Perio Protect Trays – therapy that works!
The team at Atlanta Dental Spa works hard to stay on the cutting edge of dental health. We know the health of your mouth is directly related to your overall health, and nothing is more important to us than having HEALTHY, happy patients! One of the ways we achieve this is by offering Perio Protect, a painless, easy, non-invasive, and long-term solution to one of the most prevalent diseases in our nation: periodontal disease. Hygienist Charissa Wood, RDH offers the following Q&A on all things Perio Protect.
1 How has Perio Protect® been successful in your office? Can you describe a case or two that stands out in your mind?
Perio Protect has been a huge tool in our practice at providing our patients with a minimally invasive, state-of-the-art option for their periodontal disease. It has offered us an effective scientific approach vs. the old school paradigm of just doing scaling and root planing. We have seen our patients embrace the ease of use and consistent positive results which leads to compliance, trust and confidence in the practice and the referral of family and friends. It has definitely provided a boost in production, but best of all, we are helping our patients achieve healthy smiles that they love!
We have many stories of patients who have experienced multiple rounds of scaling and root planing over the course of years but were still experiencing inflammation and bone loss. Once these patients began to use Perio Protect as directed, we saw them achieve and maintain health long-term with reduced pocket depths, no edema, inflammation, tenderness or bleeding.
We’ve had so many success stories, it’s hard to narrow them down, but I’ll highlight a few cases to demonstrate how Perio Protect has helped us be successful.
One of the best outcomes we’ve had was a 43-year-old male who presented with generalized 4-5mm pockets and moderate localized bleeding after a 6 year absence from professional dental care. He had severe decay and infection around two teeth causing him pain, which were non-restorable. Once the extractions were complete, we did impressions for Perio Protect trays, which he wore 3 times a day for 10-15 minutes for 2 months. When we saw him back for his follow-up evaluation and performed the periodontal exam, we found generalized 1-2mm with no bleeding, edema or tenderness. His tissue was so healthy and stable, we did a cleaning and put him on a 4-month recall wearing his trays once a day.
Nothing is more rewarding than helping our immune compromised, high-risk patients step out of danger by removing the threat that periodontal pathogens pose. We had a 51-year-old male who was referred to us by his cardiologist because he had just recovered from a heart attack. This particular patient had struggled with periodontal disease throughout the years, having previous scaling and root planning, but had not been for dental care in the last 5 years. He presented with generalized 4-6mm pockets and localized 7-10 mm with heavy, generalized bleeding and moderate generalized subgingival calculus. Due to his recent heart attack, we did salivary testing and upon results, administered systemic antibiotics. We had him wear his Perio Protect trays for 6 weeks 3 times a day for 15 minutes with Periogel and Vibramycin drops. We then performed scaling and root planing to remove the calculus and flush out the pockets. Now at the five-month point, we have achieved a huge reduction in pocket depths and very minimal bleeding. The patient continues to wear his trays twice a day. We are still working on getting a few stubborn areas resolved, but the patient was recently cleared by us and his cardiologist to have knee surgery!
Perio Protect not only works to eliminate periodontal infection and create long term maintenance of health, but as a side benefit – because of the 1.7% peroxide gel – also gradually whitens teeth! Here is Patient C, a 45-year-old male who has been using Perio Protect for the last 4 years. We recently updated some photos to discuss possibilities for restoration of his bite and wear and noted the drastic difference in shade. This, of course, is a big factor for motivating patients to stay compliant!
2 Are most of your patients responding well to Perio Protect® treatment? What has surprised you about their responses?
I would say that ALL of our patients on Perio Protect have responded positively. Some patients have an immediate and long term improvement that requires nothing further than a basic cleaning every 4-6 months. Others may require full or limited scaling and root planing followed by periodontal maintenance therapy, and still others may maintain periodontal health for months or years and have an unexpected flare up. We have to keep in mind that although the catalyst of periodontal disease is bacterial presence, it is still a multi-factoral disease governed by the host response. We’ve got to consider that genetics, the immune system, nutrition, stress levels, environmental factors and home care are a big part of the equation.
Perio Protect is highly effective at creating a sub-gingival environment that creates anaerobic cell death and inhibits bacterial colonization and by doing so, we consistently see an immediate improvement in the clinical signs of periodontal disease. For some patients, that’s all it takes, but for others, we’ve got to look deeper and make changes to the other factors that affect the patient’s response. It is imperative that we tailor our care to each patient’s individual circumstances – there is no such thing as a cookie cutter approach. I can honestly say that when we have Perio Protect as our baseline therapy, I know that by tweaking the other factors, we can obtain sustainable long term health.
