Question

Ms. Smith is a 65-year-old tax accountant who had periodontal surgery 12 months ago to reduce her 6- to 8-mm pockets to 3-mm pockets. At each periodontal maintenance care visit since her surgery, the dental hygienist has consistently observed a 1-mm loss of clinical attachment around two of the mandibular molar teeth (1-mm was lost at 4 months, 1-mm was lost at 8 months, and now 1-mm was lost again at 12 months for a total of a 3-mm clinical attachment loss over 12 months). The dental hygienist will complete an oral debridement procedure. However, the therapy that might BEST be used to slow disease progression in sites showing ongoing clinical attachment loss is

Answer 1

Antibiotic therapy, often a combination of tetracycline, doxycycline, macrolides, or ß-lactams, along with rigorous oral hygiene, are the best treatments to slow disease progression in Ms. Smith's case of ongoing clinical attachment loss.

Step-by-step explanation:

For Ms. Smith, a 65-year-old tax accountant who has experienced a 3-mm clinical attachment loss around her mandibular molars post-periodontal surgery, the best therapy to slow down disease progression would be antibiotic therapy along with meticulous oral hygiene. The specific antibiotics used could include tetracycline, doxycycline, macrolides, or ß-lactams; often, a combination of antibiotics is given to target the variety of microbes causing the periodontitis. Additionally, practicing good oral hygiene and receiving regular professional dental cleanings are vital components of treatment and prevention.

Periodontal disease is affected by the accumulation of plaque and the bacterial colonization that leads to inflammation and tissue damage. To prevent further clinical attachment loss, besides the antibiotics prescribed, Ms. Smith should maintain excellent oral hygiene, including regular flossing and use of mouthwash to manage bacterial proliferation. Local delivery of antibiotics directly to the gum may also be beneficial to treat the specific sites with attachment loss.