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A Better Way to Battle Biofilm

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A Better Way to Battle Biofilm

Perio Tray in bathroom Successful treatment of periodontal disease requires effectively managing the root of the problem: biofilm. However, by exploring the nature of oral biofilm, it becomes clear that this is no easy task. Dental plaque is a type of biofilm, a slime-enclosed community home to hundreds of species of bacteria and other microorganisms, both infectious and innocuous. Periodontitis occurs as a persistent, inflammatory host response to the subgingival presence of these communities and associated microbial “triggers.” Like all classic biofilms, oral biofilm possesses a protective matrix and a similarity of genetic material that facilitates cell-to-cell communication. Together, these traits allow biofilm to stubbornly resist and adapt to both host defenses and systemic antibiotic therapy.1

Due to the exceptionally resilient nature of biofilm, the mechanical debridement approach of scaling and root planing (SRP) has become the “gold standard” for non-surgical treatment of periodontal disease. Unfortunately, SRP is not without its limitations and even significant drawbacks. First and foremost, with SRP, it is impossible to remove all biofilm within the gingival sulcus. Even more disconcerting is the discovery that mechanical disturbance of biofilm via SRP can stimulate regeneration: one study revealed that removing 50% of the initial biofilm resulted in a four-fold increase in growth. This means that SRP must be deployed cyclically for patients with chronic or aggressive periodontitis, with most requiring treatment every 3–6 months.2 Repetitive treatment is especially concerning when accounting for the oral-systemic connection: for immunocompromised patients, bacteremia (transmission of bacteria to the bloodstream) as a result of SRP can potentially add to the body’s overall inflammatory response and increase susceptibility to systemic illnesses. According to another study, even when maintaining an adequate homecare regimen in addition to SRP, after 6–12 months, patients had a reoccurrence of bleeding upon probing, swelling, and redness, and biofilm populations sampled prior to treatment either remained or regrew.1

Dental care experts have looked to adjunctive therapies to address the complexities of combating oral biofilm and the shortcomings of both SRP and homecare in treating gum disease. One answer lies in the application of hydrogen peroxide, an antimicrobial agent with a lengthy, proven track record in dental settings. Subgingival delivery and maintenance of peroxide does, however, pose a unique challenge: while the sulcus is readily accessible topically, the flow of gingival crevicular fluid can prove a barrier to chemical contact and therefore antimicrobial efficacy. Thankfully, Perio Protect® offers a solution.

For over 10 years, dentists have utilized Perio Trays® to supplement conventional homecare, SRP, and surgical treatments. Designed for patient use between office visits, this sealed, custom-fit prescription delivery system administers a 1.7% hydrogen peroxide gel into subgingival pockets as deep as 9mm. When held in place for just minutes, the oxidizing agent goes to work, debriding the slimy matrix covering biofilm and dissolving bacterial cells housed within. In its wake, it leaves an oxygen-rich environment that supports a healthy bacterial balance below the gumline and host healing.

Research shows that the Perio Protect Method reduces the presence of the most damaging oral pathogens by up to 90% and, in as little as a few weeks, patients who use Perio Trays can expect less bleeding upon probing and reduced pocket depth, alongside whiter teeth and fresher breath.3 When Perio Trays are used before SRP, they can reduce inflammation and bleeding, thus minimizing the risk of bacteremia.2 As a bonus for the clinician, the Perio Protect Method can also help soften calculus, making it easier to remove for better, faster treatment outcomes and improved patient satisfaction.4

To learn more about the Perio Protect Method and how it can benefit your patients and practice, visit Perio Protect’s website.

References

[1] https://www.drduanekeller.com/direct-medication-delivery-modifies-the-periodontal-biofilm/
[2] https://providers.perioprotect.com/wp-content/uploads/2020/03/JCD-Subgingival-Delivery.pdf
[3] https://www.perioprotect.com/wp-content/uploads/2019/01/Peroxide-in-Treatment-of-Periodontal-Disease.pdf
[4] https://www.rdhmag.com/patient-care/prosthodontics/article/16405723/benefits-of-periodontal-trays

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