Non-surgical treatment

The emphasis of our practice is conservative periodontal therapy. Very often, early stages of periodontal disease are effectively treated with non-surgical periodontal therapy.

This involves the removal of bacterial plaque and Tartar which is present at and below the gum line.

Periodontal “gum” disease is typically a chronic infection caused by bacteria that works its way under the gum line, destroying the gum and eventually the bone that supports the teeth. Because the bacteria can firmly attach to the tooth roots under the gum line, regular dental cleanings maybe inadequate to resolve the infection. In these instances, root planning, commonly referred to as “deep cleaning” becomes necessary.

Unfortunately, periodontal infections are usually silent, and can be present for many years, without any significant symptoms like pain. This is why regular visits to your dentist are important especially if other health problems are present, like heart problems or diabetes.

However, subtle signs such as red or swollen gums, gums that bleed when brushed or flossed, chronic bad breath or loose teeth can alert you to the presence of gum disease and the need to see a dentist.

Our practice has made great strides in non-surgical management of periodontal problems. With the following innovative techniques, we are able to achieve periodontal health for many our patients in a simple, non-invasive and affordable manner.

Non-surgical therapy aims to eliminate both living bacteria in the microbial biofilm and calcified biofilm microorganisms from the tooth surface and adjacent soft tissues.

AAP treatment guidelines stress that periodontal health should be achieved in the least invasive and most cost effective manner. This is often accomplished through Non-surgical periodontal treatment.

The various methods used in non-surgical therapy, such as hand instrumentation, ultrasonic and sonic scalers, and ablative laser therapy.

Non-surgical periodontal therapy (NSPT) is the cornerstone of periodontal therapy and the first recommended approach to the control of periodontal infections.
It is also known as “cause-related therapy”, “phase 1 therapy or etiotrophic phase” and “initial therapy”.

It is defined as “plaque removal, plaque control, supragingival and subgingival scaling root planing (SRP), and adjunctive use of chemical agents”.

Although NSPT has evolved over the years, it is still considered to be the
“Gold standard” to which other treatment methods are compared.

However, conventional mechanical debriment procedures do not remove all periodontopathic bacteria from the subgingival environment, especially those in inaccessible areas such as furcations, grooves, concavities, and deep pockets.

It appears that the effects of mechanical therapy might be augmented using antimicrobial agents which further suppress the remaining pathogens.

A recent advance which is receiving much attention is the application of lasers photodynamic therapy (PDT), and hyper baric oxygen therapy (HBOT) in NSPT.

Types of NSPT procedures

During a typical check up your dentist or dental hygienist will remove the plaque and Tartar (plaque that builds up and hardens on the tooth surface and can only be removed with professional cleaning) from above the gum line of all teeth. If you have some signs of gum disease, your dentist may recommend professional dental cleaning more than twice-a-year. Dental cleanings are not a treatment for active gum disease. They are, though, an important preventive measure that can help you stave off its development.

To effectively take care of periodontal disease. The initial treatment is typically scaling and root planning; this treatment exists to remove Tartar at or below the gum line. Standard cleanings and polishes only deal with the plaque above the gum line, and these procedures aren’t effective on their own to truly gum disease.

Scaling is a necessary first step in the treatment process, and it clears the way for a deeper clean. “Root planing” involves cleaning plaque from below the gum line that is most often the culprits in periodontal disease. Local anesthetics are also used to numb the area for greater comfort.

Scaling and root planning are a basic approach to effectively treating the disease and allowing the gums and surrounding bone to heal properly. Collectively, these methods represent the fundamentals of non-surgical periodontal therapy.

Once successfully completed, the scaling and root planning procedure should leave patients feeling little or no discomfort. After 6 weeks, the dentist will schedule an appointment to examine the patient’s response to the treatment. If the non-surgical therapy effectively eliminates the gum disease, The only further requirement will be periodic maintenance every 3-4 months. With simple scaling and ultrasonic cleaning, and some home care instructions, the gum disease will be a thing of the past.

