In my work as the President of GumAerobics Management Systems, I see so many practices that need to have structured systems in place to best treat the sometimes overwhelming demand for periodontal services. It is all too easy to focus on "just doing" prophy’s as "perio recalls," allowing patients to pass through our offices as "watches" and stay a part of the over 80% adult population having some form of untreated periodontal disease. Scaling/root planing and antibiotic tools can be effective strategies. However, these treatment options have limitations. Some states don’t permit hygienists to place subgingival antimicrobials. What about patients who are special cases or need more? There is a clear demand for alternative solutions and tools to manage gum disease. The GumAerobics Management Systems focus on the win-win side of the formula to help practices improve patient care and increase revenue. This is done by empowering the hygienist with tools to manage periodontal disease -- as a separate, viable business -- all the while healing the patients. In this article, I’d like to highlight an up-and-coming treatment that offers an antimicrobial breakthrough in periodontal prevention, care, and treatment.

Life-Like, Dr. Rodney Ogrin, and I have been working with a procedure we call At-Home Cleaning & Debriding -- using 10% carbamide peroxide. This gives patients a powerful antiseptic option for gum disease prevention and a tool for effective periodontal treat- ment. I think of it as Neosporin-on-a-Band-Aide for the gums.

The At-Home Cleaning & Debriding procedure roots back to the pre-history of tooth whitening. ProxigelTM was used as early as 1972 in a tray as an antiseptic to treat patients who had inflammation or poor oral hygiene. Similar use of Gly-Oxide, another 10% carbamide peroxide product, predates 1968. In 1986, Dr. John Munro began the practice of using 10% carbamide peroxide to control bacterial growth after periodontal root planing. These procedures not only improved the health of soft tissue, but also were found to whiten teeth. Unfortunately, the antiseptic value of 10% C.P. quickly became overlooked -- in favor of the more visible cosmetic side effect.

The practice of using a 10% carbamide peroxide gel as a periodontal debriding treatment offers extensive advantages:

• It releases H2O2 for sustained antiseptic and oxygen-cleansing action. The anhydrous glycerol and gelling agent protects the peroxide molecule delaying its breakdown. It also holds the carbamide peroxide plus peroxide foam in close contact with the teeth and tissue.
• It eliminates supragingival aerobic bacteria and at least, reduces subgingival anaerobic bacteria via hydrostatic pressure from the debriding tray.
• It gently removes unhealthy tissues as well as cleans and soothes minor wounds and inflammations, so natural healing can occur.
• It foams and flushes out food particles most patients miss.
• With ongoing use, it guards against the risk of gum infections.
• It discourages plaque formation, decreases calculus, and reduces bleeding. This creates greater visual access to subgingival accretions.

Easy Implementation - The procedure is an easy addition to your practice. It requires making only a slightly modified whitening stent. Only a few extra minutes are required to make an At-Home Cleaning & Debriding stent using the same stone model used for making a whitening stent.

Patient Compliance - Patients are quick to accept the procedure since it is easy and can be adopted as a habit before and/or after the cosmetic inducement of tooth whitening. Also, patients stick with it because it requires brief treatment times with no negative side effects.