Periodontitis primary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Prevention

Daily oral hygiene measures to prevent periodontal disease include:

  • Brushing properly on a regular basis (at least twice daily), with the patient attempting to direct the toothbrush bristles underneath the gum-line, so as to help disrupt the bacterial growth and formation of subgingival plaque and calculus.
  • Flossing daily and using interdental brushes (if there is a sufficiently large space between teeth), as well as cleaning behind the last tooth in each quarter.
  • Using an antiseptic mouthwash. Chlorhexidine gluconate based mouthwash or hydrogen peroxide in combination with careful oral hygiene may cure gingivitis, although they cannot reverse any attachment loss due to periodontitis. (Alcohol based mouthwashes may aggravate the condition).
  • Regular dental check-ups and professional teeth cleaning as required. Dental check-ups serve to monitor the person's oral hygiene methods and levels of attachment around teeth, identify any early signs of periodontitis, and monitor response to treatment.
  • Oil pulling, an alternative medicine procedure, performed on an empty stomach.[1]

Typically dental hygienists (or dentists) use special instruments to clean (debride) teeth below the gumline and disrupt any plaque growing below the gumline. This is a standard treatment to prevent any further progress of established periodontitis. Studies show that after such a professional cleaning (periodontal debridement), bacteria and plaque tend to grow back to pre-cleaning levels after about 3-4 months. Hence, in theory, cleanings every 3-4 months might be expected to also prevent the initial onset of periodontitis. However, analysis of published research has reported little evidence either to support this or the intervals at which this should occur.[2] Instead it is advocated that the interval between dental check-ups should be determined specifically for each patient between every 3 to 24 months.[3][4]

Nonetheless, the continued stabilization of a patient's periodontal state depends largely, if not primarily, on the patient's oral hygiene at home if not on the go too. Without daily oral hygiene, periodontal disease will not be overcome, especially if the patient has a history of extensive periodontal disease.

References

  1. http://www.johcd.org/pdf/Effect_of_Oil_Pulling_on_Plaque_and_Gingivitis.pdf
  2. Beirne P, Forgie A, Clarkson J, Worthington HV (2005). "Recall intervals for oral health in primary care patients". Cochrane Database for Systematic Reviews (2): CD004346. ISSN 1469-493X. PMID 15846709.
  3. National Institute for Health and Clinical Excellence (27 Oct, 2004). "NICE guidance issued on frequency of dental check-ups". National Library for Health (UK). Retrieved 2006-05-07. Check date values in: |date= (help)
  4. BBC News (Wednesday, 27 October, 2004). "Call for tailored dental checks - Routine six-monthly dental check-ups should become a thing of the past, new guidance recommends". Retrieved 2006-05-07. Check date values in: |date= (help)

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