OUR PROTOCOL FOR PERIODONTAL CARE

 

INITIAL VISIT:

• Full Mouth Radiographs
• Plaque Assessment
• Pocket Depth Measurement/ "Perio Problem Map"
• Gross Debridement
• Oral Hygiene Instruction/ Commitment to Care Levels

 

INITIAL TREATMENT:

• Scale, Root Plane per Quadrant ( 1-4 visits)
• Re-evaluate pocket depth changes and bleeding sites
• Evaluate and recommend oral factor modifications
  • Fluoride trays
  • Diet
  • Restorative evaluation

 

RE-CARE

1. If gingivitis… 3-6 month recall
   • re-evaluate perio pocketing and sub-surface disease activity
   • plaque score
   • risk score
   • Problem Map Assessment and Review
2. If perio:… 3 month recall
   • focal pockets debrided (disrupt the biofilm)
   • soft tissue currettage (remove memory cells and infected tissue)
   • plaque score
   • risk score
   • Problem Map Assessment and Review

 

SPECIAL NON-SURGICAL CARE FOR NON-RESPONSIVE ACTIVE PERIO SITES

• local delivery antibiotics (time released gels applied to a specific area)
• systemic delivery of antibiotics (oral medication for generalized flare ups)
• tray delivery system
• oral rinse protocols
• occlusal guards if tooth mobility
• repeat aggressive scale and root planing

ADVANCED CARE FOR DEEP POCKETS

• surgical pocket elimination
• referral to a Periodontist
  • full mouth surgery
  • bone grafting
  • soft tissue grafting
  • re-evaluate cost effectiveness of replacing teeth with implants

Studies show "the greatest risk to the majority of patients is the lack of compliance". Be compliant and keep treatment simple and cost effective.