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The treatment for the early stages of gum disease usually
involves scaling and root planing. This is the Nonsurgical therapy where plaque
and calculus (tartar) is removed. This treatment controls the growth of harmful
bacteria and by treating conditions that encourage gum disease.
A dental hygienist
often does the scaling and root planing under the periodontist's
supervision.
During this phase of treatment, you may also need certain
procedures including replacing worn fillings that can accumulate plaque.
There are also procedures that may be performed in conjunction
to scaling and root planing. This includes administration of antibiotics,
chlorohexidine, bite correction, and splinting.
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Non-surgical Options Defined:
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Scaling and Root Planing:
Scaling is a type of cleaning that removes plaque and calculus
from the teeth at and slightly below the gum-line. Root Planing is the technique
used to smooth root surfaces, so the supportive tissues can better reattach to the
tooth surface. Your periodontist may use local anesthesia because this procedure
goes deeper than a regular cleaning.
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Antibiotics:
Antibiotics may be prescribed as adjuncts to periodontal
therapy because bacteria causes periodontal disease. They may be taken in
a pill form or in a tiny fiber form (tetracycline fiber). A microbiological
test is usually performed first before any antibiotics are prescribed. This
test helps your periodontist determine the type of destructive periodontal bacteria
that are present in your gums and antibiotic(s)) specific for that bacteria
may then be prescribed. Antibiotic fibers are
applied directly to the infected pocket and removed 7-10 days later.
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Bite Correction:
Your bite may also be adjusted so that your teeth meet properly and function
better. A bite that is not balanced may increase bone destruction. A
night guard - a removable mouth piece that fits either on the upper or lower teeth
- may be needed to protect your teeth surfaces and helps relax tense jaw muscles.
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Splinting:
If your teeth still feel loose after treatment because of bone loss, they may be
splinted. This technique keep the weak teeth together, making them more stable.
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PerioChip: The
PerioChip is a small, orange-brown chip, which is inserted into periodontal pockets.
Each PerioChip contains 2.5 mg of Chlorhexidine Gluconate in a biodegradable, resorbable
matrix. The PerioChip is used in conjunction with scaling and root planing,
for the reduction of pocket depths measuring at least 5 mm in patients with adult
periodontitis. It may be used as part of a periodontal maintenance program, which
includes good oral hygiene, scaling and root planing. Up to eight pockets may be
treated in a single visit. It is recommended that PerioChip treatment be administered
once every three months in pockets that remain 5 mm or greater. The PerioChip does
not require removal since it is completely biodegradable. In the unlikely event
that it becomes dislodged, the exact course of action is dependent upon the amount
of time the chip was in place.
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Periostat: Periostat
systemically delivers 20 mg doxycycline hyclate, which acts as a collagenase inhibitor.
Periostat is used in conjunction with scaling and root planing. Taken twice per
day, its properties reduce the elevated collagenase activity in the gingival crevicular
fluid. At this time, it is only intended for use in patients with adult periodontal
disease.
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Atridox:
Atridox provides the sub-gingival controlled-release of 42.5 mg doxycycline, a broad
spectrum semisynthetic tetracycline that kills bacteria associated with periodontal
disease. Atridox uses the Atrigel Delivery System, a non-surgical, bioresorbable
method of delivering anti-microbial therapy. Atridox is available for site-specific
treatment of adult periodontal disease. It is applied in fluid form directly into
periodontal pockets using a syringe. Periodontal packing is necessary. Anesthesia
is not required. Once in the pockets, the Atridox fluid solidifies, releasing doxycycline
for approximately one week. During this period, tooth brushing and flossing should
be avoided. Since Atridoxis biodegradable, it does not require removal. Atridox
offers the potential for results at least 75% as effective as scaling and root planing
in pockets measuring 5 mm or greater. Due to concerns regarding antibiotic resistance,
antibiotic-based products such as AtridoxTM are best reserved for problems that
are non-responsive to conventional therapy.
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