Scaling and root planning is sometimes followed by adjunctive therapy such as local delivery antimicrobials, systemic antibiotics, and host modulation, as needed on a case-by-case basis.

Most periodontists would agree that after scaling and root planing many patients do not require any further active treatment.

However, the majority of patients will require ongoing maintenance therapy to sustain health.

Both hand instruments and ultrasonic instruments are capable of dramatically reducing the numbers of subgingival microorganisms. The outcome of any treatment method is determined by complete and adequate access to pocket areas, The time devoted by the operator to the procedure, and the thoroughness of the procedure.


Ultrasonic scaling became an acceptable alternative to hand scalers by cold iron NB, 1967.

 
 

 

 

It is known as GBT (guided biofilm therapy), removes biofilm, stains and young calculus on natural teeth, restorations and implants. Cleans and polishes in one single procedure.

 

Using the erythritol plus powder, the Airflow supragingival hand piece is able to remove biofilm in the sulcus area & shallow pockets up to 4 mm, on the tongue and gingiva as well as on the palate-all in a minimal-invasive way for maximum patient comfort.

The classic comfort powder is able to remove remaining heavy stains & pigmentations caused by high intakes of coffee, red wine and smoking.

With rubber cups and polishing paste it is impossible to clean:

-Interdental spaces, especially in patients with mal-aligned teeth
-Exposed tooth necks
-Pits and fissures
-Orthodontics brackets

 

GBT APPLICATION WITH AIR FLOW

• Air flow is a predictable procedure for the removal of biofilm, stain and young calculus from teeth, implants, restorations, orthodontic appliances and from supra and subgingival areas.

• Air flow with plus powder can be used safely and comfortably on all soft tissues including attached gingiva, mucosa, tongue and palate.

• Air flow is the only technology that removes biofilm from inaccessible areas such as deep pits and fissures, interdental spaces, misaligned areas, below crown margins, around peri implant sulcus, recessions and orthodontic appliances efficiently and in a minimally invasive way.

• Air flow helps early detection of white spots and caries avoiding unnecessary aggressive dental treatments.

• Air flow preserves the integrity of the natural teeth, implants, restorations and soft tissues.

 

• Air flow with plus powder is the only solution to clean biofilm around orthodontic appliances.

• Air flow provides a 100% accessibility around orthodontic brackets without
The need to remove wires, ligatures or elastics.

• Air flow with plus powder safely and efficiently removes all biofilm without damaging or altering the surface of the bracket hence preserving its full bond strength.

• Plus powder is comfortable on the gingiva and soft tissues increasing patient compliance.

 

• Air flow with plus powder is the unique approach for regular implant maintenance providing efficient and safe biofilm removal.

• Air flow with plus powder is minimally invasive with no risk of scratching implant surfaces, abutments or prosthesis.

• Air flow using plus powder is comfortable and safe around soft tissues.

 

The enamel prisms of the natural tooth enamel are easily recognizable- the photo shows the remnants of the bacteria killed off with sodium hypochlorite.

The vital enamel prisms have been polished away. Pastes have caused scratches. Biofilm has been spread into natural crevices. Overall abrasive pastes cause a loss of valuable enamel no improvement of the dental surface.

While after cleaning with airflow powder plus the biofilm has been completely removed with airflow. The surface is clean down to the pores. No abrasion.
The enamel prisms remain intact and the surface is perfectly smooth. The tongue no longer feels any roughness and there is no need for polishing with (abrasive) pastes.

This saves enamel and treatment time.

 

Additional benefits of Airflow include

-Stains are removed three times faster than with other hygiene treatments.
-Making whitening treatments more effective by removing build up that could hinder bleaching.
-No vibrating instruments or heat are used, so patients with sensitive teeth remain comfortable.
-Helps prevent dental disease by preventing periodontitis, removing plaque, and keeping your gums in a healthy state.
-Orthodontic patients receive such a gentle but thorough cleaning that their teeth can support future bonds and sealants.

 

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