Pain Management for the Maintenance of Periodontitis

INTRODUCTION

Periodontal disease is a chronic oral infection that can result in the destruction of the gingiva, periodontal ligament and bone. It is an inflammatory disease with bacterial etiology and the host response to the bacterial load can be challenging to manage. ¹

The American Dental Association reports that nearly 42% of all U.S. adults over 30 years of age have some form of periodontitis (mild, moderate or severe).² Additionally, the CDC reported in 2013 that periodontitis is still one of the biggest threats to dental health in the United States.³

The goal of periodontal treatment is to eliminate dysbiotic plaque from the tooth and gingival surfaces to establish an environment that promotes optimal dental health. Once periodontal treatment has been initiated, the patient requires assiduous long-term dental care and dedication to maintain proper oral health. 

CHALLENGE: Managing Patient Pain for the Maintenance 

of Periodontitis 

Due to the complexities of disease that accompany periodontitis, managing a patient's pain during dental appointments can be difficult. Patients with more severe periodontitis have been found to be more likely to experience disease recurrence and pain during their visits. Maintaining dental care for the patient with periodontitis is imperative and doing so in a pain-free way is crucial.

There are a variety of different pain management modalities available, all with their own characteristics dependent on the type of anesthesia needed. Increasingly, patients and clinicians also desire anesthetic options that are fast-acting, efficient, needle-free and easy-to-use. 

Patients who have active periodontal disease often experience discomfort associated with the disease, which can make thorough instrumentation difficult. For proper biofilm removal, clinicians need to be able to instrument below the gumline. Maintaining patient comfort during this sub-gingival debridement is challenging if patients are experiencing pain. 

Proper pain management is imperative. It allows the clinician more efficient access for removal of sub-gingival bacteria, and it allows for the patient to be pain-free during appointments. This builds trust between the patient and clinician and enhances the quality of dental care delivered. In addition, some patients' anxiety makes them fearful of pain which inadvertently keeps them from maintaining regular dental care, which only further contributes to the progression of their disease. 

Dental professionals need to find a delicate balance between maintaining patient comfort and appointment efficiency. Pre­procedural pain management can be time-consuming in an already demanding clinical schedule. This delicate juggle can be facilitated  by using the appropriate anesthesia for pain management, especially those patients suffering from periodontitis. Often, these patients needfor an anesthetic option that will effectively eliminate their pain during instrumentation, and the clinicians need an anesthetic option that  can deliver optimal comfort in an efficient, easy-to-use manner.

Increasingly, other non-injectable anesthetic options readily available are not the most efficient option for managing a patient's pain. Often, these sub-gingival gels and liquids require site-specific delivery which  is time-consuming and can be costly to administer .

SOLUTION: Periovance Oral Rinse 

Periovance Oral Rinse delivers effective pain relief and appointment efficiency for clinicians. This oral rinse is an easy-to-administer, full-mouth anesthetic that is needle-free, alcohol-free, all-natural and delivered with a single 60-second swish. It is used to treat pain associated with a variety of oral conditions, such as moderate to severe gingivitis, periodontitis and other oral lesions. Its unique blend of benzocaine, maltodextrin and aloe­vera bind to pain receptors for a complete combination of pain relief and comfort. 

To summarize, Periovance Oral Rinse: 

• Increases appointment efficiency.

• Lessens chair-time waiting for anesthetic effects from local anesthesia.

• Delivers pain relief so that clinicians can remove sub-gingival biofilm thoroughly.

• Improves overall patient care and pain management.

• Increases revenue for rinse sales to patient for at-home use following periodontal visits.

• Delivers pain relief for patients at home who suffer from painful oral conditions.

• Does all this at just $1.99/patient use - highly competitive against other oral anesthetics.

RESULTS AND PROOF POINTS 

Recently, a controlled study was conducted utilizing patients selected at clinician discretion, based solely on their assessment of gingival conditions and the maintenance of disease associated with periodontitis. There were nine total patients for this study. It is important to note, the disease diagnosis of the cases are reported below: 

• Localized Stage I, Grade A Periodontitis

• Localized Stage II, Grade A Periodontitis

• Generalized Stage II, Grade A Periodontitis

• Generalized Stage II, Grade B Periodontitis

• Localized Stage II, Grade B Periodontitis

• Localized Stage Ill, Grade B Periodontitis

Three independent dental hygienists completed the patient selection. These patients were not solicited by OraBio, Inc. for the purpose of this study. Each patient gave their verbal consent to use the product for pain management during instrumentation and for their clinician to record the results. Each patient was between the ages of 18-99 with no bias to sex or ethnicity. Each patient was instructed to swish with 1 tablespoon of Periovance Oral Rinse for 60-seconds to obtain necessary anesthesia. 

Clinical results and in-depth patient interviews post-treatment showed that all patients remained comfortable during debridement and did not need any other pain management modality to complete the necessary treatment. All patients report the rinse was easy-to-use and effective for the management of their gingival pain during instrumentation. Additionally, all patients reported that they would use the rinse again at subsequent appointments.

The three dental hygienists completing this study offered encouraging feedback regarding how easy implementation of Periovance Oral Rinse was to use. Also of note, they reported that using the rinse for pain management increased appointment efficiency. 

The findings of the study clearly support that Periovance Oral Rinse is effective at reducing pain associated with maintaining the oral health of patients who have periodontal disease. Furthermore, all patients in the study would welcome using the product at subsequent visits and felt the rinse was easy to use. 

Periovance Oral Rinse is easily integrated into current treatment protocols for pain management and allows for increased efficiency for the clinician as it streamlines patient care. It can be used before, during or after treatment to extend comfort for take-home use.

STUDY TESTIMONIALS 

Clinician Testimonial #1: "The patient was very comfortable during subgingival scaling." 

Clinician Testimonial #2: "The patient was able to remain comfortable which helped to speed up the process of the appointment." 

Clinician Testimonial #3: "The rinse allowed for more comfort and an easy flowing appointment." 

Clinician Testimonial #4: "I was able to get through the appointment more fluidly, and I did not have to stop multiple times due to discomfort." 

Patient Testimonial #1: "This felt painless, I did not notice any pain during the appointment." 

Patient Testimonial #2: "I was very appreciative of the rinse today." 

Patient Testimonial #3: "I was comfortable and able to relax because I was not anticipating pain on my gums." 

Patient Testimonial #4: "I was thrilled to be pain free." 

REFERENCES

1. Periodontitis. (June 2022). American Dental Association. Date fetched: March 1, 2024.

2. Oral Health in Adults. (December 2020). Centers for Disease Control and Prevention (CDC). Date fetched: January 31, 2024.

3. Genco R, Williams R. "Periodontal Disease and Overall Health: A Clinician's Guide." Yardley, PA: Professional Audience Communications, Inc.; 2010. Date fetched: March 4, 2024