Academy draws a line in the sand

Oct. 9, 2006
General dentistry profession sets the record straight regarding AAP referral guidelines.

CHICAGO--The Academy of General Dentistry, a professional association of 35,000 general dentists, finds the American Academy of Periodontology's recent referral guidelines for the co-management of patients with periodontal disease to be extremely offensive to well-qualified AGD members.

General dentists are not only skilled in periodontal treatment, but also frequently perform periodontal procedures. The AGD also reports that of even greater offense is the guideline's implication that the AGD endorsed such an erroneous set of guidelines for referral of periodontal patients.

"The AGD has communicated grave concerns over this document to the AAP,"
says AGD President Bruce DeGinder, DDS, MAGD. "The AGD has requested the AAP immediately remove any reference to the AGD from these guidelines, and
rescind the AAP guidelines until such time as a true collaborative effort
can be accomplished."

"We certainly advocate for appropriate periodontal treatment performed by a
qualified professional, however, there are inaccuracies in the AAP's
guidelines which imply that the general dentist should abstain from
procedures that many of our members are qualified to administer," says Dr.

In June 2005, the AGD was solicited by the AAP to provide comments on their
draft document, "Referral Guidelines for the Co-Management of Patients with
Periodontal Diseases." In July 2005, the AGD submitted a thorough review and expressed substantial concerns to AAP leadership about many of the draft

"When the AAP released their final guidelines in August of this year, they
apparently disregarded our input," says Dr. DeGinder. "We categorically do not endorse this document and our board of trustees has communicated through legal counsel to the AAP our critical concerns. Our goal is to set the record straight among the dental profession and to educate the public that many general dentists can and do in fact serve as a patient's dental home in the treatment of periodontal disease."

Many of the procedures listed for referral in the AAP guidelines are routinely taught in undergraduate curriculum in the nation's dental schools. The AAP's guidelines inadequately address the general dentist's competence in treating periodontal disease.

A more accurate statement would have read "referral to a periodontist should
be discussed and offered to the patient as part of their diagnosis and treatment plan review." Referral would also be indicated if the general dentist does not provide corrective dental services for periodontal procedures.

"The AGD always advocates for appropriate periodontal treatment performed by
a qualified professional," says Dr. DeGinder. "However, the bottom line is that the patient should have the freedom of choice to select the most qualified professional to help them manage their periodontal disease."