3 What does Perio Protect® allow you to do that other conventional treatments do not?
Perio Protect allows us to offer our patients a successful, painless, simple modality to treat their periodontal disease. It provides treatment for acute and chronic infection as well as long term maintenance of health. I would say the most appealing advantage for me as a healthcare provider is that it provides a way to prevent bacteremia. In a world of patients plagued by auto-immune disorders (cardiovascular risk, diabetes and cancer, just to name a few), coupled by the science pouring out about the direct involvement of periodontal pathogens in these systemic illnesses, I am passionate about not contributing to these conditions or increasing the risks! Perio Protect allows me to eliminate the bacteria directly at the site of involvement so that when I go into the pockets to clean and remove debris and calculus, I am not exposing billions of bacteria into a patient’s blood stream in one fell swoop. By the time a patient has been using Perio Protect for 4-6 weeks, we are really dealing with the leftover dead bacteria and calculus which we can confidently remove knowing we aren’t increasing any systemic risks.
Another unique benefit that only Perio Protect can provide is the rebuilding of bone. By using a liquid form of Vibramycin in the trays as a topical antioxidant, it is able to stimulate osteoblasts to lay down new bone. I realize it sounds too good to be true, but we’ve seen this happen in our practice multiple times with teeth that were once mobile now fully stable. We’ve had oral surgeons comment on how difficult it was to extract wisdom teeth that had been treated in this manner because the bone was so solid around the teeth, they were almost impossible to remove. We have found a lot of value in using the therapy to help ensure implant success as well. I will add that the Vibramycin therapy is not recommended if orthodontic work is in the patient’s future due to the fact that the teeth are very resistant to movement once the bone has been rebuilt and solidified.
4 Have any of your patients not responded as anticipated to Perio Protect® treatment? Have you encountered any problems with treatment?
As mentioned before, with periodontal disease being multi-faceted, there are times when we have not seen the anticipated results initially. But by addressing the issues outside of bacterial assault, we have been able to achieve health. Sometimes we make changes to diet or supplementation so we are supporting the immune system nutritionally, sometimes it’s a matter of addressing environmental factors like smoking cessation or a spouse with untreated periodontal infection, it can be as simple as communicating with the patient’s physician to try an alternate medication for blood pressure, diabetes or hormone therapy, or helping a patient make a plan for stress management or get tested and treated for sleep apnea. We have found that by using Perio Protect as our main course of therapy and altering what we can of the contributing host response factors, we can count on consistent positive results.
As is prevalent in the dental world, I’d say our biggest hurdle when it comes to using Perio Protect is patient compliance. I tell my patients that “I guarantee it works, but only if you use it.” In general this is not a big issue, because the patients can see and feel the benefits of treatment, but it does happen where patients will be slack or drop off their routine. We’ve had a few patients who experienced tooth sensitivity similar to what whitening creates, but were able to adjust their wear frequency to make it work for them.
5 It can be challenging to incorporate a new therapy, how did you begin to implement the Perio Protect Method in your office?
The science of Perio Protect makes so much sense to us considering Dr. Boulden’s background in microbiology. When we first heard about Perio Protect at an ACE conference, it was like a lightbulb went off. All this time, through scaling and root planing, we had been disrupting these complex bacterial communities while assaulting and creating tears in the gingival tissue, thus pushing them into the bloodstream at the highest concentration possible. We weren’t sterilizing anything and knew we weren’t completely eliminating every bacterium present so those left would repopulate and start the process again.
Perio Protect was presenting a way to address the microbiologic community without creating tissue damage or create further introduction into the bloodstream. It was a simple, easy to use process for the patient and involved taking a set of impressions. It was a no-brainer and so we decided to just dive in and give it a try! We sat down as a team and learned all the steps needed to get trays made. We began to offer it to our patients who presented with perio and they were saying yes. After our first few cases, we saw how beautifully it worked and were thrilled with the results! The more we saw, the easier it became to recommend to our patients and feel confident in what we could expect result wise.
6 How do you introduce patients to Perio Protect® and present treatment options?
When we see a patient who is a good candidate for Perio Protect, we explain their current condition and what the progression of those conditions can look like. We briefly discuss the science behind perio and how Perio Protect can address their situation to get and keep them healthy long term. We discuss the process as far as timing and expectations of their involvement at home. Because most insurance plans do not yet cover this method, we do also offer full Scaling and Root planning for those patients who are more insurance driven. When we are dealing with immunocompromised patients, depending on their conditions, we will recommend the Perio Protect as our first course of action, so as not to create greater risk to their overall health.
7 Do you have any additional information you would like to share with readers?
I think a lot of people hear about Perio Protect and write it off as a gimmick or too good to be true. Even though the science made sense, even we started a bit skeptical, but I have seen it work literally hundreds of times and patients absolutely love you for giving them a pain free option that works!
I challenge everyone to hear and see the science for yourself, give it a shot and you will be amazed! If the old school paradigm of Scaling and Root planning was all it took, we’d have a much greater healthy patient population!