Alternative Gum Disease Treatment Options for Deep Gum Pockets
This post will define the available professional “alternative gum disease treatment options” for deep gum pockets.
When traditional therapies such as root planing (deep cleaning) with antibiotics, or basic laser periodontal therapy are exhausted, the next indicated step for a more definitive treatment to stop infection in unresponsive deep pockets may be traditional periodontal surgery. However, many individuals decide to seek alternatives to traditional periodontal surgery for the following reasons in our experience: to avoid pain and long term tooth sensitivity, to prevent large gaps or black triangles between the teeth, to avoid recession of the gums following surgery, to avoid extractions of teeth deemed hopeless, and to avoid the potentially huge costs associated with periodontal surgery and tooth replacement.
The following periodontal treatment options are at this time considered to be alternatives to traditional periodontal surgery.
Regenerative Periodontal Endoscopy – Non invasive procedure to promote closure of deep gum pockets and repair bony defects.
This non-invasive procedure employs the use of a periodontal endoscope. RPE differs from a standard perioscopy procedure in many ways. The inclusion of enzyme inhibitors and regenerative proteins to promote reattachment of pockets and bone fill. In addition, RPE is performed with very precise and efficient tools (piezo diamond tips), which allows skilled clinicians to complete the procedure more efficiently while preventing root damage and tissue trauma from occurring. An occlusal adjustment is often performed to aid in overall healing. Teeth deemed hopeless can be treated with RPE as an alternative to extractions due to the non-invasive nature of the procedure.
Before RPE - deep gum pockets/bone loss After RPE – reattachment of gum pockets/bone fill
See case studies (actual patients of PerioPeak Innovations)
Perioscopy – visual removal of tartar in deep pockets only
This non-invasive procedure employs the use of a dental endoscope to “see” microscopically into deep periodontal pockets. This allows the clinician to better remove the tartar and plaque (biofilm) from the roots which have already been root planed blindly without success. It is simply “visually enhanced root planing” (removing tartar from pockets). Local anesthetic is used. The tools used to actually remove the root deposits (tartar) vary widely from clinician to clinician, as well as the actual proficiency and skill. Results and long term results will vary due to skill level, experience, and technique. This procedure may include adjunctive therapies such as antibiotics, either placed beneath the gums or given systemically. While there is some impressive published research to support perioscopy, it has still not been embraced by the main stream dental profession as a viable treatment option for periodontal disease. In some offices perioscopy is only employed when all other methods have been exhausted rather than utilizing it as a first phase treatment approach.
Perioscope in hand (miniature fiber optic) - 48X magnification on a 10,000 pixel color monitor allows for real time pinpoint tartar removal in deep gum pockets.
PerioProtect – a non-definitive approach for first phase treatment, but an impressive maintenance program if necessary.
PerioProtect is a relatively new treatment non-definitive option for patients with unresolved periodontal infections and periodontal pockets. This professional treatment involves having a custom mouth tray fabricated by the dentist for the patient to use at home. These trays are then filled with antibiotics, or antimicrobials such as hydrogen peroxide (depending on the need), and are worn several times a day, up to several hours a day. PerioProtect is intended to be an adjunctive therapy with traditional root planing and periodontal maintenance cleanings. No surgery is performed to correct pockets and no dental endoscope is employed to aid in the removal of tartarand biofilm from deep gum pockets, therefore periodontal infections and gum pockets may continue to be a chronic problem. PerioProtect trays are supposed to kill bacteria in deep pockets, but the depth that the medicament will reach remains questionable due to lack of research. The company has gone to great lengths to market their product but to date have only demonstrated their medicament reaching one pocket of 6mm. Tartar trapped under the gum in deep pockets is not removed by this product, therefore results may be temporary.