A lot has been written lately about managing the inflammatory aspects of periodontal disease. After all, it is the body’s inflammatory response that is causing hard and soft periodontal tissue destruction.
When a patient presents to the office with periodontitis, an anti-inflammatory protocol may be indicated. Another way of thinking about this is revealed, however, if we go further back in the disease process. What causes mobilization of the inflammatory response in the first place? Bacterial invasion of the gingival epithelial cells is the trigger that ignites the body’s immune-inflammatory response, which is accompanied by the release of enzymes that destroy the gums and bone.
Using anti-inflammatory meds as part of the treatment plan appears to have merit, but the primary objective should be knocking down the cause—namely the bacteria. How do we know how effective our bacterial reduction efforts were? We don’t, unless we provide salivary testing both pre- and postop.
This is not rocket science, but sometimes the simplest solutions are the most difficult to see.
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