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Periodontal SRP

I had a patient today that had radiographic bone loss visible, furcation involved bone loss. She was very tender and had some radiographic evidence of calculus. Although radiographic calculus is not 100% nor is it the only diagnostic tool in finding calculus. (40-60% of calculus does not show radiographically). However while perio-probing I found limited pockets. Most of her probing depths were 2-3. However she had a few 4mm pockets. She did have generalized recession. So attachment loss was up to 5-6mm mostly generalized. I recommended SRP due to the furcation involved teeth and radiographic bone loss. In addition, she was very tender and completely terrified of dental treatment. Should I have suggested something different?



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1 Answer

Non-surgical periodontal treatment/SRP is warranted if there is active disease. So my question would be is if her disease is active? Was there active bone loss (lamina dura not present)? Was there bleeding? Even though she has a history of disease, CAL of 5-6 mm with furcation involvement, it doesn’t necessarily mean she has active disease. My other question is whether her tenderness was due to infection or due to recession? With 2-3 mm pocketing, there may be an issue of insurance paying for periodontal treatment without a summary including other factors that may be present (smoker, diabetes, etc.). Not that we treat based on insurance, it’s just worth mentioning as a heads-up. Ultimately, you saw the patient and used your best clinical judgement, I did not so its hard to say!

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