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Perioscopy - non surgical treatment option

Periodontal infection is typically a chronic infection that works its way further into the gum and bone over a long period of time. Because the bacteria are organized and different from the normal bacteria in the mouth, and because the bacteria invade the gum and affect the bone, many times conventional/routine cleaning does not serve well to control the infection.

This infection is typically without symptoms, such as pain. However, it can give you signs of infection such as swollen gums, bleeding, bad breath and looseness of teeth.

The "Cleaning" is typically done using local anesthesia, with very small ultrasonically powered probes ("micro ultrasonics"). This technology eliminates the need for scraping of the roots with hand instruments. This cleaning technique very thoroughly cleans diseased roots and pockets with micro ultrasonic vibrations of the instrument, as well as, with highly energized flushing of water irrigation.

To aid in visualization of diseased tooth roots our office uses a fiber optic endoscope (Perioscopy). This micro camera slips into pockets so root surfaces can be observed and endoscopically cleaned.

The "Disinfection" is done with an antibiotic. Because there are specific bacteria that invade the gum tissue and affect the bone, our office has found that a course of a systemic antibiotic helps to eliminate any bacteria residual to the cleaning. The antibiotic used may vary based on patient tolerances to different medications. When the infection is generalized it is better to use systemic medications (oral pills). However, when the infection is more localized, antibiotics may be placed directly into the pocket to provide the disinfection. These local antibiotics work in the gum for over a week as they dissolve.

The results of "cleaning and disinfecting" together, have been shown to be much more effective than either one alone. The procedure is one of the best approaches for giving the body a fresh start at healing the gum and bone around the teeth.

After the initial procedure, patients typically have little or no discomfort.  A reevaluation is performed after 3-4 months to check the initial response to treatment and patients are asked to have supportive periodontal treatments at 3-4 month intervals for one year. These treatments are micro ultrasonic cleanings (without anesthesia and without antibiotics) and are performed to support healing by keeping the teeth above and below the gumline as clean as possible. Additionally, we help our patients with their effectiveness in cleaning at home.

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