New understanding of periodontal systemic therapy Periodontal disease is a long-term chronic process of destruction of periodontal tissue, on the one hand, due to long-term chronic stimulation of plaque, tartar and other local irritants; at the same time, due to the influence of systemic or other external susceptibility factors leading to changes in the rate of development of periodontal lesions. Periodontal systemic therapy —- is a collective term for a series of therapeutic approaches that address the etiology of the disease. (Ecology, pathology, clinical therapeutics) Principles of periodontal systemic therapy —- control plaque and eliminate inflammation; restore the physiological form of periodontal tissue; restore function; maintain long-term efficacy and prevent relapse. Corresponding treatment procedures (close cooperation between the doctor and patient): basic periodontal treatment; periodontal surgical treatment; restorative treatment; periodontal supportive treatment. The situation of periodontal patients varies widely, so it is important to design effective treatment plans that address the lesions and save time and money. Meeting the needs of the patient is critical, and achieving all goals may seem difficult, but it is the ultimate goal of clinical work. It is essential for the successful periodontist to understand what periodontal systemic therapy is all about and to really follow it through. Basic periodontal treatment: completely targeting the etiology. Oral hygiene education: The success of periodontal treatment is directly proportional to the effect of oral hygiene education and should be given sufficient attention. Since oral hygiene education cannot be directly related to economic benefits, it is easy to be neglected. Continuous adherence to oral hygiene education is an essential step in doctor-patient communication, and if we simply focus on treatment and neglect the patient’s own maintenance, it will inevitably lead to waste of treatment time and cost and delay the recovery of the disease. Exclude the promotion of some systemic factors or susceptibility factors. Most periodontal disease is caused by the patient’s “inability to brush”. Many people will emphasize that they brush 3-4 times a day, and others will brush a toothbrush in a few days, so many people will disagree with the doctor’s opinion that “periodontal disease is caused by poor oral hygiene”. How to teach patients to brush their teeth correctly, change some misconceptions and establish correct concepts is the responsibility of doctors at all times during the treatment process. Because some misconceptions of patients can directly affect the trust and confidence of patients in doctors and treatment. (1) Why does tartar grow even if I brush my teeth every day? If you do not master the correct method of brushing, it will lead to some parts of the teeth are not brushed for a long time, and the stain deposit will calcify and form tartar. The bacterial plaque on the tooth surface will not fall off without mechanical methods (toothbrush, dental floss, toothbrush) but simply rinsing. (2) Why does tartar grow even after regular annual cleanings? Each cleaning only removes tartar from the past. If you brush your teeth improperly or not carefully after the cleaning, new tartar will be deposited. Some patients have serious periodontal disease, and most of the tartar is deposited inside the gums. Due to professional limitations, many doctors fail to give patients thorough treatment (subgingival scaling) and do not give patients a suggestion to “continue to see a periodontist for treatment”, so that periodontal lesions are not really treated and controlled. (3) After periodontal treatment, patients feel that the problem is more serious: periodontal disease rarely has conscious symptoms, so many patients do not realize that they have a very serious periodontal disease, some patients have loose teeth and do not feel discomfort, and some patients do not even think that their teeth have fallen out. On the contrary, some uncomfortable symptoms may occur during or after treatment, making some patients have a low desire to seek treatment or even refuse treatment. However, if the development of periodontal lesions is not curbed by treatment, it will lead to more loose and lost teeth, resulting in greater physical and economic losses and bringing pain that is more difficult to repair. (4) What discomfort will occur after periodontal treatment? The reason is that after periodontal treatment, the gum inflammation subsides, the gum adheres closely to the bone around the root, and the degree of gum and bone destruction shows up, and a series of discomfort symptoms appear as a result. If no treatment is carried out, periodontal inflammation is not controlled, there will be more destruction of gum and bone, and teeth will loosen or fall out. On the contrary, after treatment, the discomfort will gradually decrease or even subside as the lesions are controlled and improve. If necessary, local anesthesia can also be used. (5) Taking medication alone will not solve periodontal problems. Because the cause of periodontal disease is the local accumulation of irritants, without removing these irritants through periodontal treatment, medication alone will not work, and the effect of any medication is temporary and auxiliary. (6) Since periodontal lesions make the roots of the teeth more exposed and the gaps larger, it is easier to accumulate tartar and other irritants, and it is more difficult to brush the teeth clean, so it is necessary to use special cleaning tools such as dental floss or tooth brushes in conjunction, only then can the exposed teeth and root parts be brushed clean, otherwise, new tartar will soon be formed. Because of this, periodontal treatment is all the more important for early prevention and early treatment. Moreover, with the popularity of periodontal cleaning, some negative effects are expanding and stretching.