Evidence Based Periodontal Treatment

At Adult Dentistry of Rochester, we do a periodontal examination at every oral health examination.  With the new information on the association of periodontal disease and systemic diseases, Dr. Dulski puts a lot of emphasis on assuring that the gums are healthy.  So, we routinely screen for the early warning signs of gum disease for all patients at the re-care visits with the hygienist.

We examine the gums with a blunt-end measuring device called a periodontal probe.  Any bleeding during probing means that there is an infection in the gums.  The infection is caused by bacteria.  Any probe readings greater than three indicates the tender, red, swollen gums of disease.  Larger numbers mean that the gum disease has spread from the gums to the supporting bone around the tooth and that the bone is beginning to deteriorate in that area.

Readings of ones, twos or threes with no bleeding indicates healthy gums.  Two or three bleeding points with a reading of  four indicates a local gum infection and commands special attention by the hygienist at the cleaning appointment.  Special brushing and flossing instructions and a re-evaluation on a six month re-care schedule follows. Six or eight bleeding points indicate a more generalized gum infection called gingivitis and more intense hygiene therapy and a three month re-care schedule with the hygienist.  Persistent gum infection can cause gum decay which can progress to the bone resulting in a condition called periodontitis.  A persistent gum and bone cavity with a reading of five requires teeth scaling to remove root deposits of toxic plaque and tartar and disinfection of the site with an antimicrobial such as Arestin to promote healing.  Healing and maintenance is closely monitored at three month re-care appointments with the hygienist.

Ultrasonic teeth scaling is one of the most effective procedures for removing plaque and tartar from the teeth.  An ultrasonic scaler consists of a small wand that produces a gentle vibration and flow of water.  As the tip moves along the tooth surface, its vibrations break up the plaque and tartar.  These vibrations also cause millions of microscopic bubbles to form in the water.  When the bubbles collapse, the energy that is released helps to dislodge the toxic deposits of plaque and tartar..  Ultrasonic teeth scaling can be more comfortable than using manual teeth scalers because the tip is extremely small and the action  more gentle to the gums.  In addition, we add an antibacterial solution, Peridex, to help disinfect the tissues to aid healing.

Arestin is used together with teeth scaling  to kill the bacteria that cause gum decay.  This is a cartridge filled with Arestin, an antibiotic in powder form.  After scaling, we apply the powder to your periodontal pocket where it combines with the moisture in the pocket and adheres immediately to the infected gum tissue.  The individual powder particles release a steady flow of the active ingredient, minocycline, a potent antibiotic.  The medication helps fight your infection for 21 days.  You should know that scaling and Arestin are not a cure for periodontal disease.  Once bone is lost, no amount of medication will bring it back.  And for periodontal therapy to be successful, you will need to be very thorough with your home care and continuous with your re-care schedule.  Visit www.dulski.com for a free periodontal exam and recommendations for a periodontal therapy and  re-care schedule designed to help you keep your healthy, beautiful smile.

Tags: Periodontal Exam, Periodontal Disease, Gum Disease, Hygienist, Periodontitis, Arestin, Periodontal Therapy, Ultrasonic Teeth Scaliing