Ph. I Perio Therapy: Mechanical Plaque Control

Ph. I Perio Therapy: Mechanical Plaque Control

1. Phase I Therapy

   • alter or eliminate periodontal microbial etiology or contributing factors to gingiva or periodontal disease
   • Stop disease progression
   • Allow dentition to return to healthy comfortable state
   • =Initial therapy =non-surgical therapy =case-related therapy
   • Plaque Control
   • Removal of Plaque & Calculus
     • MPC
       • use scalers, currettes, ultrasonics; evaluate, reinforce, improve px OH skills
   • Prevention, Intervention, successful care are critical
     • plaqe biofilm mgt. is key Failure to remove plaque=mature biofilm

2. Plaque/perio disease Facts

   • Prevalence in US
     • >75% adults have gingival bleedin, calculus, poor OH; >82% adolescents have overt gingival inflammation/bleeding
   • gingivitis is reversible
     • but ppl with overt inflammation= higher freq. of attachment loss
   • No Adult is plaque free
     • over 1/3 = visible plaque on 90%+ tooth sfx
     • after 1-3 min of self care adults only have a plaque reduction of 1/4- 1/5
   • prevelance & severity increase w/
     • Age
       • unclear whether its due to disease progression process or cumulative effects of time
     • socioeconomic status
       • Low $ > High $
     • Gender
       • M>F
   • Unequal distribution of care
     • Economics
     • location of prof. care
     • personal beliefs, fear, relative value of dental care
       • 40% of Americans do not seek dental care

3. Plaque Control

   • Significance
     • more plaque=more gingiva inflam.
       • plaque removal reverses this
     • Regular use of OH is req'd for proper supragingival accum.
     • Perio disease can be prevented/delayed by proper OH and maintenance program
     • perio disease progresses w/ lack of plaque control
   • brushes & other devices are most dependable mode
     • Public spending on OH products >$3.2 Bill; advertising >$272 mill
   • chemicals that inhibit plaque/calculus formation (mouthwash, dentifrice, etc.) are adjunctive agents to mechanical techni.