One thing I talk to my patients about is something called biofilm. It is the layer of bacteria that lives on the teeth, both above and below the gum-line, and it is there all the time. There are hundreds of different oral bacteria, but each person has their own combination of bacterial types. Some oral bacteria that are acid-loving and in turn release acid onto the tooth (such as Strep mutans) causing tooth decay, and some release toxins that cause periodontal inflammation and bone loss. This is why certain individuals are at risk for decay and/or periodontitis, regardless of diet/habits/oral hygiene.
The simplest solution for at-risk people would seem to be altering the bacterial types in the mouth to favor the healthier ones, but unfortunately the oral biofilm is very difficult to penetrate and to alter. There are rinses and gels that can have an effect, but the ever-present saliva quickly washes away anything we put in there.
Enter PerioProtect trays. This new treatment we are excited to be offering to decay prone patients consists of a custom-made set of clear, thin, rubbery trays that sit on the teeth. They are fabricated with a special beading along the gum-line, set to areas where the periodontal pocketing is deeper in someone who has periodontal disease. The beading pushes a low-percentage hydrogen peroxide gel around the necks of the teeth and below the gum-line into areas that are nearly impossible to reach any other way at home, and holds the gel there for the duration of the tray wear (which is recommended to be 15 minutes). Optimal use is daily. Hydrogen peroxide has many benefits:
Basic (not acidic)
Antibacterial: kills stubborn biofilm bacteria
Whitens teeth with minimal sensitivity at the low concentration of the gel
Bubbling action allows access to deep below-the-gum-line areas
PerioProtect trays and gel have a lot of research behind them, and we are happy to have an option for our patients who brush, floss, Waterpik multiple times a day but still struggle with gum tissue inflammation or active tooth decay, and are willing to take the extra 15 minutes a day to tackle that stubborn oral bacteria.