A localized approach to reducing periodontal pocket depth that goes above and beyond the limitations of routine oral maintenance
Is it possible to treat conservatively and aggressively at the same time? It is for Abraham Jaskiel, DMD, who continuously researches different products to help increase his patients' comfort during treatment. In addition to scaling and root planing, he uses ARESTIN as part of his periodontal maintenance program. Here, Dr. Jaskiel shares how the concentrated, locally applied antibiotic can be an aggressive solution for periodontal issues today that leads to more conservative treatment tomorrow.
When it comes to oral maintenance, the typical approach is to look for large amounts of calculus or very big pockets, instead of understanding that there’s a massive amount of bacteria above the gumline that is actually going beneath the gumline. When I see signs or symptoms of this in my patients, I may do scaling and root planing to remove the subgingival bacteria and then try to get them in every 3 to 4 months for periodontal maintenance. I also use ARESTIN, which is a locally applied antibiotic designed to target periodontal bacteria for an extended period of time.
ARESTIN is indicated to treat pockets that are over 5 mm deep, but I also place it in areas in the mouth that have a lot of inflammation, or before crown or bridge cases where I want to make sure I am shrinking the gums and reducing inflammation. I’ve done many cases where I needed to take impressions but there was too much calculus and bleeding. A week after doing scaling and root planing and placing ARESTIN, the bleeding would be gone.
Patient Comfort
Before using ARESTIN, I was treating patients with a similar product that caused them pain. The problem was that it would harden too much—sometimes even popping out of pockets altogether. ARESTIN is very easy to place and the powder is super thin, so it’s very unlikely that a patient can feel it after it's placed. I’ve actually never had a patient call in and say they had postop pain because of ARESTIN.
Localized Treatment
One thing I love about ARESTIN is that it’s localized and doesn’t affect the gut flora or the mouth. Oral antibiotics have to go through the entire body, so for a patient who has a severe infection that’s localized to one tooth, ARESTIN does a better job with less effect to the body. Sometimes it will help buy a patient time who hasn’t decided whether to extract a tooth. The area might be very inflamed or have a periodontal abscess, so I will put it directly into the area to provide some relief.
I was part of one of the original studies with ARESTIN and have been using the product since it launched. I have had very good results treating patients with it after doing scaling and root planing. Once you know how and where to place it, ARESTIN is a great addition to any SRP or oral maintenance program.
After earning his DMD from Boston University in 1999, Dr. Jaskiel relocated to sunny South Florida and earned a certificate for Advanced Education in General Dentistry. In addition to expanding his dental knowledge, Dr. Jaskiel volunteered and taught other dentist volunteers at Community Smiles Dental Clinic, where he also served on the board of directors in various capacities for over 10 years. He loves being a dentist and takes pride in providing an excellent service for his patients while helping them overcome their fears.
