SAN FRANCISCO - In his recent freewheeling talk at the recent ADA convention held in San Francisco, Gordon Christensen paused to ponder periodontal disease and treatment of same. While there's much speculation about different clinical approaches, Christensen came down on the side of conservative periodontal therapy--even though he admits that "collective" research on conventional therapy is lacking. His "proven components of conservative periodontal therapy:"
- Education, education, and more patient education about periodontal disease.
- Frequency of oral hygiene and lots of follow-up. Neither of these work, of course, says Christensen. "If the patient drives up in a broken down old car with rust stains and hamburger wrappers on the floor, and you say to them, 'Clean your teeth!', well...come on!" In short, says the doctor, don't count on patients being consistent or aggressive about oral hygiene. "It's hard to change human behavior."
- Patients should clean their tongues twice a day.
- Frequent scaling and root planning--maybe every two to three months!
- Systemic antibiotics delivered for nine months.
- Alternate oral rinses, changed frequently.
- Deliver local antibiotics to non-responding pockets.
The doctor's fave perio products? For local, topical anesthesia, Oraqix is the pick. "If you have to give patients an injection every time they come in for scaling, they won't come back!"
Fave rinse? Peridex from 3M. A good "natural" alternative are rinses from Dental Herb. "These rinses are strong...if they don't kill the bugs, they'll kill you," he kidded. "These rinses really work."
Great disinfectants (and other related products)? The Oxyfresh lineup catches the doctor's eye.
Christensen's parting shots and advice? Basically, offer conventional perio therapy first. Just remember that many patients don't want--or can't afford--this kind of work.
