Periodontal disease and appliance use

Nov. 1, 2008
According to the World Health Organization, in 2003 more than 75% of the U.S. population over the age of 35 had some form of gum disease.

by Rob Veis, DDS

For more on this topic, go to and search using the following key words: oral–systemic link, Perio Protect, appliance therapy, gum disease, Dr. Rob Veis.

According to the World Health Organization, in 2003 more than 75% of the U.S. population over the age of 35 had some form of gum disease. Current studies (completed and ongoing) have shown a connection between gum disease and serious systemic dysfunction. The general population is getting it — a healthy mouth directly contributes to a healthy body.

Drifting teeth, changes in alignment and spacing, bone loss, a deepening bite or posterior bite collapse, tipped molars, anterior flaring — all are problem conditions associated with periodontal disease. All can significantly hinder your efforts to restore those beautiful smiles your patients want.

The good news

Consider this: appliance therapy can be the key to periodontal control, treatment, and restorative care enhancement. I'm talking about realigning teeth, leveling infrabony defects, creating harmonious gingival lip line relationships, and retaining and stabilizing compromised dentition. Minor tooth movement, in conjunction with excellent periodontal therapy, can often restore the normal occlusal patterns desired.

Sometimes a simple Hawley Appliance with an elastic force and occlusal bite plane is sufficient for retracting the anteriors and closing down an open bite. Once this is accomplished, an intracoronal splint can be placed. This, along with nightly wear of an extracoronal splint, is usually enough to maintain the orthodontic corrections. Overlooked and simple measures, like using fluoride trays to give daily fluoride treatments, can go a long way toward preventing recurrent decay, not to mention controlling root sensitivity after root planing or periodontal surgery.

The better news

Today there is a full range of appliances that can be used to go beyond mere control of the condition — appliances that continue to attack the periodontal problem, and in some cases control the periodontal disease.

Foremost is "Perio Protect®," a noninvasive method of periodontal infection treatment. The patented Perio Protect Tray® (dentist–prescribed and made in an FDA–registered lab) directs antimicrobial agents into the gingival sulcus to overcome crevicular flow and deliver proven medication to the source of the infection, and keeps it there long enough to kill the bacteria. Since the medication modifies the biofilm, the patient continues to use the method daily as part of a new home care system.

Microbiologist–conducted electron microscope scans show that after 17 days of Perio Protect treatment, 99.98% of the disease–causing bacteria is killed.

Let's construct a practicum scenario. You're treating a patient with a tipped molar (and the periodontal pocket, deepening bite and periodontal disease that often accompany this condition). You upright the molar with a fixed banded Broussard appliance, place an occlusal splint to stabilize the occlusion, and follow up with Perio Protect treatment(s). You have corrected a collapsed bite, returned the patients vertical dimension, corrected the periodontal pocket, and are effectively controlling the patient's periodontal disease. This achieved, you now place an implant or construct a bridge to restore that smile spoken of earlier.

The best news

The results of Perio Protect treatment are immediate and long lasting, the practice–growing benefits are profound, and it‘s easily managed through your hygiene department.

Treatment with these appliances and techniques offers an excellent opportunity for the specialist and general dentist to work together for mutual growth and prosperity. Either can perform the actual appliance therapy. Both will benefit from the inarguably distinct advantages.

FYI: Perio Protect will be one of the focal seminars at the next annual ATPA (Appliance Therapy Practitioners Association) Symposium March 12 to 15 at Green Valley Ranch and Resort in Las Vegas. I strongly urge you to attend. You won't regret it.

Appliance therapy is a simple, effective, available way to address the full range of your periodontal patients' needs — to grow your practice, dramatically expand your professional scope, and take the lead in embracing the technology and techniques that are literally shaping the future of modern periodontal treatment and therapy.

Won't you please join me?

Dr. Rob Veis is chief executive officer of The Appliance Therapy Group® (ATG), comprised of Space Maintainers, Inc.®, Success Essentials®, Second Opinion® The Smile Foundation®, and The Appliance Therapy Practioners Association®. For more information, visit or call (800) 423–3270.

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