Periodontal Disease Report--
Evaluation & Treatment Options
Patient: _________________________
Date: ___________________________
Your gum disease classification:
- Healthy; no disease present
- Gingivitis
- Chronic Periodontitis
- Number of areas with 5mm or deeper periodontal pockets: ______
- Loss of supporting bone around teeth
Your home care options:
- Sonicare® Electric Toothbrush—Use two times or more every day; full two minute cycles.
- Floss—use at least once every day.
- ProxaBrush®—use at least once every day.
- Stimudents®—use at least once every day.
- PerioAid®—use at least once every day.
- Rubber tipped stimulators—use at least once every day.
- Mouthrinse
- Chlorhexidine mouthrinse—Peridex® or Perioguard®.
- Listerine®
- ACT®
- WaterPik®
- Home Fluoride gel or paste—PreviDent®, Gel-Kam®.
In-Office Non-Surgical Treatment Options:
- Preventive Cleanings—to prevent gum disease.
- every 6 months
- every __ months
- Maintenance Cleanings—after active treatment of existing gum disease, to help keep infective bacteria under control.
- every 3 months (long-term)
- every 4 months (long-term)
- Scaling/Root Planing—a “deep cleaning” for periodontal pockets 5mm and deeper; using anesthetic, ultrasonics, irrigants, and specialized cleaning instruments.
- Arestin®—localized bioadhesive antibiotic placed in deeper pockets.
- Laser curettage & disinfection—Nonsurgically removes infected gum tissue.
- Periostat® doxycycline—low level oral antibiotic taken for a few weeks during active treatment.
- Root desensitization treatment—helps make sensitive roots less sensitive to cold air and liquids.
Other Treatment Options:
- Referral to a gum disease specialist (Periodontist) for evaluation and treatment. May consist of corrective gum surgery, gum and bone grafting, extractions.
