Perioscopy: An alternative treatment for Periodontal Disease

Perioscopy: An alternative treatment for Periodontal Disease

Millions of adults have or could have periodontal disease, a bacterial infection of the gums and bone around teeth, caused by commonly spread oral bacteria, different than those that cause tooth decay.  Periodontal disease causes detachment of the gum from the tooth, known as “pocketing”.  As it gets worse, it can cause bone loss around the roots of the teeth.

If you have periodontal disease, one option is to do nothing.  However, periodontal disease will not get better on its own.  Besides getting worse, gum and bone infection can affect the body in general.  Research is investigating systemic links between periodontal infection and increased risk of coronary artery disease, diabetes, pre-term low birth weight babies, stroke, respiratory disease, and pancreatic cancer.  It seems inflammation accompanying periodontal disease may be a co-factor in the initiation of other problems.  Disease-associated bacteria getting into the blood stream on a regular basis from inside the gumline complicate matters, as well.

One typical treatment option is to treat periodontal disease non-surgically.  Cleaning out the hard and soft bacterial deposits in the pockets and on the roots of teeth is critical to reestablishing a healthy gum attachment.  Done with a variety of instruments, current technology favors using very small ultrasonically powered instruments, or “micro ultrasonics”.  Many adjuncts, like antimicrobials/antibiotics, rinses, or irrigators, aimed at disinfecting the gum and bone, are useful, as cleaning plus disinfection is generally more thorough treatment than either alone.

Surgical treatment, another option in the management of periodontal disease, is helpful, because visual access allows for thorough root cleaning.  As appropriate, other adjuncts can be used such as bone grafts, regenerative proteins, membranes, and growth factors. 

Non-surgical treatment is limited by the inability of the operator to see under the gumline.  But what if it were possible to see under the gumline without surgically opening the gum?  Well, now with Perioscopy, it is!

Perioscopy allows dentists, hygienists and periodontists to see under the gum, and, under high magnification, perform minimally invasive, non-surgical treatment technique, using micro ultrasonic instruments, comparable to many medical procedures now performed with the aid of small cameras placed into all areas of the body. 

The Perioscope is a long, 1mm diameter, flexible endoscope, connecting a camera and viewing screen to special Perioscopy instruments that access under the anesthetized gumline around the tooth, without cutting the gum.   Additional local or systemic antimicrobials/antibiotics or other adjuncts vary to enhance the results of this micro-visual treatment.  Premedicating with an over-the-counter pain medication assures very little discomfort, if any, after the numbness wears off. 

Thousands of patients, all over the world, have benefited from minimally invasive periodontal treatment with Perioscopy at less cost than surgical treatment.  With less pocketing and bone loss, and good follow up care, patients can remain stable.  In seeking out the best ways to provide treatment for our patients, using the Perioscope is helping us achieve “healing through a better vision”.

Written by John Y. Kwan, DDS

Practicing the Art and Science of Periodontal and Implant Care
Board Certified Periodontist, Oakland/Berkeley, CA
Assistant Clinical Professor, UCSF School of Dentistry