Understanding the Etiotropic Phase of Periodontal Disease

Periodontal Disease

Periodontal Disease is known as etiotropic phase because its goal is to eliminate the etiologic factor of periodontal diseases.

Periodontal Disease is also known as initial phase, nonsurgical phase and hygienic phase.

“Understanding The Causes Of The Etiotropic Phase Of Gum Disease”

Objectives of Etiotropic Phase Therapy

• To reduce or eliminate the gingival inflammation.
• To eliminate the periodontal pocket produced by the edematous enlargement of inflamed gingiva.
• To achieve surgical manageability of gingiva.
• To improve healing after periodontal surgery.

“Symptoms Of The Etiotropic Phase Of Gum Disease”

Primary goal of etiotropic phase is the elimination of inflammation and plaque control, which includes following:

“What Is The Etiotropic Phase Of Periodontal Disease”

• Patient education and motivation
• Mechanical plaque control: Scaling and root planning.
• Correction of restorative and prosthetic irrational factors: Overhanging margins of dental restoration should be removed.
• Excavation of caries and restorations (temporary or final): Caries control should be performed. Amalgam and composite restorations can be performed to close contacts and to correct food impaction.

“Causes Of The Etiotropic Phase In Periodontal Disease”

• Topical and systemic antimicrobial therapy: Chemical control of plaque can be achieved by mouthrinses, irrigation and antibiotics.
• Occlusal therapy: Occlusal adjustment should follow scaling and root planning. If tooth is mobile gross occlusal adjustment should be done before scaling to reduce mobility.
• Minor orthodontic movement: It can precede or follow any surgical interventions. It is performed as a part of phase I but when there are inflammation or bone deformities due to tooth alignment. Major orthodontic tooth movement done for purposes of reconstruction or esthetics may follow surgery.
• Provisional splinting and prosthesis: Wire ligation and composite acid etched splintings are performed during phase 1 therapy. Temporary splinting can be done to control secondary occlusal trauma before the surgical planning.
• Diet control: Diet control or diet modification is done.
• Additional preventive measures: These include fluorides which are advised to caries prone patient.

Reevaluation Visit

• It is performed in 4 to 8 weeks following completion of initial phase of periodontal therapy.
• All the data taken during the initial visit should be recollected at re-evaluation visit such as oral hygiene status, gingival inflammation, bleeding on probing, probing depth, attachment level, dental caries and calculus.