Chemical plaque control - Periodontology
Chemical plaque control
Medicines can be used to support mechanical cleaning. These drugs can be effective against supragingival plaque or against both supra and subgingival plaque. Supragingival plaque management uses so-called antiseptics, of which chlorhexidine is the best known. Mouthwashes, toothpastes and chewing gums, to which, for example, fluoride or xylitol has been added to combat plaque, are also prescribed. Research has shown that rinsing with a chlorhexidine rinsing fluid prevents the formation of supragingival plaque and gingivitis. Chlorhexidine is also supplied in the form of a gel that can be placed in the pocket with a small syringe subgingivally after cleaning. Chlorhexidine has some side effects, such as the appearance of discoloration on the teeth and on the composite fillings, it has a bitter taste and influences the taste experience.
In addition to locally administered agents, antibiotics are sometimes prescribed. To determine which antibiotic is needed, a bacterial culture is done first. With a culture, four or five plaque samples are taken from the pockets (with paper markers). In this way it can be determined which bacteria are present in the oral cavity. Based on this, it can be determined whether an antibiotic or a combination of antibiotics is necessary. This depends on the amount and types of bacteria found. A combination course is given to patients who, despite good oral hygiene and sufficient treatments, maintain periodontal problems.