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Treating patients with severe gingivitis

This one patient came to see me last week. Generalized 1-4mm pockets with localized 7-9mm pockets. Heavy BOP. I took x-rays and saw no bone loss evident. Pt also did not have any attachment loss/recession. No calculus at all. Moderate plaque. I concluded that the pt has severe gingivitis. I educated him and placed him on PerioGuard, recommended Sonicare, and demo flossing. I put him on a 3 month recall. I told him if the pocket depths stay the same or get worse the next time he sees me, I would recommend him get to a periodontist. Did I do the right thing?



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5 Answers

No medications and no outstanding medical history. I think most of his pockets where due to the amount of inflammation.

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I honestly think with even localized pockets of 7-9mm is cause for scaling&root planing. Even without bone loss sometimes, I am suprised to find subgingival calculus. 4+mm is infection, I would feel like I’m telling my patients that having 7-9mm pockets is ok, and that it’s “just a cleaning” when in fact there is disease present.

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Sounds good to me. If flossing seems to be an issue, you can suggest soft picks or Reach Access to make it easier for him. Were there any other contributing factors besides the plaque? Was it true inflammation or maybe some gingival overgrowth from meds or health related issues?

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Rdhnola1025 please explain the 7-9mm probing depths…… I don’t understand. Also, what is the GM / CAL numbers along with the 7-9mm PD’s? Can you post radiographs…. Bwx would be best if it shows posterior bone heights. When you wrote generalized 1-4mm PD with no recession/attachment loss was there -1-2-3mm of ginigval margins? As in pseudo pockets? What is pts age? I have more questions, but I don’t want to overwhelm.

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Im confused.How can there be no bone loss with 7-9 mm pockets? Isnt anything above 4, perio?

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