By: Lee Ann Brady DMD
Topic originally appeared on PankeyGram.org. Dr. Brady granted permission for igniteDDS to share with our readers.
Chlorhexidine has had a wide range of uses in dentistry for many years, including maintaining tissue health during periodontal therapy, reducing the risk of caries, and minimizing sensitivity.
Along with the positive effects it has, it is reported by patients to cause mild alterations in taste perception and teeth discoloration. However, the use of chlorhexidine for tissue management is proven to be an effective antimicrobial agents against a range of microorganisms such as gram-positive and gram-negative bacteria, fungi, and yeasts – making it the number one choice in infection with candida albicans.
Provisional Restorations and Tissue Health
Managing tissue health during the time period our patients are in provisional restorations has become even more critical as we have incorporated more resin bonding techniques to seat indirect restorations. Isolation is critical to long-term success and can be challenging after multiple weeks in a bisacryl provisional.
We emphasize oral hygiene to our patients during this period, but there are often obstacles to maintaining optimal tissue health by the time they return for the seat appointment.
One common issue is that patients may be hesitant to perform thorough hygiene routines, fearing that their actions might dislodge the provisional. This fear often leads them to brush less, floss infrequently, or even neglect that part of their mouth completely. Even for those who are diligent in their hygiene, the provisional itself can be a barrier. Suboptimal contacts can increase interproximal food impaction, and the bisacryl material tends to attract and retain plaque due to its surface texture, even when finely polished.
Overcoming Oral Hygiene Challenges During These Times
Chlorhexidine comes also in the form of a varnish, and knowing these barriers and the goal of super healthy tissue in the seating appointment, Chlorhexidine varnish (Cervitec® Plus, Ivoclar) has become one of my favorite products. We are all familiar with the incredible anti-microbial effects of chlorhexidine, and also the reasons we dislike it.
Cervitec does not have a bad taste, does not cause the typical brown staining, does not affect the patient’s taste buds, and they don’t have to remember to use it. Cervitec® Plus is a clear liquid applied with a micro-brush. At the end of any appointment where we have placed a provisional, my assistants will coat the gingival margin with Cervitec as the last step before the patient leaves.
Having incorporated this into my restorative procedures for over five years, I can confidently say it’s a game-changer. Tissue health at seat appointments is nearly perfect, and I rarely encounter difficulties with isolation due to poor tissue management.
If you’re interested in learning more about tissue management for successful restorative outcomes, I recommend you visit many resources and advanced education courses at The Pankey Institute. Elevate your practice’s success and network with a community of learners who support one another personally and professionally for a thriving dental practice.
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