Periodontal Disease Report--
Periodontal Disease Report--
Evaluation & Treatment Options
Date: ___________________
Your gum disease classification:
□ Healthy; no disease present
□ Gingivitis
□ Chronic Periodontitis
o Number of areas with 5mm or deeper periodontal pockets: ______
o Loss of supporting bone around teeth
Your home care options:
□ Sonicare( Electric Toothbrush—Use two times or more every day; full two minute cycles.
□ Floss—use at least once every day.
□ ProxaBrush—use at least once every day.
□ Stimudents—use at least once every day.
□ PerioAid—use at least once every day.
□ Rubber tipped stimulators—use at least once every day.
□ Mouthrinse
o Chlorhexidine mouthrinse—Peridex or Perioguard.
o Listerine
o ACT
□ WaterPik
□ Home Fluoride gel or paste—PreviDent, Gel-Kam.
□ Oral-B Rembrandt Toothpaste
In-Office Non-Surgical Treatment Options:
□ Preventive Cleanings—to prevent gum disease.
o every 6 months
□ Maintenance Cleanings—after active treatment of existing gum disease, to help keep infective bacteria under control.
o every 3 months (long-term)
o every 4 months (long-term)
□ Scaling/Root Planing—a “deep cleaning” for periodontal pockets 5mm and deeper; using anesthetic, ultrasonics, irrigants, and specialized cleaning instruments.
□ Arestin(—localized bioadhesive antibiotic placed in deeper pockets.
□ Laser curettage & disinfection—Nonsurgically removes infected gum tissue.
□ Periostat( doxycycline—low level oral antibiotic taken for a few weeks during active treatment.
□ Root desensitization treatment—helps make sensitive roots less sensitive to cold air and liquids.
Other Treatment Options:
□ Referral to a gum disease specialist (Periodontist) for evaluation and treatment. May consist of gum surgery, gum and bone grafting, extractions.
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