diseases that af-fect humans, such as diabetes, cardiovascular disease or neurodegenerative diseases, is no longer in doubt. That is why future research must continue to look into effective preven-tive and therapeutical strategies to reduce the incidence of periodontal diseases, and also to evaluate whether that efficacy also has an impact on the general health of patients.

What are the main challenges for periodontics in the 21st century?

The main challenge is to reduce the high prevalence of periodontitis worldwide. Epidemio-logical studies show that one in ten adults suffers from severe periodontitis and this dis-ease continues to be the leading cause of tooth loss in adults. In addition, these epidemio-logical data have barely changed in the last 50 years, which indicates that our preventive strategies are not effective in correcting this high prevalence, which as we have mentioned earlier, not only has important implications for patients’ oral health and quality of life but is also necessary to maintain good overall health. We therefore must develop new preventive methods that are proven effective, not only in controlling gingival inflammation, that is, gin-givitis, but also in reducing the incidence and progression of periodontitis.

How do you think we can improve society’s understanding of oral health?

Scientific progress is always a great way to promote the understanding of health in society. In fact, the recent findings regarding the association between periodontitis and the severity of COVID-19 infection have been widely publicised throughout the world and have served to boost our effort in raising awareness in society of the importance of oral health to pre-serve general health. But collaboration with many other bodies is also necessary, and I would highlight promotional campaigns on oral health facilitated and carried out by the au-thorities; our scientific societies, where I believe that SEPA is doing a magnificent job in breaking down barriers, making dentistry relevant in the medical and pharmaceutical spheres; and finally, the oral hygiene industry, which has a very important role to play, since it reaches the public most directly, and the relevance of the messages can have an outstanding impact on improving awareness of oral health throughout society.

What are the main milestones in periodontics that you would like to highlight?

In the last 40 years, during which I have had the opportunity to participate as a teacher, a researcher, and as a professional in the evolution of periodontology, there is a series of breakthroughs that have effectively changed our approach in the management of patients affected by periodontal diseases, of which I would like to highlight:

The present-day knowledge of the multifactorial aetiology of periodontal diseases, including the role of dental biofilm and also of the factors associated with the patient, like smoking, stress, general health, and so on. This has allowed a much better fo-cus on preventive strategies, emphasising the importance of mechanical removal of plaque, and at the same time the importance of coadjuvant treatment in some pa-tients, above all including the control of the patients’ risk factors in the preventive strategies, such as giving up smoking, weight loss, healthier lifestyles, etc.

The development of predictable techniques in periodontal regeneration that allow us to greatly improve the individual prognosis of teeth whose prognosis would previ-ously have been considered hopeless, and which today we are able to keep healthy for much longer.

The inclusion of implant therapy in the armamentarium of periodontal therapy and considering peri-implant tissues just as important as periodontal tissues in our pre-ventive and therapeutic approach.

The consideration of periodontal health as a fundamental part of general health by clearly demonstrating the association between periodontitis and many other system-ic diseases.

 

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