I agree with your disagree!
And I raise you two contrarians ........
Mark & Steven Bornfeld DDS said:Judy said:I've got some 5mm and 6mm pockets in my gums, and they haven't been
improving with regular cleanings and brushing/flossing. My hygienist
wants me to get a deep cleaning and then use a water pik with half a
teaspoon of bleach in it to irrigate the pockets. I have an extremely
well-developed gag reflex when it comes to unpleasant-tasting things,
up to and including ordinary mouthwash, which was the recommended way
to mask the bleach smell/taste. So, I'm nervous about trying to use
the water pik. I know some dentists are not fond of the water pik,
but if I've got pockets this deep, how else can I keep crud out of
them? The hygienist wants me to get the rubber 'pik pocket' tip. Is
using bleach better than using ordinary water -- is it the
antibacterial action that's necessary, or the physical flushing of the
pocket? Is there anything else antibacterial that I could use in it
that wouldn't have a pronounced taste?While trying to find other articles that might address these
questions, I've found many mentions of people getting "pseudomonas"
infections from unclean water piks. Is this common? Do I really have
to clean it with vinegar daily to prevent this? People were saying
that cleaning the pik with bleach on a weekly basis didn't kill the
bacteria. It sounds like this whole pik thing is going to be a lot of
work, and/or potentially dangerous. I only want to do it if it's
really going to help. I can't find anyone else online who will admit
to squirting a bleach solution into their gums; is this a reasonable
thing to do? What would be a more ordinary course of action for
trying to deal with these deep pockets, if this isn't typical? I'm
willing to put the pik time and maintenance in if it will really help,
but if I'm spending the whole time gagging I'm probably not going to
stick with it.A lot of my pockets are 2 and 3mm, but the upper molars have some
nasty ones. They've progressed from 4mm to 5-6 in a year, and
obviously that has to stop. I floss compulsively and that's not doing
it. Deep cleaning followed by ordinary brushing and flossing wouldn't
be enough, would it? Help!I disagree. I think using a bleach solution for home use is a very
bad idea. There are rinses that are more appropriate for this use, such
as Peridex. I do however have reservations about a patient effectively
irrigating pockets as deep as 5 or 6 mm. In my experience there is too
great a chance of impacting any debris further into the gum rather than
out, and this can lead to an abscess.
Generally speaking, pockets as deep as 5-6 mm will not resolve with
normal oral hygiene--some form of pocket elimination therapy (probably
surgical) will be necessary. Also, pockets this deep in the upper molars
frequently extend into the furcations (spaces between the roots), which
can complicate the prognosis.
A patient of mine who's pockets are deepening in the presence of good
oral hygiene automatically goes to the periodontist.Steve
--
Joel M. Eichen, .
Philadelphia PA
DISCLAIMER FOLLOWS:
*********
Dental health-related material
is provided for information purposes
only and does not necessarily
represent endorsement by or an official
position of the SciMedDentistry gang
or any other official agency either
actual or fictitious or Steve Mancuso.
Advice on the treatment or care
of an individual patient should
be obtained through consultation
with a dentist who has examined
that patient or is familiar with
that patient's dental history.
STANDARD DISCLAIMER