NON-SURGICAL THERAPY FOR GINGIVITIS AND PERIODONTITS

non-surgical-therapy-for-gingivitis-and-periodontits

1.ROUTINE ORAL PROPHYLAXIS- INCLUDES SCALING AND ROOT PLANING

Scaling and Root planing is the conventional and most basic form of periodontal therapy.It is the non-surgical therapy commonly referred to as deep cleaning of the gums. It involves the removal of the causative factors like the dental plaque, the toxins produced by the bacteria, and the calculus/tartar on the root surfaces, thus establishing a clean, and smooth surface, which helps in resolving the inflammation. This can be achieved by using hand instruments called scalers or curettes, or electrically driven instruments called ultrasonic scalers. They vibrate at a frequency that breaks down bacterial cell membranes and removes both plaque and calculus.A prophylaxis refers to scaling and polishing of the teeth in order to prevent oral diseases. Polishing is done with pumice cups and polishing abrasive paste and only helps in removing some plaque and stains, yet forms an important part of the procedure.

2.CURETTAGE

Procedure used to remove the soft tissue lining of the inflamed periodontal pocket to reduce the granulation tissue, edema and promote healing. It is usually done with hand curettes, after administering local anesthesia.

3. LOCAL DRUG DELIVERY OF ANTIBIOTICS IN SHALLOW PERIODONTAL POCKETS

Since periodontal disease is a bacterial infection, certain microorganisms are highly tissue invasive and difficult to eradicate with mechanical instrumentation. Thus, there is a need for prescribing adjunctive antibiotics at times. A concentrated form which can be applied locally in the form of gels, fibres, chips, etc,is used for few cases where it can be useful as an adjunct. This prevents passage of the drug through the systemic route, allows increased local concentration, thus having a local antimicrobial effect and reduction in the gum pockets.

4. SPLINTING OF MOBILE TEETH

A common sequel of periodontitis is mobility or loose teeth. Sometimes, it can be increased due to trauma. Splinting is the use of thin niti wires, tooth coloured restorative material, or ribbo-like fbre to strenghthen or join all the mobile teeth and redistribute the biting forces as the weakened teeth cannot bear the forces.This procedure enables the patient to eat, bite properly because of the improved stability, also helps in improving speech, and esthetics as loose teeth can affect the overall health and confidence of an individual.

5. ADJUSTMENT OF MINOR OCCLUSAL PROBLEMS (DISCREPANCY IN THE BITING SURFACES OF TEETH)

6. MANAGEMENT OF SEVERE DENTINAL HYPRSENSITIVITY

Dentinal hypersensitivity is the sensation that emanates when a cold, sweet stimulus leads to irritation of the nerve endings, which are present in the second layer of the tooth, that is the dentin. The most common cause is thinning down of enamel, open dentinal necks due to caries or gum disease, root exposure due to faulty tooth brushing or due to gum disease, following gum surgery, or eating very sour foods, which leads to erosion of enamel. Patients often complain of moderate to severe sensitivity, or even dentinal shocks. Often it can be a cause of constant worry and discomfort to the patient. Patients with hypersensitivity are asked to refrain from eating extremely cold, or sour foods, use soft tootbrushes, and use dentifrices or pastes having agents to block the dentinal tubules. Common agents are Pot. Nitrate, stannous fluoride, novamin, arginine, which are applied daily so that the agent settles into the dentine and blocks sensitivity. Of late, use of lasers along with desensitizing pastes are used as they lead to melting of dentine and blocking the impulses.