Periodontitis secondary prevention
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
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.
Secondary Prevention
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.[1]
Instead it is advocated that the interval between dental check-ups should be determined specifically for each patient between every 3 to 24 months.[2][3]
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. However, it is generally accepted that pockets are self-cleansable (at home, by the patient, with a toothbrush) if they are 3 mm or less in depth. This is important because if there is a pocket which is deeper than 3 mm around the tooth, at-home care will not be sufficient to cleanse the pocket, and professional care should be sought. When the pocket depths reach 5, 6 and 7 mm in depth, even the hand instruments and cavitrons used by the dental professionals cannot reach deeply enough into the pocket to clean out the bacterial plaque that cause gingival inflammation. In such a situation the pocket or the gums around that tooth will always have inflammation which will likely result in bone loss around that tooth. The only way to stop the inflammation would be for the patient to undergo some form of gingival surgery to access the depths of the pockets and perhaps even change the pocket depths so that they become 3 or less mm in depth and can once again be properly cleaned by the patient at home with his or her toothbrush.
References
- ↑ 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.
- ↑ 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) - ↑ 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:
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