Class III Moderate Periodontitis with Halitosis

By: Jamie Rotunno, RDH

February 8, 2018

The Challenge:

To reduce periodontal pathogens, a significant cause for the periodontal inflammation and halitosis.

The Background:

  • Age: 61
  • Sex: M
  • Medical History: None given
  • Family History: None given
  • Last Dental Exam: 3 months ago
  • Home Care: Manual toothbrush daily and flossing on & off
  • Chief Complaint: Halitosis
  • Periodontal Assessment: Type III generalized with localized Type IV periodontitis. Patient has history of periodontal therapy in past with 3 month re-care intervals. The patient had generalized heavy, bleeding on probing and tissue was bulbous & erythematous.

The Solution:

  • Pre-therapy MyPerioPath®, Celsus One & OraRisk® HPV on 7/13/2017
  • Perio therapy: Initially recommended 12 hrs of non-surgical periodontal therapy due to Celsus One Inflammation Index High. However, only 4 hrs were needed due to patient’s home care compliance (see Home Care below). The therapy consisted of microsonics, irrigation and laser therapy.
  • The systemic antibiotic option would be considered if patient didn’t respond favorably to the non-surgical periodontal therapy.
  • Home Care: Perio Protect trays 2-3x/day with a vibramycin (doxycycline gel) for 6 weeks following the non-surgical periodontal therapy, PerioProtect trays 2x/day with 1.7% peroxide gel, waterpik daily and electric toothbrush 2x/d
  • Perform MyPerioPath® (aka MyPerioProgress®) post-therapy test on 11/09/2017

The Result:

Clinically there was a significant decrease in bleeding on probing and pocket depth reduction was amazing. The MyPerioProgress showed pathogen reduction from 8 above threshold to 0. I enjoy seeing the patient’s reaction when they realize they have some control over what is happening. When they do the expected increased home care and reduce therapy time, they are thrilled. This re-enforces home care for maintenance. In this case, the patient’s partner was tested and revealed periodontal pathogens very similar to this patient, however the partner has refused treatment at this time. This places our patient at risk for relapse especially due to the Celsus One results.

About the Author:

Jamie graduated from Colorado Northwestern Community College’s Dental Hygiene program in 2015. Shortly after, she found herself immersed in an amazing opportunity that is McCreight Progressive Dentistry. She is laser certified through the World Clinical Laser Institute and Perio Protect, LLC. Jamie’s career in dentistry began in 2007 as an orthodontic assistant a and later transitioned into a treatment coordinator position. In 2010, Jamie decided to continue her education and follow her passion and true calling, by beginning dental hygiene school. Jamie’s passion for dentistry shows through her clinical skills and patient interactions. She loves making the world brighter one smile at a time! Jamie’s is both a national and international lecturer discussing advanced dental hygiene concepts as well as a key opinion leader with several dental companies. Contact Jamie at