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In January 2006, Dr. Malkemus began writing dental health articles for The Community
Voice newspaper. He wanted to give back to the community and share his passion for
health, as well as his observations of the remarkable planet around us. Current
and past articles are provided here. To view his articles as they appear, see the
Health, Beauty, and Fitness Section at www.thecommunityvoice.com.
Other Resources
Arestin: New Remedy for Periodontal Disease
Gum Disease and Improved Treatments
Gum disease is rampant in our society. More than half of all people over 18 have at least the early stage of gum disease called periodontal disease. After age 35, three out of four adults are infected. The major cause of tooth loss is gum disease. Gum disease affects the entire body being correlated with heart disease, diabetes, strokes, ulcers, and pre-term births. Luckily, there are new advances in periodontal treatment. One of the best is the use of antibiotics put directly in the gums, a product called Arestin.
What is Periodontal Disease?
Periodontal disease is a chronic bacterial infection of the gums that causes damage to the gums, tissue, and bone around your teeth. Periodontal disease is often painless, and usually develops slowly over many years, but may progress in rapid destructive stages. The destruction of tissue and bone causes pockets around teeth that can lead to tooth loss. Being warm and moist, gum pockets are an ideal environment for bacteria. The bacteria can feed on the sides of the pocket, increasing the pocket depth, which adds instability to the teeth. Bacteria form rough deposits, which are an irritation to the gums, causing gum bleeding and swelling.
Improved Treatments
Scaling and Root Planing
Often called a ‘Deep Cleaning’, scaling and root planing (SRP) is the first step in treating gum disease. Scaling removes plaque, tartar, and stains from the surface of the tooth and its root; planing smoothes the rough areas on the roots of teeth to promote healing. Root Planing sounds like a rough carpenter term but actually is the fine smoothing of root surface using numerous light strokes. The objective is to make the root surface super smooth by removing all the rough tartar and making it more difficult for the bacteria to adhere to the root surface. Ultrasonic scalers comfortably speed up the process using ultrasonic vibration and warm water. Depending on a person’s comfort needs, numbing with topical gel, anesthetic, headphones, nitrous oxide or conscious sedation can be used.
Arestin – Antibiotic Treatment
A recent advancement in periodontal treatment is the use of Arestin, an antibiotic treatment that is put into deep gum pockets during root planing. Antibiotic treatment has been tried for many years but without an effective method of keeping the antibiotic in the gums until the advent of Arestin.
Arestin contains “Microspheres”, tiny, bead-like particles that are smaller than grains of sand and are not visible to the eye. The Microspheres are filled with the antibiotic minocycline, and they release the drug over time into the infected periodontal pocket, killing the bacteria that cause periodontal disease. Arestin Microspheres continue to fight the infection for up to 21 days.
Arestin is placed inside infected periodontal pockets just after the scaling and root planing (SRP) procedure is finished. Even though SRP removes a great deal of the bacteria that cause periodontal infection, the instruments used during this mechanical procedure can’t always reach the bacteria that hide in the bottom of pockets or in difficult to reach areas. Adding Arestin helps to kill the bacteria left behind, plus the slow release of Arestin allows the gum tissue to heal without the reinvasion of bacteria.
Amazing Results with Arestin
Since using Arestin for the past 3 years, I have seen amazing improvements in gum health. In the past teeth that were very loose with extremely deep gum pockets would be considered not savable and need an extraction. With the use of Arestin, many of these teeth have tightened up with major gum pocket reduction. Two years ago, a 45-year-old woman had a loose first molar with a 12 mm pocket; extreme bone loss and I recommended extraction. She wanted to try and safe the tooth so I said we could try Arestin with scaling and root planning. Amazingly the tooth tightened up. She works hard on her dental hygiene and continues to have cleanings every three months. During those appoints, Arestin is added as needed. The tooth is still going strong today.
Avoiding Surgery
Arestin has helped avoid the need for gum surgery. Surgery is very affective treatment, but is much more invasive and costly. Plus with Arestin, the gum pocket can be retreated much easier. The most important aspect of periodontal treatment is the regular on-going maintenance visit, usually every 3 months. It always bother me when patients would have gum surgery, their gums would look great afterwards, and they would have regular cleaning appointments for awhile, doing great and then disappear for a few years, return and need surgery again. Scaling and root planning with Arestin can often prevent that need. Often a periodontal pocket can be controlled with the retreatment of SRP and Arestin.
Periodontal Disease is often called ‘The Silent Killer’, because it can occur gradually and painlessly over time. The good news is that gum disease can be stopped with professional treatment, such as SRP and Arestin. So, please don’t wait till it hurts! Have regular dental exams and cleanings.
Enjoy Life and Keep Smiling!
George Malkemus has had a Family and Cosmetic Dental Practice in Rohnert Park for over 22 years at 2 Padre Parkway, Suite 200. Call 585-8595, or email info@ malkemusdds.com. Visit Dr. Malkemus’ Web site at http://www.malkemusdds.com
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