Comprehensive Periodontal Disease Treatment = SRP +Antibiotic
Scaling and Root Planing (SRP): The Foundation of Treatment
Why isn't scaling and root planing (SRP) enough to eliminate persistent periodontal infections?
Even after the very best professional SRP, the red complex bacteria responsible for the active infection and inflammation remain, multiply, and can return to baseline levels within days.
Use of scaling instruments is limited in areas of restricted access and cannot eliminate periodontal bacteria.
As with many active infections, periodontitis should be treated with an antibiotic, like ARESTIN®.
Limitations of SRP
No matter how expert our technique, the instruments we use during SRP cannot reach all the tooth surfaces that harbor bacteria, due to:
- Furcations
- Root flutings
- Adjacent teeth in close proximity
- Microscopic irregularities in tooth surfaces - especially at cementoenamal junctions
- Restorations
Areas of restricted access create reservoirs for bacteria and residual biofilm left behind after scaling
What about lasers?
Soft tissue lasers have applications - and benefits:
- Delivery of multiple, minimally invasive soft tissue procedures for oral surgery, tissue fusion, implant exposure, and incisions
- Improved coagulation leading to better visualization of the surgical field
- Sulcular debridement/curettage to remove infected soft tissue in the periodontal pocket
But there is insufficient evidence that lasers result in greater reductions of subgingival bacteria vs traditional mechanical treatments:
Microbiological limitations of periodontal laser surgery include:
- Requirement of a direct hit by the energy beam to remove bacteria is made difficult by hard-to-access areas and anatomical limitations
- The density, thickness, and protective matrix of subgingival biofilm
- Persistence of subgingival bacteria following laser procedures (As with other mechanical therapies, bacteria remain, multiply, and can return to baseline levels within days)
