During a recent national speaking engagement, a hygienist told me that they used to do clinical laboratory testing. “We stopped doing it because when we tested months later, the bacteria had come back and the patient had an active infection again. We decided ‘it’ wasn’t working so we stopped,” she explained.
I thought to myself, wow, this is very interesting and a perfect example of ‘throwing the baby out with the bath water’! It wasn’t the clinical laboratory testing that wasn’t working, it was the therapy being provided that was falling short.
When a patient has a periodontal infection, it’s essential that we remember these bacteria burrow into the non-keratinized gingival col, begin to reproduce and alter the integrity of the epithelial tissue. These bacteria cause chronic inflammation which is defined as simultaneous healing and destruction. In some cases, we have been treating patients for many years who have experienced bleeding every time we provide a prophy. This would indicate that they have not only a chronic infection, but very well established virulent sub gingival biofilm.
Think with me on this… if a patient seeks care with their physician for a sinus infection or pneumonia and the bacteria involved do not respond with the initial round of treatment, what do they do? They certainly don’t throw their hands in the air and say, “Oh well that didn’t work, there is nothing we can do.” If your MD told you that, you would find another one.
Perhaps it’s the clinical protocols and frequency of visits that are not sufficient to control the sub gingival bacterial biofilm. Did you know that once the sub-g calculus has been removed, an additional 30 – 60 seconds of ultrasonic instrumentation, per pocket, is necessary to completely dismantle and destroy the biofilm? Calculus removal is only the first step. We must address the living organisms in the pockets that are causing the disease activity.