Phase 1 Therapy
Causal, Antimicrobial, Non-surgical Therapy
Primary prevention—the early prevention of disease—is initially the responsibility of parents. Using simple, non-traumatic tooth brushing methods, the small child is gently guided down the path of personal hygiene and especially oral hygiene, hopefully with the support of his/her role models: Mother, father and perhaps older siblings. It should become a habit that the results of a child’s own efforts in oral hygiene be observed, lauded and, when necessary, modified.
In healthy individuals, prophylactic measures are usually short, painless and require little time. Nevertheless, they prevent dental caries and gingival diseases!
If disease occurs over the course of time, e.g., initial gingivitis in the specialty of periodontology, a brief description of the cause (bacterial biofilm), and its professional removal, as well as renewed instruction in plaque control by the patient (tooth brushing, oral hygiene), healthy conditions can be again established—secondary prevention.
If true pockets have formed and attachment has been lost, it is necessary to intervene as early as possible for such cases of early periodontitis. Using the simple measures of closed, causal therapy (debridement, root planing) such cases can be cured. Only a few years ago, predictable treatment success was only possible in pockets of 4—6 mm; but today it is possible to achieve predictable success even in pockets of 8 mm and more with the help of new and improved procedures (“After Five” curettes, disinfectants, modified timing, and other equipment innovations).
Nevertheless, anatomical relationships such as furcation involvement, grooves, narrow bony craters, and the regeneration of tissue defects oftentimes make it necessary still today to employ a multifaceted, often complicated corrective (surgical) technique with open therapy (Phase 2 therapy/surgery; p. 295) following Phase 1 (closed, subgingival) treatments.
This chapter, “Phase 1 Therapy,” will unfold as follows:
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• Case presentation |
– Motivation toward self-help |
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• Initial treatment 1 |
– Oral hygiene by the patient |
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– Creation of hygienic relationships by the dental team |
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• Initial treatment 2 |
– Traditional closed pocket treatment |
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– FMT—“full mouth therapy” |
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