Hi,

I have been put on a regimen of 90 days of periostat (which is a mild dose of tetracyclin - 20 mg. in the a.m. and 20 mg. in the p.m. for 90 days). I am a nervous wreck. I know I hadn't been to the dentist is a while but I never figured I would have this bad of a gum problem. My dentist told me that he wants to do scaling and root planing more often and that is goal is to keep everything as clean as possible so that I don't have any build up under the gum line. He said the next time I go back for a checkup/cleaning/scaling/rootplaning (in July) he wants to take antibiotics and put it directly in the gum line. I read something about this recently but I don't remember exactly what they said about it. It is a way to treat the disease I guess and attack it aggressively. I am so afraid I am going to lose my teeth.

Can anyone tell me if they have had it done or if they know of this treatment? Is this the norm?

Thanks.

P.S. I go to an IV dentist so I don't feel anything during the treatment.

Periodontal disease is often treated by a combinations of things. It really depends on the severity of the case, the individual response to "conservative" or non-surgical procedures, the individuals risk factors (smoking, diabetes) for disase, homecare and how progressive the doctor is ect.
Periostat works great from what I have seen. But if homecare is not great the infection will often reoccur after the 90 day treatment is over.
Also it sounds like you will need some scaling and root planing with adjunctive locally delivered antibiotics (placed in the deeper, infected pockets). Depending on the type, they also work pretty well and are clinically effective.

However, the outcome of your disease ultimately lies in your hands. After scaling and root planing, homecare is very important. And often with perio disease people have to work harder to keep them clean. Follow the dentist/hygienist instructions and continue regular visits to keep the disease under control. This will save your teeth.

Good luck

Thanks for your replies. I am working harder at home. I bought a "Sonicare" brush at the advice of the dentist. I am being sure to brush correctly (with the brush angled at the gum line). I am trying to floss every night, although there are a couple of spaces where I cannot get the floss between the teeth (not even waxed floss). I am trying hard to do what I must.

My brother in law, who is in his 50's had it very, very bad. He was diagnosed with leukemia so I am sure the cancer/treatments had something to do with it. He is in remission and he has been trying very hard to take care of his teeth at home as well as keeping all his appts. with his peiodontist every 3 mos. He went this past Saturday and the periodontist said his teeth and gums look GREAT. I hope that I eventually hear the same. <u dentist never used the word "gum disease" I don't think he wants to alarm me as I am an extremely apprehensive patient but he did say he needs to see me more often for gum work and that he wants to put me on these pills to attach my "gum issues" aggressively. He did scaling and root planing. I am scheduled to go back in July (July 30th).

MY NEXT QUESTIONS IS, NOW THAT I have this problem will I need SRP every 3 mos? I read that it cannot be cured ever. Is this true? Is it not reversable?

Thanks.

After you finish your rounds of scaling and root planing, the dentist/hygienist will recommend a maintenance intervals (supportive periodontal treatment or "perio maintenance visits") They are similar to the patient as a "regular cleaning" but since you have some areas of gums disease these areas are monitored and retreated if necessary by the dentist or hygienist so they are very different. It varies by individual but most commonly you see 3, 4 or 6 month intervals. Research has found that it takes about 9-11 weeks for bacteria to get back down under the gums after therapy so the closer you are to that time frame the better the prognosis is for diseased sites. Most insurances will only pay for 2 "cleanings" a year so the rest is out of pocket. That is where you see patient compliance waver.

The disease can get better but does not entirely go away since once you have bone loss you have it for life (unless you have surgury). So the goal of scaling and root planing/perio maintenance (non-surgical periodontal treatment) is to maintain the disease so you do not loose anymore bone. Even though you have lost bone the periodontal probing numbers can improve (going from 6mm to 4mm) with no bleeding. This will make it easier for you to keep clean at home on a continuous basis and easier for the dental team to treat.

Sounds like you are doing everything right, that is awesome. It is hard work but its worth it :)

I'm committed to trying but I don't know what will happen. I only hope it gets better over time. Thanks for your advice. He didn't say anything to me about bone loss but I assume that if I have this problem, there is bone loss.

I am thankful that I have this site!