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Periomaintenance w/chlorhexidine gluconate

I’m one to believe that antimicrobials (chlorhexidine gluconate) and antibiotics (arestin) are not necessary unless absolutely needed. Overall, I’ve had excellent patient compliance and many of my peridontal diseased patients have really turned things around to where their original probe depths of 5+mm have shrunk to 3mm w/little to no BOP. When there is active infection with deeper pockets, I recommend chlorhexidine gluconate along w/their cleaning to flush the tissues out, reduce harmful bacteria and promote reattachment. When their pocket depths are WNL and stable, I simply scale and polish. My question is should antimicrobials be used for every periodontal maintenance patient regardless of how good their gums are? If anyone knows of any clinical research that has been done, please let me know. Thank you!



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3 Answers

Unfortunately I don’t have any case studies off the cuff but basic logic to me would say that peridex on a pmaint patient by default is not best practice. 1) peridex is a prescription level antibacterial mouth rinse. If a person needs it, they should be prescribed to have it. A doctor wouldn’t go give antibotics to every patient that walked in to his office with a history of sinus infection complaining of a stuffy nose. It would need to be indicated. If at a perio maintenance the pockets are healthy with no BOP, it doesn’t seem like dosing them with an antibiotic is necessary seeming as there is no infection present. 🙂

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Triology seems very promising compared to CHX that actually kill fibroblasts.

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isn’t chlorine INACTIVATED by blood? I’d use povidone iodine or even diluted sodium hyp

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