16 Oct, 2011
Periodontal Disease and Perio Protect
Periodontal disease effects most people to some degree. Research now supports the role of periodontal disease as a contributor to Diabetes, Heart Disease, Stroke, Preterm and Low Birth Weight Babies, Respiratory Disease, and Alzheimer’s disease. It is the most common reason why adults lose teeth. Symptoms include painful and swollen gums, bleeding from the gum tissue, tooth mobility, recession of the gum tissue, and chronic bad breath. Periodontal disease is caused by the biofilm (plaque) found on the surfaces of teeth and in the periodontal pockets. Traditional treatment includes home care with the tooth brush, floss, interdental stimulators, oral irrigators, and other devices. Efforts to get rid of the biofilm have been unsuccessful, until now.
Perio Protect is a FDA approved medical device called Perio Tray. Impressions are taken of your teeth and gum tissue and the models are sent to a FDA approved laboratory where the Perio Trays are made. The trays form a positive pressure seal around the periodontal pocket that forces the medication in the tray into the periodontal pockets, destroying the biofilm. Hydrogen peroxide is used as the antimicrobial to kill the bacteria. A solution of tetracycline (Doxycycline) is used to help generate bone growth in areas that have lost bone due to periodontal disease.
The Treatment Protocol:
The trays are available 2 – 2 ½ weeks after the impressions are taken. Which medications, and the length of treatment depends on the severity of the periodontal disease. Typically the trays are worn for 10 minutes, morning and night. (One side effect of treatment with hydrogen peroxide is that you will get a whitening effect over time.) Because the trays work by making a seal around your teeth, they may need to be replaced as your gum tissue heals. The biggest objection we hear is, “Do I have to do this twice a day for the rest of my life?” I think that you will want to do the treatment daily, because it makes your teeth and gums feel good. But remember, wearing them some is better than never wearing them. If you miss a day, it is not a problem.
The complete Perio Kit is $600. This includes upper and lower trays, 1 tube of gel that will last approximately one week, a carrying case, a home storage tray, eye dropper and bottle, proxabrush, 2 mixing brushes, and instructions. Replacement trays are $550 if needed. You will need to purchase larger tubes of hydrogen peroxide that will last several months ($20) and Vibramycin Syrup a brand of Doxycycline ($40), if prescribed.
We will do our best to get insurance coverage for the treatment, but the treatment is new and may not be a covered benefit. Perio protect is still considerably less expensive than what your share of periodontal surgery would cost even with insurance payment.
About The Daily Use of an Antibiotic:
Tetracycline is used in a very low dose. The therapeutic dose of tetracycline is 1000 mg – 2000 mg / day. The dose that you will get with Perio Protect trays is approximately 9 mg daily, 99% of which you will rinse out. Tetracycline stimulates the cells that lay bone down, and inhibits the cells that remove bone. This is the reason that tetracycline is placed in the trays. Tetracycline should NOT be used if you are pregnant or trying to get pregnant. It can cause stain in the developing teeth of your child when given in therapeutic doses. It is not know if you will get the same stain in small doses, but it is not worth taking a chance.
Hydrogen Peroxide is very safe to use in the relatively small dose (1.7%) that is in Periogel-H. Like all medications, it can be misused. Use only a small amount in your trays to avoid getting excess hydrogen peroxide in your mouth. If you do get excess, your tongue may turn dark, a condition called black hairy tongue. This will go away as soon as you start using LESS hydrogen peroxide in your trays. It is caused by an overgrowth of fungus that produces a black pigment. Gently brush your tongue and in several days it will be gone.
The impressions have to be perfect, so it is possible that it will take more than one attempt to get a good impression. In some cases we may use the impressions to make “custom trays” to get a perfect impression. Please be patient. We want the impressions to be perfect so the appliance will work correctly