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PERIODONTITIS EXAM

The detailed exam of the gums are done on the entire mouth. We carefully examine  the gums by taking 6 measures per tooth. Those measurements, in millimetres, express the depth of the periodontal pocket and are transferred onto a table. For example, in the case of a patient with 32 teeth, we get 192 measurements. This step takes about 30 minutes and is crucial to determine the teeth to target during the gums treatment.

SCALING - ROOT PLANING - CURETTAGE

The scaling procedure is done with ultrasound instruments. The main goal of scaling is to remove the deposits, calcified or not, and the bacterias on the surface of the teeth. It eliminates the tartar above the gum and if it is accessible, the tartar found under the gums. It allows to reduce inflammation and reestablish the health of the gums.

When periodontal pockets are deep and that the tartar is formed in depth, root planing must be done instead of scaling. It is performed with ultrasonic instruments and manual curettes with or without local anaesthetic. The goal of root planing is to remove deposits, calcified or not, and bacterias on the surface of the roots of the teeth. The tartar eliminated is therefore the one under the gums. During the root planing, we also eliminate granulation tissues (bad scars that get in the way of good healing). This procedure is called curettage and is performed especially with a laser.

IRRIGATION WITH CHLORHEXIDINE

During the root planing, we irrigate the periodontal pockets with an antibacterial solution, chlorhexidine. The solution acts on the barrier structure of the bacteria and causes a loss of its internal components, provoking its death. By its antibacterial effect, chlorhexidine allows the reduction of inflammation, redness and gum bleeding.

LASER THERAPY

To have optimal results after root planing, the gums must heal. To do so, the laser therapy is primordial, because is allows a biostimulation, a faster healing process, an elimination of the infected tissues (curettage), less discomfort following the treatment, a diminishment of inflammation and a disinfection of the pockets. This allows a rapid and ideal healing process from a healthy and clean environment.

PROPHYLAXIS

Prophylaxis is another term for teeth polishing. It is performed once the scaling procedure is done and eliminated the plaque on the surface of the teeth. The prophylaxis procedure uses a rubber rotative acorn with fluoride paste.

ANTIBIOTHERAPY - PERIOSTAT

In advance cases of periodontitis, the Periostat, an antibiotic containing doxycycline hyclate, is prescribed with the gums treatment. Given in small doses, 20 mg, Periostat does not act as an antibiotic, but as a regulator of the body’s response. It prevents the production of destructive factors of the gums, the collagenase, allowing the gums to heal.

HOME CARE

You are the principal therapist. In clinics, the therapy consists of a debridement and a punctual disinfection, so you must keep the sites where surgery occurred clean to allow healing.The home care include:

- brushing teeth after every meal, during 2 minutes

- dental floss once a day, preferably before going to bed

- antibacterial mouth rinse twice a day, during 30 seconds

FOLLOW-UP & RECALL

A follow-up every 3 months is prescribed to control the periodontitis and insure that the disease does not worsen. There is a scaling procedure involved, and a new gum exam is done to compare it to the previous one for a follow-up of the evolution of the disease. The root planing, the laser therapy and the chlorhexidine are repeated once more if necessary. Once the disease is under control, the follow-ups are every 6 months.

PERIODONTICS

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