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  Dr Minh Nguyen
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Chlorhexidine oral rinse

CHLORHEXIDINE oral rinse (Peridex®, Periogard®) is used to treat gingivitis. Bacteria that grow on your teeth between brushings cause gingivitis. Chlorhexidine destroys this bacteria. Chlorhexidine oral rinse will help to decrease gum bleeding and redness and swelling of your gums. Chlorhexidine oral rinse will not prevent plaque or tartar from forming on your teeth. Proper toothbrushing and flossing are still needed. Treatment with chlorhexidine oral rinse usually begins immediately after a dental cleaning.


Prior to prescribing this medication, your dentist will need to know if you have any of the following conditions:
•an unusual or allergic reaction to chlorhexidine, especially skin antiseptics
•other gum or dental problems
•front tooth fillings, dentures or other mouth appliances, especially those having rough surfaces

Chlorhexidine oral rinse should be used immediately after brushing and flossing. Rinse all toothpaste completely from your mouth. The cap on the original container may be used to measure the 15ml (1 tablespoonful) dose. Fill the cap to the "fill line." If you do not have the cap, ask your pharmacist or other healthcare professional for a device to measure the dose. Swish 15 ml chlorhexidine oral rinse in your mouth for 30 seconds. Do not swallow the medicine. Use the medicine full strength; do not mix with water before using. Do not eat or drink for several hours after using the oral rinse as this may decrease the effect of the medicine. Your dose and daily use may be different from these directions. Follow the directions from your dentist or other healthcare professional.

Contact your pediatrician or health care professional regarding the use of this medicine in children. Special care may be needed. If you miss a dose of this medicine, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and start back on your regular schedule. Do not use double doses. Very little chlorhexidine is taken-up by your body. The oral rinse should not interact with any other medications you are taking.

Tell your dentist all other medicines you are taking including non-prescription medicines, nutritional supplements, or herbal products. Also tell your dentistl if you are a frequent user of drinks with caffiene or alcohol, if you smoke or if you use illegal drugs. These may effect the way your medicine works. Check before stopping or starting any of your medications.

Side effects that you should report to your dentist as soon as possible include:

•shortness of breath
•rash
•hives
•itching
•swelling of tongue or throat

Side effects that usually do not require medical attention (report to your prescriber or other health care professional if they continue or are bothersome). Visit your dentist every 3 months for gum diease maintenance and to check on your progress. Chlorhexidine oral rinse may have a bitter aftertaste. Do not rinse your mouth after using chlorhexidine oral rinse because that will increase the bitter taste. Also, rinsing will decrease the effect of the chlorhexidine.

Chlorhexidine oral rinse may change the way food tastes to you. This effect may last up to 4 hours after using the rinse. Usually this effect becomes less noticeable as you continue using the rinse. Your taste should return to normal after stopping the use of chlorhexidine.

Chlorhexidine oral rinse may increase tartar build-up and stain your teeth, dentures or fillings. Brush with a tartar control toothpaste and floss daily to help decrease the amount of tartar build-up and staining. It is important to visit your dentist at least every 6 months to have your teeth cleaned.

PerioChip

More than 75 percent of Americans over the age of 35 suffer from periodontal disease, a bacterial infection of the gums, teeth, and bone that surrounds the teeth. As the disease progresses, your immune system produces white blood cells to fight the infection. Unfortunately, the white blood cells release enzymes that destroy the soft tissue and bone that hold your teeth in place, and as a result, your teeth may become loose. If left untreated, this destruction of supporting bone will eventually lead to tooth loss.

Fortunately, we now have an effective treatment called PerioChip that we apply directly to the infected area. PerioChip fights periodontal disease and its tissue-destroying effects by reducing the number of harmful bacteria in your gums.

A PerioChip is a biodegradable gelatin chip that's about the size of a baby's fingernail. It contains the antiseptic chlorhexidine, a medication that's placed directly on the infected gum tissue. As the chip disintegrates, it releases the medication into the periodontal pocket, first at a high concentration, then at a controlled rate for the duration of the treatment. The antiseptic greatly reduces the number of bacteria in the infected pocket and speeds the healing process. Unlike antibiotics, PerioChip does not produce bacterial resistance; it works by destroying the bacteria's cell walls.

Depending on your needs, we can place up to 8 PerioChips in a single visit. We typically recommend PerioChip treatment after we perform a procedure called scaling and root planing, and then again about every 3 to 6 months for as long as periodontal pockets are 5 millimeters deep or more. Unlike some other treatments that contain antibiotics, PerioChip can be administered every 3 months for up to 24 months.

PerioChip is not a cure for periodontal disease and cannot replace supportive bone that may have been lost if the disease was left untreated. You'll still need to be meticulous about your daily oral hygiene and come to see us every 3 to 4 months for exams and professional cleanings. However, when it's used as part of your comprehensive periodontal therapy, PerioChip can help prevent further destruction of bone and connective tissue.

Periostat

Periodontal disease is an infection of the teeth, gums, and the bone that surrounds the teeth. It's caused by specific bacteria that live in the spaces between the teeth and gums, called pockets. The bacteria that cause periodontal disease trigger the body's immune system to produce enzymes, and these enzymes are what actually cause bone loss.

If left untreated, the destruction of supporting bone eventually leads to tooth loss. In fact, periodontal disease is the number-one cause of adult tooth loss. The traditional treatment for periodontal disease has always included a series of steps, beginning with the removal of plaque and tartar from the root surfaces. This procedure is called root planing. After healing, the areas are re-evaluated, homecare techniques are modified, and in severe cases, surgery is recommended. Fortunately, recent breakthroughs have led to the development of another effective tool in the ongoing fight against periodontal disease -- a new systemic medication called Periostat.

Periostat is taken not for its antibiotic effect, but for its inhibiting effect on the bone-destroying enzymes that are released by the body in response to periodontal disease. It's taken twice daily, one capsule in the morning and one in the evening, about an hour before meals. When used in combination with scaling, root planing, and improved homecare techniques, Periostat suppresses the level of destructive enzymes that cause bone loss, which will in turn help to reduce pocket depth and promote healthy gum-tooth attachment. We won't prescribe Periostat if you're allergic to tetracyclines, or are pregnant or nursing; we also don't prescribe it for infants or children under eight years of age.

Periostat is an important advance in the treatment of adult periodontitis that, when combined with scaling, root planing and improved homecare techniques, can help stop the ongoing damage caused by periodontal disease.


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