Gingivitis/Periodontitis

Sometimes the obvious escapes everyone except the first one to see the obvious. Then Bill Domb from California closed in the loop for us. For at least thirty years we would eliminate even the most stubborn gingivitis, i.e. a stubborn teenager who would not brush their gums above ortho brackets, by having that person in once a week and using NaBiCarb prophylaxis. Then Bill Domb (www.nt4bg.com) suggested "packing" the gums with baking soda. The easiest way? Use "whitening trays" for about a thirty second application, then floss and brush. If they don't like Arm & Hammer, sell 'em the same NaBiCarb you use in your ProphyJet. It raises the pH above neutral, kills the most stubborn pathogens. Only dilemma here is why it took us thirty years to see the obvious. If the Prophy Jet would clear up gingivitis, why not have the patient use NaBiCarb the way Domb suggests?

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Comment by Barbara L. Prokup on March 6, 2010 at 1:48am: Yes, thank you for reminding me. I do not think that is enough respect. We deserve it the other way also. There are countries where RDHs have more freedom; and all this time I thought we were the forerunners - we are not. So, it is time to let go!!!!

Comment by Mary Jane RDH BS on March 5, 2010 at 6:13am: Not a blessed thing. We are there to serve the patient's well being. That is our reward. It is such a good feeling when we can have a patient see the difference they can make with just a little more effort on their part..it is exciting and gratifying. When we take the time to see them on a periodic basis to check on their progress, they really do understand that we care..because we do.

Comment by Barbara L. Prokup on March 5, 2010 at 5:09am: Yes, I have. This group of patients has to be seen 'often' to see how effective the treatment is and to remotivate them. You need a patient willing to do this. Periodontal disease or syndrome (?) is not easy to treat. I always have a look at the oral hygiene. If it is good then I begin to search for adjunctive methods. I have many patients who do not want to take antibiotics. They are willing, however, to try baking soda. For one thing the patients notice that I do not give up until I see stability. Will Dentists ever begin to accept as colleagues instead of helpers? Or co-theapists? What is wrong with that?

Comment by Mary Jane RDH BS on March 4, 2010 at 9:52am: Has anybody had a case of Refractory Perio that has responded at all to this therapy?

Comment by Mary Jane RDH BS on March 4, 2010 at 5:33am: I am intrigued. Dr. Keyes did something similar a number of years back. I am going to pick a patient that has tried every other more typical methods and offer this method. Some people just seem to have a higher percentage of bacteria that causes this, and even persistent care doesn't work. Now, maybe it is time to make it less hospitable for the bacteria to thrive.

Comment by Daniel Diser on March 3, 2010 at 3:56pm: Very interesting idea. At our dental thornhill office, we use sodium bicarbonate with our prophy jet, but I never thought about at home use via a whitening tray. It can't hurt to try. I will use this technique on a select number of patients and follow up to see if there is any improvement.

Comment by Barbara L. Prokup on March 1, 2010 at 1:17am: A baking soda slurry or rinsing with a saline solution has always proven beneficial in my office. I always rince out the sulcus or pocket after deep scaling, curettage or root planing. I also like to see my patients the day after treatment or at least two days after treatment. It is part of the wound management. We need RCTs in wound management. I would also like to see a study regarding disinfection DURING scaling, curettege and root planing.

Comment by Mary Jane RDH BS on February 28, 2010 at 8:26am: Please don't use any mixture in your ultrasonic before checking with the manufacturer. I don't think it would be good for the machine itself. I have my patients very gently flow medicaments into the sulcus with a small syringes; depending on the flow of the cavitron, it can be rather forceful if you're not careful. Anything I have followed in my reading lately really doesn't promote putting anything but water in the bottles; there hasn't been any proven benefit.

Comment by Carra Demrow on February 27, 2010 at 6:14pm: I used a prophyjet while working in a dental office in Germany, but since returning to the States I haven't worked in an office that has one. With the amount of cosmetic dentistry I haven't pushed for one - I don't want to pit the surfaces of the restorations. Currently, I use Chlorhex in the ultrasonic as my last step to flush the sulcus and dispense a 4oz bottle for the patient to use at home (rinse while Arestin is in place since I only want them to brush gently in the tx area, and no interproximal home care). Would a baking soda mixture be just as effective for use in my ultrasonic and/or for the patients home use? Also, have you seen good results from having patients mix a baking soda slurry at home and apply with a proxy brush? Thanks!

Comment by Mary Jane RDH BS on January 21, 2010 at 5:02am: Thank you for your support, Barbara. We are all aware of the acid/alkaline connection..we are well educated people. But as you and I know, when you work with individuals, you sometimes, most of the time, have to compromise and come up with solutions with what your patient will use on a daily basis. If they see improvement in small ways, many times they are willing to take even more time with their mouths i.e. possibly baking soda in trays because now they have proven to themselves that it will work. They get excited about it and that is our goal. It's wonderful to see! My Master's will based in nutrition..another passion of mine.