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3-4 month Prophys

Can anyone tell me if a pt with 4-5mm pockets, light Ant Mand Calc & bleeding would place the pt in a 3/4 MRC reg prophy or do an SRP? In school we were told to do an SRP, but my doctor places a lot of the New Pt on a freq PRO if there is no cal on the x-rays and minimal calc.



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2 Answers

The amount of calculus is not the deciding factor on disease present. Bleeding is the first sign of disease. If there is bone loss (attachment loss) and disease present (bleeding and pocketing), I would do SRPs. Go with your training and what you know is the best treatment for the patient!

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I agree with Kara- definitely SRP. Our in office periodontist says you will almost never see the start of bone loss on films. It happens too slowly. Where you do see it is in the pocket depths and tissue response. 5mm pocketing with BOP is active infection and loss of attachment happening. Perio is about bacteria, NOT calculus. Definitely stick with your education and treat what you see. You have a license too!
(Side note: #1 reason dentists are sued….. Failure to diagnose Perio)

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