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In the management of a gingivitis-periodontitis patient, baseline GCF scores
and other gingivitis-periodontitis parameters such as periodontal pocket
depths are obtained at the sites selected for examination. GCF measurements
should be done prior to probing of pocket depth, since probing may disturb
the inflammed ginvgia and stimulate additional fluid flow. When disease is
present, initial treatment consists of scaling and root planing (SRP),
instruction in oral hygiene, and information on use of an appropriate
mouthwash and dentifrice (see next paragraph below). At the beginning of the
next visit, GCF scores and other gingivitis-periodontitis measurements are
again performed at the chosen sites. Several visits are often required and a
reduction in GCF is indicative and supportive of a continuation of SRP and
hygiene instruction including instructions on mouthwash and dentifrice use.
When GCF levels cannot be reached that are below about 50, a more aggressive
approach such as tetracycline therapy or surgery may be necessary.
Inability to lower GCF scores
below about 50 can be the result of irritating substances, such as sodium
lauryl sulfate which is found in most dentifrices. Use of a "brushing
mouthwash", one that is used to brush one's teeth instead of or along with a
toothpaste, and is also used as a mouthwash is very useful here. The most
effective are mouthwashes that contain zinc such as Lavoris, Viadent and
TriOral. The last is particularly effective because it also contains
stabilized chlorine dioxide (namely sodium chlorite).
Patient observation of GCF
data shown as color graphics on the computer screen (the Periotron 8000
companion program, Periotron Professional, allows this) can serve as a
motivating factor for enhanced home care. |
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