Full mouth disinfection concept

Full mouth disinfection concept

There are so many people out there who wandered for months, or even years, whether they have periodontitis? Watching the commercials on various toothpastes and mouthwashes we have all occasionally feared that maybe that bleeding of the gums is not so normal and it should raise some suspicion calling for a concern and subsequent action, even maybe a professional treatment? How can we tell whether someone suffers from periodontitis or not? Unfortunately this very question does not bother just the people not related to the dental profession, but also our colleagues who frequently ignore signs and symptoms of periodontitis or wrongly define conditions such as non-inflammatory receding gums as periodontitis. Much too often patients go from one dental practice to another in search for the right diagnosis without the basic diagnostic tool such as a panoramic X-ray…

Once the true infection and inflammation have developed (and the inflamed area may reach the mathematical value corresponding to the area of both palms), what can be done? Let the disease evolve at its own dynamics? Extract all teeth? Or maybe take an action, seek professional help and treat the disease? Somehow when everything is laid dow like this it seems logical and simple: after all, we are living in the 21st century, hopefully something can be done! Absolutely, just like any other infection, periodontitis needs to be controlled, treated and its consequences corrected. The next question is: how? The answer is not philosophical since there are numerous investigations proving one and the same: the first step is to reduce the number of bacteria which caused the disease to the minimum so that the body can start its defensive and reparatory mechanisms. After this we may start thinking about the advanced treatment options which aim at correcting and recuperate what had been lost during the active disease. Which brings us to the concept of "full mouth disinfection” where we practically disinfect the mouth in order to reduce the number of pathogenic bacteria to the minimum.

This concept is rather new - it has been proposed in 2001. and it had raised immediately the interest of the experts. The basic rule is to clean and disinfect all available tooth surfaces within 24 hours and additionally disinfect the soft tissue by using special solutions, and tongue scrapers where indicated. Cleaning of the tooth surfaces is performed without surgery, under local anesthesia, with ultrasonic and hand instruments, and a few other adjunctive methods improving the efficiency of the treatment. During this procedure we rinse the tooth and soft tissue surfaces with disinfectants in order to achieve detoxification. The procedure is not painful, and subsequent tenderness is controlled with widely available pain control medications, while the first results are visible after a few days: gums will stop bleeding, and acquire a healthy pink hue. tooth surfaces will be clean, brighter and smooth, and the mobility (if present in the beginning) will be gradually reduced. Patients suffering from swollen lymph nodes, slightly elevated blood sedimentation levels, or even joint pain of unknown origin report a complete resolution of the above mentioned symptoms soon after the completion of the therapy. Let us just remember that we are talking about the surface of our 2 palms…

The described procedure may be performed in one or to visits - all within 24 hours, depending on the availability and desires of the patients. In more severe and advanced cases the described therapy will have to be accompanied with administration of specific antibiotics - they make absolutely no sense if they are administered outside the mouth disinfection procedure since they simply reduce the quantity of bacteria in the soft tissues while those on the tooth surface remain undisturbed and ready for the next "attack”. 

And finally, are there situations where this procedure can not be applied? The only true counter indication are severe diseases which do not permit the use of local anesthesia (injection), render the organism extremely sensitive to infection (so called immune deficiencies), the patient has serious problems with blood coagulation, or we are dealing with a first-trimester pregnant lady. In those cases we need to consult first the treating physician who will propose the adequate antibiotic protection or control the rate of coagulation. In pregnant women, treatment may be performed during the second trimester.

Periodontal treatment is a step towards the general health. Healthy mouth is the prerequisite for the healthy body.