Gingivitis: a prelude to periodontitis?

Products have been recently developed which have been shown to be effective in the reduction of gingivitis; specifically a stabilized stannous fluoride dentifrice. However, there has been doubt raised as to the role of gingivitis in the progression of periodontitis. Gingivitis in children provides an appropriate model illustrating how the condition creates an environment in the gingival sulcus which in the long run potentiates the development of periodontitis; e.g., by favoring the establishment of a more pathogenic flora, such as spirochetes. In addition, from epidemiological evidence there appears to be a strong link between gingivitis progression to periodontitis in older adults. Other epidemiological evidence supports the observation that intermittent episodes of gingivitis account for net destructive disease progression over time, and the absence of gingival bleeding is consistent with a continuation of periodontal health. Therefore, efforts to develop effective products which have the potential to control gingivitis should be supported as an important goal and periodontal oral health benefit.