I am a 62-year-old female with a history of chronic periodontal disease, particularly involving a pocket between teeth #7 and #8, which is associated with some bone loss and becomes infected every few months. I take fastidious care of my teeth and gums, including flossing, using a proxy brush and water pick at least two to three times a day, which helps to keep the periodontal inflammation under control. But, every few months, I have a flare-up of redness, swelling and sometimes bleeding with pus in this area in spite of diligent care. During times of flare-ups, I use hydrogen peroxide in water pick, good germs designed specifically for gums and Peridex following cleaning. Sometimes, this regimen works well and resolves the infection. Other times, it does not, and I have to resort to having the pocket cleaned out using Cavitron ultrasonic and treated with Arestin (Minocycline) 0.1 % antibiotic gel by my periodontist.
I started having symptoms of pressure and mild pain in and around tooth #8 about two days ago. I guess these symptoms to be the beginning of infection. There is no redness, swelling or abscess of the gum at this point. I do not want to lose the tooth, so I am very concerned to treat this infection early but, I am concerned about using the antibiotic gel too much and creating a resistant superbug.
The X-ray consistently shows a large pocket between #7 and #8 with some bone loss. I am unable to post the X-ray here. The tooth is intact.
The pocket was treated using Arestin (Minocycline) 0.1 % antibiotic by placing it in the pocket on several occasions since five years with in-between gaps of one to two years. Otherwise, it is managed with my daily hygiene regimen, regular hygienist cleanings every two months, including using Cavitron ultrasonic to clean out the pocket, and, use of Hydrogen peroxide, good germs, and, Peridex during flares.
My questions for you are:
Welcome to icliniq.com.
The antibiotic resistance is not a big issue as such, but I would suggest to not apply antibiotic gel more than two weeks with one or two months gap in between. Using warm salt water gargle twice a day is more than enough for good hygiene of gums.
Root canal treatment will not help much in resolving gum infection as such but will stop any toothache or sensitivity you might be having in the concerned tooth.
The X-ray which you have attached suggests a ceramic bridge which is placed to replace a missing tooth (attachment removed to protect patient identity), but root canal treatment has not been done for the supporting two teeth. It is better to get them root canal treated to prevent any mobility of those teeth and to get added strength by ankylosis of the roots to the bone. And if the gum infection is around that bridge then it is highly recommended to get them root canal treated for more strength.
Chlorhexidine antibiotic gel or even Metrogyl (Metronidazole), if available there, is good enough for a local application. Continue with mild Hydrogen peroxide gargle or salt water (I recommend) and scaling of your teeth and gums once in six months.
For more information consult a periodontist online --> https://www.icliniq.com/ask-a-doctor-online/periodontist
Was this answer helpful?|
When you have periodontal problems, there is a high chance of spaces opening up between teeth and so retainers are a must ... It will be better to wait to get your braces removed the next month and then plan Read fullIs it possible to have gingival recession by faulty brushing technique?
You have a pathological pocket or a healed pathological pocket ... The gum recedes due to the pocket or due to faulty brushing technique ... Read fullMy teeth are wearing away and roots are exposed.What do I do?
.. done to the inside area of lower front teeth is necessary to remove calculus deposited at the site. This procedure is called the dental scaling. We definitely have to remove those calculus deposits for longer life of the teeth. Use warm ... Read full
Query: Hello doctor, I am six weeks pregnant. Before knowing that I was pregnant, I was treated for recurrent bacterial vaginosis with Metronidazole orally and Tergynan vaginally for a week approximately on weeks 4 to 5 of pregnancy. How it can harm my baby? Cause I heard that it is contraindicated in fir... Read Full »
Query: Hello doctor, I got reported as liver abscess and the size is 70 x 60 mm. The doctor's treatment is Metronidazole. How much time will it take to cure? Read Full »
Query: Hello doctor, I have yellow stains in my teeth. I feel very bad before others. This problem has been there since childhood. I have attached the pictures of my stained teeth. Please advise. Read Full »
Ask your health query to a doctor online?Ask a Periodontist Now