Non-Surgical

“The AAP treatment guidelines stress that periodontal health should be achieved in the least invasive and most cost-effective manner.”. This is initially, if thought to be an effective form of care, accomplished in our office through non-surgical periodontal treatment. Non-surgical periodontal (NSP) or soft tissue management (STM) is grouped in a category called initial therapy (IT). This includes scaling and root planing (SRP-a careful cleaning of the root surfaces to remove plaque and calculus [tartar] from deep periodontal pockets and to smooth the tooth root to remove bacterial toxins), followed by adjunctive therapy such as local or systemic delivery of antibiotics, as needed on a case-by-case basis. The discussion to go forward with this type of care is based on sound diagnostic reasoning, not as an alternative for surgery based on fear. The rational for care, diagnostics and the end result is our primary focus.

Most periodontists would agree that after scaling and root planing, many patients, with slight periodontitis do not require any further active treatment, including surgical therapy. However, the majority of patients will require some surgery and ongoing maintenance therapy to sustain health.

Non-surgical therapy does have its limitations, however, and when it does not achieve periodontal health, laser or osseous surgery may be indicated to restore periodontal anatomy damaged by periodontal diseases and to facilitate oral hygiene practices. Since periodontal disease has few symptoms, it is necessary to stop its progress before it is too late. Many factors are taken in consideration before therapy is recommended. The Kodak CT scanner makes these decisions easier and safer when combined with all our tools and tests.

Facts from the AAP regarding a tray delivery device marketed for the treatment of gum disease.

American Academy of Periodontology is an advocate for the periodontal and general health of the public and promotes excellence in the practice of periodontics. As the recognized authority in the specialty of periodontology, the AAP is an information resource regarding new and emerging technologies used to diagnose and treat periodontal diseases. We invite you to browse Perio.org for more information on periodontal diseases and their treatments. The Academy also encourages you to speak with your periodontist or dentist for more information regarding your risk for being affected by these chronic inflammatory conditions.

Recently, questions have been raised in regards to the Perio Protect® tray, a product marketed for the treatment of gum disease. The following fact sheet aims to set forth some facts regarding this product.

The Perio Protect® device is a custom-fit tray made by a specialized dental laboratory from impressions of the patient’s mouth taken by a dentist. The medications placed in the tray are determined by the dentist.

• The Perio Protect® tray was cleared for marketing by the Food and Drug Administration (FDA) on grounds that it is substantially equivalent to a previously marketed disposable fluoride tray. This type of tray is traditionally used to prevent tooth decay.
• The FDA clearance process did not determine that the Perio Protect® tray has been proven to be a safe or effective modality for the treatment of gum disease.
• The Academy is unaware of any randomized, controlled clinical trials evaluating the efficacy of this therapy that have been published in a peer-reviewed* scientific journal with a generally accepted scholarly reputation.
• Numerous clinical studies have suggested that topically applied medicines do not reach the source of periodontal infections.

*Note: Peer-reviewed journals publish articles that have been reviewed by experts in the field. The peer-review process is intended to support publication of relevant findings and acceptable interpretations, while guarding against publication of unwarranted claims and personal views. Professionals look to the peer-review process to support solid scholarship in their field or discipline.