Re: Is this a valid regimen for periodontitis?

ckouza@xxxxxxxxxxxxxx wrote:
What if targeting ANY bacteria is the EXACT OPPOSITE of what a patient with periodontitis should be doing?

This is just my layman's supposition.

Maybe someone with periodontitis should not use any topical or internal medication, OTC or prescribed, that targets bacteria.

Maybe these agents are actually counterproductive.

I've posted here before, and I have 5mm pockets. My new regimen has one simple goal: Keep my teeth clean.

I brush with tap water for about fifteen minutes, twice a day (when I'm watching TV or something).

I use an extra soft toothbrush.

I use that puffy "superfloss" twice a day (again, when I'm on break or watching TV).

I brush for two minutes with fluoride toothpaste and floss with Glide before bed.

In other words, don't directly target good and bad bacteria ... Improve the conditions in your mouth to minimize the damage of bad bacteria. Any thoughts from the professionals?



This is of course the traditional approach, and as far as it goes, it is valid. The backbone of traditional periodontal therapy is careful debridement of bacterial-laden deposits on the roots of the teeth, pocket elimination therapy to minimize the anatomic sites subject to infection by pathogens, followed by meticulous and regular oral hygiene, and regular professional followup This removes the more or less organized bacterial plaque, without which (it is said) periodontal disease will not exist.
This works well for some patients, but not all. The reasons for variable outcomes probably include variable levels of oral hygiene, professional expertise, and also microbial virulence and host factors (immunology). So what to do with patients who have done all this and found it not effective?
Antimicrobials are used, but generally they are used short term to eliminate superinfection and bacterial resistance. Some antimicrobials are used longer-term, but generally in doses subtherapeutic as antimicrobials, because they have been shown to inhibit enzymes implicated in periodontal breakdown. These seem to work, but are far from a panacea.
As you can see from my description, there is not yet a "magic bullet" to stop the periodontal process. For most patients, your "simple goal" will be very effective for those patients who can achieve it. However, after 31 years I must conclude that for most patients that "simple" goal just ain't so simple.

Steve
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