Achieving Successful, Long-Term Results in Periodontal Treatment
Successful periodontal therapy includes:
1. Involving the patient. Involving each patient in his/her diagnosis and treatment is essential in achieving results. The level of priority that patients give their dental health, and the associated lifestyle choices they make, will ultimately decide the long-term outcome of treatment. Therefore, dental professionals must enter a non-judgmental role of "coach" to help identify habits that contribute to gum disease so that patients may make necessary changes. If these contributory habits persist, no level of treatment will be successful long-term.
2. Using appropriate forms: There must be a meaningful system to collect data at each visit and trained staff to interpret the data. Forms that show probing depths, bleeding and plaque control are critical. Records should be compared with patients from visit to visit; emphasizing all the positives and collaborating on ways to improve any negatives.
3. Using a disclosant: Lack of effective plaque control is a huge limitation in achieving results. Plaque control that subjectively appears to be excellent may be found to be quite poor when objectively measured. Set a plaque-free goal of 80% or better. There are a number of longitudinal studies that assess the long-term merit of periodontal therapy and it has been shown that perio therapy is very effective when a disclosant is used and the patient achieves a plaque-free level in the 80-90% range. There is no substitute for disclosing.
4. Focusing on inflammation: No bleeding-upon-probing and no marginal redness is the best indicator that there is no longer infection. When scaling is performed effectively, surgical treatment on single rooted teeth can almost always be avoided. After effective nonsurgical treatment, which requires managing plaque control to 80% or better and keeping BOP at 5% or less, patients have an excellent chance at staying healthy.
5. Taking advantage of the newest periodontal technology: The Perioscope is a real eye-opener. It allows us to see that calculus is present in furcation sites following root planing almost 100% of the time. Without removal of the calculus, inflammation in these sites will persist. The 48x magnification provided by the Perioscope allows us to visualize and most effectively remove the calculus, thereby eliminating the inflammation.
Of course it also allows us to avoid surgery in areas that do not require regeneration, an advantage that patients truly appreciate.
6. Paying particular attention to furcations: Don't expect to get the same result for furcations that you do for single rooted teeth. Once a furcation is involved, (even an early one), there is risk of recurrent inflammation. Furcations require additional treatment with either the Perioscope or periodontal surgery for removal of calculus and possible regeneration. They will always need to be monitored closely.
7. Knowing when to use antibiotics: Antibiotics are rarely needed to successfully treat periodontal disease. Also, the trend in dentistry, as in medicine, is to reduce antibiotic usage to avoid creating antibiotic resistance or clostridium difficile colitis (C-dif). Culture/DNA sensitivity tests often show evidence of antibiotic resistance and even multiple antibiotic resistances. (That is why two antibiotics are often recommended today, where as that was not the case 15 years ago). The ultimate key to inflammation control is not antibiotics, but rather, the effective removal of plaque and calculus. Patients truly can be healthy, stable and inflammation-free without the use of antibiotics.
8. Limiting the use of topical antibiotics: As the Perioscope has shown us, calculus is present in even early furcations almost 100% of the time after scaling and root planing. Therefore, placing topical antibiotics in these areas is like painting over rust - the results are short lived. Once again, the goal is resolution of inflammation and this can only be achieved through effective removal of the cause of the inflammation, i.e. PLAQUE AND CALCULUS.
Questions and Answers
Article Tags:
dental pittsburgh
,cosmetic dentistry pa
,dentist pittsburgh
,periodontist pennsylvania
,dental implants pittsburgh
,periodontist pa
Periodontal specialist, Dr. John Nikas has joined Dr. Briglia's West Chester dental practice team. His expertise is focused on developing strategies to prevent the ravages of gum disease, which includes tooth and bone loss and can produce to other oral, general health problems. As a periodontist, Dr. Nikas is trained in implant treatment, improving function, health, comfort and smile appearance.
Dental implant is a procedure which replaces old teeth and implanting new fake ones. This is a long procedure and can be dangerous too if you have not appointed a good dentist. You need to be patient and have trust in your dentist for implanting new teeth.
Teeth are a small part of your body but they can cause a lot of discomfort when it gets infection or cavities. Just like our body we need to take special care of our teeth so that they do not cause problems.
When selecting a periodontal practice, be sure that the periodontist is Board Certified. This means that the doctor has made significant achievements beyond the mandatory requirements of his specialty.
Putting up with damaged or missing teeth is something which modern cosmetic dental dentistry has turned into a thing of the past. Dental implants will fill any gap and replace any tooth, or even teeth, in a manner which is simple, convenient and highly effective.
There are some things you may want to skimp on to save a few pennies: shoes you'll only wear once or twice, generic cereal that tastes just like the real stuff or sticky notes for your office that don't cost an arm and a leg. When it comes to your teeth and the health of your mouth, though, spare no expense. Finding dentists in Las Vegas is made easier when you know exactly what to look for.
When you are trying to decide on which dentist that you should go to in order to have a dental procedure performed, you can easily become overwhelmed by all of the choices that you will have. Chances are extremely high that there are large amounts of dentists that are practicing in your area.
The list of excuses for not brushing or flossing is endless, but according to a new study published in the Journal of Periodontology, these are two tasks that should not be omitted from the daily hygiene routine.
Researchers recently demonstrated an association between gum disease and the increased risk of stroke due to potential blockages of the main blood vessels leading to the brain (carotid artery). These blockages, or atheromas, contain calcium and can be detected on dental panoramic radiographs.
When selecting a periodontal practice, be sure that the periodontist is Board Certified. This means that the doctor has made significant achievements beyond the mandatory requirements of his specialty.
Gingival recession is presently one of the most common problems that adult dental patients have. There probably isn't a single day that your hygienists don't see 3 or 4 patients with recession.
Regular flossing and brushing are important first steps in helping to maintain good oral health, but when and how often should you visit a dentist and a periodontist?
Healthy gums are important not only for your smile but for your overall health. Researchers have linked periodontal disease to severe medical conditions such as heart disease and diabetes.
Discuss this Article
