Plaque control in the treatment of juvenile periodontitis.

With the purpose of establishing to what extent "periodontosis" responds to total plaque control, 21 such patients were observed over periods ranging from 8 to 34 years. Total plaque control in the present context means complete removal of all supragingival plaque by the patient and complete removal of all subgingival plaque by the dentist. The results were evaluated in terms of the number of lost teeth and the percentage of lost attachment during the observation period. It was observed that "periodontosis" cases responded to total plaque control in the same way as do ordinary cases, but with periodontosis, incomplete plaque control on any teeth led to extremely rapid bone loss and eventually to extraction. The reason for this is the unusually rapid apical migration of the subgingival plaque which is the most typical feature of the juvenile periodontitis. Some attachment and some teeth were lost in most of the patients, but a sufficient number of teeth with a sufficient amount of supporting tissue were maintained to provide a set of natural teeth that functioned well. This study shows that the reduced resistance to the invasion of subgingival plaque can be compensated for by a correspondingly strong emphasis on total plaque control. The term "periodontosis" is misleading, and should be replaced by the name "juvenile periodontitis" as suggested by Lehner et al. (1974).