When it comes to periodontal care, hygienists are always looking for tools and techniques to yield effective long-term results. We know that removing subgingival calculus is just part of achieving successful treatment outcomes. The other, more critical, part is managing the individual’s bacterial dysbiosis, which is a complex, multifactorial issue. Plaque biofilm removal during nonsurgical periodontal therapy (NSPT) is pivotal in disrupting this imbalance, but clinical limitations exist; it is nearly impossible to remove all red-complex bacteria from subgingival pockets and the surrounding tissue. With this in mind, what can be done to enhance our plaque removal efforts?
Benefits of desiccation
Desiccant products can help to cauterize bleeding from inflamed tissue, which enables the hygienist to maintain an unobstructed view during treatment. In randomized controlled clinical trials, areas that received desiccation therapy in conjunction with NSPT showed significantly reduced levels of plaque, bleeding on probing, and probe depths as opposed to areas that only received NSPT mechanical instrumentation.1 In these split-mouth studies, patients also experienced clinical attachment gain in the areas where desiccation was used.
In addition to its antimicrobial and antihemorrhagic properties, desiccation offers another benefit: easier calculus removal. Drawing the moisture from supra- and subgingival calcified deposits allows them to be more easily detached from the tooth’s surface during instrumentation. Clinicians find that areas with heavy calculus buildup respond very positively to desiccation and result in more effective instrumentation. This is especially helpful for debriding around those lower lingual bars—every hygienist’s arch nemesis!
Desiccation products
Periodontal desiccation is available in both gel and liquid forms. Some clinicians prefer the gel because it is easier to control, while others prefer the liquid since it can easily flow into deeper, less accessible areas. To use desiccation, dry the area well with air or gauze, then apply enough product subgingivally until i
There are no unique post-op instructions for the patient, but they should be informed that the color change in their treated gingiva is temporary and will return to normal within the day. Desiccation can be repeated at follow-up visits as deemed necessary by the clinician. Additional procedures like such as gingival irrigation, locally applied antibiotic agents, or laser bacterial reduction are not recommended when desiccation is applied; these aids can be used at future appointments if needed.
Periodontal desiccation is a transformative addition to the oral health-care professional's soft tissue management protocol. This simple, painless service allows clinicians to enhance their NSPT care to achieve elevated treatment outcomes. Keep in mind this technology is still new to many providers, so completing online continuing education courses and reading published research is recommended before implementing desiccation in your practice. Welcome to the future!
Reference
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Micu IC, Muntean A, Roman A, Stratul ȘI, Pall E, Ciurea A, Soancă A, Negucioiu M, Barbu Tudoran L, Delean AG. A local desiccant antimicrobial agent as an alternative to adjunctive antibiotics in the treatment of periodontitis: A narrative review. Antibiotics. 2023;12(3):456. https://doi.org/10.3390/antibiotics12030456
