A 16-year-old patient with aggressive periodontal disease (AP) was referred to my office by his father who had also suffered from severe periodontal disease. According to their records in my office, their periodontal disease appeared to have a genetic predisposition. At the first visit, the patient did not complain about his mouth, except for the aesthetic problem of median diastema. After effective periodontal surgery on almost all of the teeth with periodontal destruction, the periodontal condition improved. Also, an orthodontic procedure was performed on the upper and lower front teeth for the diastema. Over a 12-year follow-up period, useless unnecessary tooth loss could be prevented by comprehensive treatment consisting of careful periodontal surgery, establishment of occlusal support, and orthodontal treatment. Regular maintenance therapy with occlusal adjustment was also necessary to reduce the relapse of each risk factor, such as orthodontal treatment. Early detection and early onset of active periodontal treatment, including periodontal surgery, are effective for maintaining a stable and healthy periodontal condition in AP patients. In addition, high compliance and motivation levels of the patient are essential for successful treatment of AP with regular supported therapy.

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The aim of this study was to determine the smoking status of members of the Japanese Society of Periodontology (JSP). Self-administered questionnaires to determine the smoking status were distributed to certain members of the society who were selected through stratified proportional random sampling. A total of 631 members responded, which represents a response rate of 42.1%. Of those who responded, 62.4% were males and 30.3% were in their 30s, which represented the largest of all the age groups. The respondents consisted of dentists (75.4%), dental hygienists (22.5%), dental technicians (0.2%), students (0.3%) and others (1.6%). The respondents were also divided into the following groups: university dental staff (15.2%), university hospital staff (8.1%), general practitioners (71.6%) and others (5.1%). According to the JSP qualification, the respondents consisted of instructors for periodontists (4.9%), board-certified periodontists (13.0%), periodontists (8.6%), board-certified dental hygienists (13.2%), and general members (60.4%). With regard to the workplace policy on smoking, a completely smoke-free workplace policy was reported by 48.2% of the respondents, and 34.9% reported that smoking was allowed only outside the buildings; 30.7% of those not actively smoking reported being exposed to second-hand smoke at home. The sample included 376 people who had never smoked (59.6%), 211 ex-smokers (33.4%), and 44 current smokers (7.0%). The prevalence of smoking in dentists was 8.4%, which was higher than that in the dental hygienists (2.1%, P<0.05). When analyzed by qualification, the prevalence of smoking in all the certified periodontists was 7.8%, which was lower than that in the general members (8.7%). By age-group, the prevalence of smoking was 8.9% in the 30s age group, 6.9% in the 40s age group, 6.2% in the 50s age group, 8.0% in the 60s age group, and only 3.1% in the respondents who were in their 20s. Among the smokers, 70.5% had actually tried to quit smoking and 81.8% reported that they were in the contemplation stage. The present study highlights the importance of focusing attention on members of the JSP for smoking cessation in periodontal treatment.

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