Alternative Gum Disease Treatment Options

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.

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.  Long-term results will vary due to skill level, experience, and technique.  As well as host factors. 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 not
been embraced by the mainstream 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.

PerioProtect is a 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 tartar and
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.