Guiding your periodontal patients to a positive nonsurgical treatment: Treatment modules that have become a standard of care
Ever since I was a young girl, I have always wanted to be in the dental field. As I got older, I realized this dream was possible, but it would take many years. Looking back on just these last few months of Dental Hygiene school, I see every class, every book, every bit of information is not only required but it is necessary. Dental Hygiene should be looked at as being a simple job of “scraping teeth,” as some patients like to call a dental prophylaxis. The author Karen Donaldson, CDA RDH, BS, EFDA, really summed up how I feel about Dental Hygiene by stating, “The technique has not changed much over the years, but research about the cause of disease has strengthened our responsibility to patients and helped them make educated decisions about treating the disease, and hopefully maintaining treatment with diligent home care (Donaldson, 2011).”
As I went on to read this article, I found myself appreciating the knowledge I am acquiring in the class and in clinic at Carrington College. There has been decades of research over the years about nonsurgical periodontal treatment, which has caused many changes over the years to the standard of care. While the author was in dental hygiene school, she noticed that ultrasonic scalers were rarely used for periodontal treatment. She could see the benefits of using the ultrasonic scalers, which is now the standard of care because they provide a lavage action and help with a more thorough calculus removal (Donaldson, 2011).
According to the author, the most common products added to the standard to care in chlorhexidine gluconate, Peridex. Due to the staining it took the FDA years to approve its use here in the United States. Peridex is now used routinely after SRP procedures for home use and considered the standard of care. The PerioChip was briefly discussed as another delivery system for chlorhexidine gluconate, but because it proved to be difficult it has not been widely used (Donaldson, 2011). Listerine rinses have also been recommended as part of a post-SRP regiment, but due to the negative effects ethanol can have on the gingival tissues it is not the standard of care.
A new product, Periogen, was described as being able to dissolve both supra- and subgingival calculus. This product is not FDA approved and has no studies. It is said to be a version of baking soda, water, and sodium bicarbonate, a product by the Keyes Technique. Another unique therapy discussed was actisite fiber placement into pocket. It was taken off the market because there was a difficulty with the product, it had to be removed 10-14 days later (Donaldson, 2011).
Many new products hope to become the standard of care. Arestin, which contains minocycline, is one of the most widely used products after chlorhexidine gluconate. Arestin is a tetracycline derivative and not used in children and pregnant women. Arestin is packaged as premeasured cartridges of powder and when combined with gingival fluid, it congeals. It has a learning curve to placing it in the pocket. Another product being research is a probiotic lozenge. This product promises to fight periodontal infections and caries in both adults and adolescents that may drink sodas or sugary drink (Donaldson, 2011). I have worked in many dental offices over the last few years and agree with Donaldson when she states, if an office doesn’t have a NSPT program should be discussed and implemented (Donaldson, 2011). Along with a discussion of recommend treatment, alternate treatment and the possible outcomes of no treatment, a written agreement should be documented for the patient and for insurance purposes. This article was a great example of why healthcare professionals should stay up to date on all new products. Each year new research is done to improve the treatment of periodontal infections. The treatment of periodontal infection is the same as it was many years ago-remove the bacteria, but the methods used today are far superior (Donaldson, 2011). Our patients depend us to provide them with the most up to date information and methods available to them. This article is a great reminder that what we are learning now, will not necessarily always be the standard of care. I look forward to continue researching all areas of nonsurgical periodontal therapy for positive development in my profession.
Donaldson, K. (2011). Guiding your periodontal patients to a positive nonsurgical treatment: Treatment modules that have become a standard of care. Rdh, 31(9), 106-110.