3.3 Advanced Subgingival Anti-Microbial Therapy

True

T/F: Although there is no evidence that irrigation reduces plaque, there is evidence that it can change the quality of the plaque and reduce BOP

True

T/F: When recommending an oral irrigation system to patients, it should be emphasized that they are an adjunct to mechanical plaque control and not a substitute

Viadent

Which chemotherapeutic mouth rinse was pulled off the shelves because of its link to leukoplakia and possibly SCC?

Cepacol/scope

This mouthrinse has shown short-term plaque reduction but has also shown to cause tissue sloughing in patients and does not have an ADA seal

Plax

This mouth rinse is high in sodium and doesn’t have the ADA seal or any real clinical benefits

Hydrogen peroxide

Mouth rinse products such as amosan, oxyfresh, and orthoflur use which ingredient that has been shown to be carcinogenic with chronic use?

Listerine

Which mouth rinse uses essential oils and has been shown to reduce plaque and gingivitis by about 25%?

Crest pro-health

Which mouth rinse has been shown to reduce both plaque and bleeding but can also cause brown staining of teeth and increase in calculus?

Chlorhexidine/perioguard/peridex

Which mouth rinse has shown to cause lysis of gram - and gram + organisms but has a side effect of staining teeth and soft tissue?

True

T/F: Unsupervised use of antimicrobials over extended periods of time is not recommended and its use should be discontinued when gingival health is achieved

True

T/F: Professional subgingival irrigation is used as an adjunct therapy that may provide additional clinical benefits but have not been proven conclusively

• Initial therapy

• At re-evaluation

• Recurrent disease

• Peri-implantitis

• Periodontal abscess

• Preparation for surgery

When can LDAs be used as adjunct therapy?

PerioChip

An LDA that is delivered in chip form containing 2.5 mg CHX gluconate that biodegrades after 7-10 days. Is used to help reduce pocket depths in addition to SRP

Rounded end

When inserting a periochip, which end is inserted to the base of the pocket?

10 days

When placing an LDA, how long should interdental cleaning be avoided?

Arestin

An LDA with 1 mg of mini cycling that is dosed in a single-unit cartridge as a dry powder to reduce PPDs

• Pregnancy and nursing

• Children

• Pts with tetracycline or minocycline allergy

What are the contraindications of arestin?

Headache

What is the most common side effect of arestin?

12 hours

How long should brushing be avoided after applying arestin?

Doxycycline gel

An LDA using 10% doxycycline that uses a 2-syringe system for reduction of PPDs and BOP and gain of CAL

100

How many times does the 2-syringe system of doxycycline be shaken after attaching the cartridges together?

One week

After applying doxycycline gel, for how long should oral hygiene in the area of treatment be avoided?

False

T/F: RDH are authorized to place tetracycline fibers as an LDA treatment

Periostat

An LDA containing 20 mg doxycycline in tablet form taken BID

• Warfarin users

• Birth control (can reduce efficacy)

• Children

• Pregnant or nursing women

• Pts with tetracycline allergy