Preserving natural teeth: a shared commitment between the EFP and AAP

The importance of preserving natural teeth has long been a cornerstone of periodontal care, and a recent statement from the American Academy of Periodontology (AAP) reinforces this critical principle. Responding to reports highlighting potentially unnecessary tooth extractions and replacement with dental implants, the AAP emphasised the need for ethical treatment planning centred on maintaining oral health and natural dentition. This aligns closely with the values and guidelines championed by the European Federation of Periodontology (EFP).

As specialists in preventing and treating periodontal disease - a leading cause of tooth loss - both the AAP and EFP advocate for retaining natural teeth whenever possible. EFP president Moritz Kebschull stressed this point: “To be fair, this is what we at the EFP have been saying all along in our guidelines for the treatment of stage IV periodontitis, published in the Journal of Clinical Periodontology in June 2022. The most important recommendations at the beginning of the guidelines are very clear: even this very severe form of periodontitis can be treated, and this is based on retaining teeth and maintaining, where at all possible, the integrity of the dental arch. While teeth are not the only restorative solution available, this principle of a serious attempt to preserve teeth is fundamental. To make these guidelines more accessible for our members and patients worldwide, we’ve been rolling out national versions of these guidelines globally and we have invested significant efforts in creating tools like the brand-new infographics, where we insist on the importance of preserving natural teeth.”

The AAP’s recent statement echoes concerns raised in a CBS News report, which highlighted cases where teeth may have been unnecessarily extracted due to financial motivations. The AAP underlines that dental implants, while an effective solution for unsalvageable teeth, come with their own risks and maintenance requirements.

The EFP shares this view, emphasising that dental implants should only be considered when saving the natural tooth is not feasible. Both organisations advocate for open, honest discussions between patients and dental professionals to explore all treatment options, their risks, and their benefits.

By preserving natural teeth, periodontists help patients maintain their quality of life and avoid unnecessary procedures. The EFP remains a leader in providing evidence-based recommendations and practical tools to guide the periodontal community in delivering optimal care.

AAP statement 

EFP comment on YouTube

EFP guidelines and infographics