Reviewing nonsurgical periodontal therapy

Article Abstract:

Periodontal disease is the deterioration of the gums and bone which support the teeth in their sockets. If not effectively treated, this very common condition progresses over time and eventually leads to tooth loss. In this review, nonsurgical treatments for early periodontal disease are discussed. The nonsurgical approach can only be used for patients with the earliest stages of periodontal disease, often referred to as gingivitis. The main cause of gingivitis is poor control of plaque, the sticky film manufactured by bacteria in the presence of food residue. If not removed frequently, plaque becomes a hard substance called calculus, or tartar, that must be scraped off the teeth by a dental professional. The first step in treatment is removal of plaque and tartar by the professional, who instructs the patient on effective brushing and flossing practices to control plaque on a daily basis. Motivating a patient to follow good oral hygiene habits may be more critical than using any particular device (such as a special brush). While no toothpaste contains ingredients directly effective against gingivitis, two over-the-counter rinses have been proven effective; these are Listerine and Peridex. But the patient can only access the bacterial plaque adhering to teeth above the gum line. The professional uses techniques known as scaling and root planing to remove plaque from underneath the gums. Antibiotics may also be helpful in some cases, especially in children. These techniques are only effective in patients with early, minimal periodontal disease; advanced disease must be treated surgically. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Product/Service Evaluation, Preventive dentistry, Listerine (Dental aid), Peridex (Medication)

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Maintaining periodontal treatment

Article Abstract:

Patients who have been treated for periodontal disease (of the gums and tooth sockets) need to visit the dentist frequently to maintain the health of these structures. In this way, new signs of disease or recurrence of the previous problem can be treated promptly. The ultimate goal is to prevent loss of the natural teeth, because in advanced periodontal disease, teeth loosen as the diseased gums and supporting bone structures degenerate. While the importance of these maintenance visits (referred to by dentists as supportive periodontal treatment) has received little recognition so far, it was recently shown that they are critical to the patient's dental health. The dentist and patient should form a partnership in this ongoing care; one study found that patients who went for regular visits as recommended did not lose any teeth during a five-year period. This report describes the procedures that should be included in the supportive periodontal treatment visit, and discusses the need to follow the same procedures for dental implants as for natural teeth. The average patient who needs this maintenance treatment should see the dentist four times a year, but this schedule may be adjusted according to the severity of the individual's disease. Each visit takes about one hour, and an important activity is teaching and motivating the patient to follow good oral hygiene at home. If periodontal disease is caught early, patients should be treated by their general dentist, but advanced gum disease cases should be referred to a periodontist, who specializes in this type of dentistry. (Consumer Summary produced by Reliance Medical Information, Inc.)

Practice, Dentistry, Periodontics

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Periodontal therapy: reviewing subgingival irrigations and future considerations

Article Abstract:

It is well known that plaque, the bacterial film that accumulates in the mouth, can lead to gum disease (gingivitis and periodontal disease) and eventual tooth loss. If plaque is not controlled by good habits of brushing and flossing, it invades the space between the tooth and the surrounding gum tissue. The gums and the underlying bony support structure gradually deteriorate and the tooth becomes loose in its socket. Plaque can exist both above and below the gum line, and it has been found that different types of bacteria produce the plaque found in these two locations (because of the differing availability of oxygen). Patients who develop periodontal disease may have pockets in the gums that trap bacterial plaque. If plaque is not removed from these pockets, it will breed recurrent infection and progression of periodontal disease. In this report by the American Dental Association, the usefulness of subgingival (under the gum line) irrigation with antibacterial solutions is discussed. Subgingival irrigation has recently been suggested as part of the treatment regimen for periodontal disease; using an irrigator, the antibacterial solution is directed into the crevice or pocket below the gum line. It is concluded that subgingival irrigation is not likely to help patients who have been treated with scaling and root planing techniques or those who have good oral hygiene. Research may demonstrate that subgingival irrigation is beneficial to patients who do not have good brushing and flossing habits; however, this has yet to be confirmed by controlled studies. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Prevention, Drug therapy, Dental plaque, Irrigation (Medicine)

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