Interview: “Periodontics was never a static field”

Jeremy Booth, Dental Tribune International

Tue. 4. May 2021

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Prof. Lior Shapira was elected president of the European Federation of Periodontology (EFP) in March, and he promptly outlined his vision for a return to normality during the COVID-19 pandemic. In the ensuing weeks, Shapira also raised important social issues, such as the need for wider recognition of women clinicians and a greater focus on sustainability where oral care is provided. Dental Tribune International asked the professor and chairman of the Department of Periodontology at the Hebrew University of Jerusalem about the road to normality and how to navigate it.

Congratulations on being appointed the new EFP President, Prof. Shapira. Could you briefly tell us about your professional background and experience?
I have been involved in periodontal research and clinical periodontics for many years. Over time, I climbed the profession’s ladder—little by little—and served my university as programme director, department chair and associate dean. During those years, I participated in a number of Perio Workshops that were organised by the EFP—some of them as a reviewer—and served on the editorial board of some leading scientific dental journals, including the Journal of Clinical Periodontology (JCP), which is the EFP’s flagship scientific publication and the leading publication in periodontics. Recently, I served as the deputy chair of the EFP’s science committee, and for the last four years, I have been a member of its executive committee. In addition to this, as former president of an EFP-affiliated society, I have in-depth knowledge of the needs of the national periodontics societies and of how the EFP can work with them. I bring all this experience to my year-long tenure as EFP President, which I consider to be one of the high points of my career.

Prof. Lior Shapira is professor and chairman of the Department of Periodontology at the Hebrew University of Jerusalem, and president of the European Federation of Periodontology for 2021. (Image: EFP)

This year will mark 30 years of the EFP. Periodontics has come a long way since 1991. How would you describe the current direction of the field and the factors that are effecting change?
Periodontics was never a static field, and it continues to evolve based on the latest research and scientific knowledge. The driving force behind periodontics is science—from molecular studies to randomised controlled clinical trials. It would be hard to mention all the recent developments. In short, it has been recognised that periodontitis is a multifactorial disease involving a complex interplay between host, environment and microbes. The connection between periodontitis and other overall health issues, such as diabetes and cardiovascular diseases, has been established. We have developed surgical methods and new materials to regenerate the lost supporting tissues and to change the prognoses of teeth. The current direction of periodontics is to identify individual risk factors that will enable us to provide “personalised periodontal treatment”, and genomics may play an essential role in this process. Cell-based therapy will soon be available for periodontal regeneration, and host-modulating drugs will be part of our treatment modalities. Considerable work has already been done in this particular area, and this work will continue in the form of international research; and so, I predict that such therapies will soon be put into practice and become a reality.

One of the topics that you have raised since becoming president is the urgent need to recognise and increase the visibility of women periodontists. How do you think that periodontics stands to benefit from greater gender equality, and what needs to be done?
Over the years, the number of high-quality women periodontists has considerably increased, and these women have often served, in their respective countries, as leaders of their national societies and academic institutions. Unfortunately, however, they are still under-represented in the global and European professional forums. We need to be more conscious of this and rectify it, and the EFP is committed to being part of the process. Diversity is the hallmark of the EFP. As a federation we are multicultural, multiracial and multigenerational by nature, and we welcome many voices and opinions. I am sure that—in a few years—it will no longer be necessary to talk about gender equality in the field of periodontics.

You have outlined the next twelve months as bringing a return to a sense of normality for the international periodontics community. Can you tell us about the steps that need to be taken to achieve this?
The COVID-19 pandemic has affected the EFP as an organisation, and it has also affected us personally: we could not travel or meet, and it was necessary to postpone EuroPerio10 to 2022. However, during the pandemic, we have gained new skills—often relating to new technologies—and this has helped to keep our federation alive and well. We developed EFP Virtual, a technology-based strategy that includes new platforms for electronic communication and e-learning, such as our Perio Sessions webinars. We have also learned how to use social media to efficiently communicate with our stakeholders, and we have put this communication into practice in our interactive Perio Talks. These new capabilities are now part of the federation and will stay with us after the pandemic.

However, as an educational organisation, we know that personal contact is still the heart of the EFP and that virtual education alone is not sufficient in our field. We all hope that the pandemic will soon be brought under control, and plans are already in place to continue our educational activities. Gum Health Day will take place on 12 May this year, and a new set of guidelines on treatment of periodontitis, stage IV, will come from Perio Workshop scheduled for November. The semi-annual executive committee meeting will take place this October, and the EuroPerio10 congress will be held in June next year.

“The pandemic has also served as a kind of ‘field study’ and has shown us that the postponing of preventive and regular treatment can inflict a high cost on oral health”

The pandemic has provided us with a chance to question the status quo. What have been some of the insights taken on board by the EFP and its community?
Nobody could have predicted the events of the last twelve months and their impact on our profession. The pandemic disrupted the personal and professional lives of all of us, including our members and their patients. During the pandemic we outlined a set of recommendations that aim to better protect dental patients and those who provide oral care. The EFP has developed and published protocols for this purpose, and those protocols will also remain in use by the EFP after the pandemic. We have also developed effective platforms for hosting virtual educational events, and now is the time to implement this technology in order to offer hybrid-format events so that we can make our knowledge available more widely.

The pandemic has also served as a kind of “field study” and has shown us that the postponing of preventive and regular treatment can inflict a high cost on oral health. Patients have learned more about the importance of proper self-care, and periodontists around the world are ready to help them to adopt and put into action new oral care routines.

Periodontics and the pandemic: A recent EFP survey found that 91% of periodontists have adapted their clinical protocols since the pandemic began. (Image: Alona Siniehina/Shutterstock)

Turning to the EFP’s community: issues related to the pandemic will be the key focus in the coming year, but what other challenges are facing EFP members?
As the influential driving force of periodontics globally, the EFP and its societies will continue with their efforts to develop and implement guidelines for periodontal and dental implant therapy. This process was delayed owing to the pandemic; however, it is now necessary to resume our efforts. This is a complex process which starts at the EFP level before continuing within each respective national periodontics society. The development of guidelines for treatment is essential and it affects the entire dental profession—in our experience, we have found that it raises interest not only in the dental community but also among the general public. The EFP and its affiliated societies will continue in our ongoing effort to establish the recognition of the periodontal specialty in Europe, and we feel that this is important for the dental profession and public health.

Sustainability is an additional and very important challenge that we are facing. As a healthcare federation, the EFP and its affiliated societies and partners are in the process of accelerating and scaling up sustainability performance. This is being done through the development of a new strategy and taking actions that will help our community on a global level. We are currently taking the first steps, and we plan to identify innovative solutions to help dental teams with the sustainability challenges that they are facing. We conducted a sustainability workshop together with the national societies at our last virtual general assembly in March and received a very enthusiastic response.

EuroPerio10 will now take place in Copenhagen in June 2022. What can practitioners expect in the build-up to this event?
EuroPerio10 will be a great celebration of “returning to normal”. We are all eager to travel, to meet friends, to learn from the best experts, and we expect that EuroPerio10 will fulfil our expectations. There will be hundreds of lectures from world-known clinicians, live surgeries, a huge exhibition and friends from all over the world.

This year, we have organised an event that will provide participants a taste of what awaits them in 2022. For those who have registered to attend EuroPerio10, the EFP is about to launch the EuroPerio Series. This is an educational series of interactive presentations and the free kick-off event is scheduled for 5 June. More information can be found on the event website.

See you all in Copenhagen in June 2022!