Non-Surgical Periodontal Procedures

Periostat

Most non-surgical treatments for adult periodontitis (gum disease) focus primarily on reducing the number of bacteria on the surface of your teeth. For example, scaling and root planing is usually done to help reduce surface bacteria above and below the gum line. This is an important part of your treatment because periodontal disease begins with a bacterial infection on the tooth surface, and by reducing the number of bacteria, the symptoms of periodontitis (such as bleeding and pus) can be reduced. We can control most cases of gum disease by detoxifying the root and reducing the amount of bacteria that is present.

Recent research has shown that in some cases of periodontal disease it may also be important to suppress your body's overproduction of gum- and tissue-destroying enzymes. The destructive cascade of events in periodontal disease begins when bacteria cause the cells of the gum tissue to produce chemical substances called cytokines. The cytokines, in turn, stimulate certain cells present in the gum tissues to produce a number of enzymes known collectively as matrix metalloproteinases (MMPs). These MMPs work together to degrade collagen, the structural framework of all periodontal tissues. This collagen degradation ultimately produces the classical symptoms of periodontitis. It is now very clear that while bacteria are necessary to initiate periodontal disease, it is actually the host-derived MMPs - not the bacteria - that directly cause most of the tissue destruction. In simple terms, genectically susceptible individual’s immune systems fight too hard, the result being loss of supporting bone around the teeth.

This is where Periostat® comes in. It is the first and only oral systemic medication that works by reducing the activity of the enzymes produced by the body that destroy tooth and gum tissue.

Periostat® is available only by prescription and should be taken in conjunction with non-surgical or surgical treatments to reduce pocket depths and improve gum and bone attachment levels. This will not occur by taking the drug alone – one must also have the offending bacterial deposits removed. A course of Periostat usually lasts from 3 to 6 months, and may be repeated as necessary.