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Gum Diseases

Why is there a difference in treatment of SRP

03/26/2007

Question:

Why there is a difference in treatment of Scaling & RP?

I am 30 yr old female. Periodontists suggested to have scaling and root planing as gums pockets were 4,5 and 6 mm . S & RP Treatment was divided into two parts,left part was cleaned by one hygienist and right part was cleaned by another hygienist.

In my left part, I started to see improvement in my gums the very next day, they were more firm and red. But in my right part even after 4-5 days also they are still pink,pluffy. It is looking similar to what it was before treatment.

Did another hygienist didn`t did scaling properly ?

When it is the same mouth, why treatment of one side is better than other ?

I insisted on perscribing me with prescribed mouthwash as my pockets are quite deep, but they did think it will discolour my teeth and hence not necessary. Isn`t the healthy mouth more important to maintain my perio disease ?

What other things can I do besides brushing three times, flossing once and using listerine twice a day to get maximum benefit from the S& RP treatment ?

Thanks so much for the help.

Answer:

Root planning is performed under local anesthesia. The clinician (this can be either a periodontist, dentist or hygienist) needs to reach root surfaces where the patient presents >4mm probing depths (pockets) with small hand instruments and tries to remove both plaque, calculus and contaminated cementum+dentin structures. This procedure is performed by using tactile senses (meaning that the clinician cannot directly see the work area but feels and checks the surface for smooth/polished texture). 

Studies show that there are differences in treatment outcomes based on the clinician's experience, the anatomical location, the severity (depth) of the problem. 1 week is a very short period to determine treatment outcome. We generally wait 4-12 weeks and re-probe the area to re-evaluate periodontal health.  If the patient still presents deep pockets, we recommend periodontal surgical treatment alternatives so that we can surgically open the area. This allows us to see the area directly and use different treatment modalities to eliminate pocketing. 

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Response by:

Binnaz   Leblebicioglu, DDS, MS, PhD Binnaz Leblebicioglu, DDS, MS, PhD
Associate Professor of Periodontology
College of Dentistry
The Ohio State University