A gentleman in his early 70s was referred for potential dental implant work as he was experiencing food packing between his teeth. He had been seeing a hygienist previously for a few appointments.
He presented with generalised severe periodontal disease with gum recession which was the cause of the food packing. Despite the severity of the disease almost all his teeth had a good long term prognosis of being periodontally healthy and able to eb retained. However, he would have to accept that food packing would always remain a problem, which he was happy to accept.
He used an electric toothbrush twice daily and interdental brushes once daily. He was suing Blue and Yellow Tepe interdental brushes as previously advised. Despite having the right habits in place, he presented with generalised plaque deposits. Xrays showed a heavy build up of calculus. He had generalised moderate-deep periodontal pocketing and bleeding on probing.
The patient was instructed on more effective toothbrushing techniques. All the interdental brushes were sized and the patient required much bigger interdental brushes, which showed gross plaque deposits after being sized.
The patient returned 2 weeks later for professional periodontal treatment. At this appointment, he reported using the correctly sized brushes daily as advised. He noted that whilst his mouth felt healthier he was getting more food packing. It was explained to the patient this was a sign of his periodontal health improving which can be seen from the noticeable reduction in periodontal pocketing depths.
This is another case that highlights that even in the presence of calculus, it is possible to improve periodontal health by effective removal of plaque. It also emphasises the utmost importance of using correctly sized interdental brushes for optimum outcomes.