Making perio probing more comfortable?

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GoGatorsDMD

GoGatorsDMD

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Does anyone have any tricks to reduce the discomfort of perio probing? Of course, I mean short of injecting local...

I guess I'm looking for some kind of tricks with topical or something... anyone?
 
GoGatorsDMD said:
Does anyone have any tricks to reduce the discomfort of perio probing? Of course, I mean short of injecting local...

I guess I'm looking for some kind of tricks with topical or something... anyone?
Click to expand...

I think there's something from the same company (Collagenex Pharmacueticals) that makes Atridox. They have special syringes that are used to inject the material into the periodontal pocket. I think it's a combination of lido and benzo. The company claims that it provides sufficient anesthesia for SRP. While it may work during probing, I highly doubt that it provides adequate anesthesia for root planing pockets. I don't know the cost. Sorry, don't remember the product name.
 
along that thread....
Ext = no pockets, no problem 😀
 
If there is pain on probing then there can be three reasons. Either your technique is wrong, the patient is hyperresponsive to stimuli (wuss) or they're so inflammed that its just damn painful. For one learn to use a finger rest, for two there isn't much to do beside telling them to get over it or anesthetizing, for three do a gross debridement and probe later.
 
nitrous oxide provides analgesia (perio loves anal-gesia when they probe and make sweet love to the gingiva)
 
I had the same issue with a patient in dental school, just really hyperresponsive with alot of anxiety, technique was fine, I couldn't have been more gentle if I wanted to.

Perio faculty went to their department and came back with a Lidocaine rinse, not sure what the brand name was but I was able to complete the probing after that. I think there was a psychological component to it to be honest with you. I don't think it helped at all physiologically.

I've heard of rinsing for 30seconds with listerine, seems counterintuitive to me though.

So before you go telling them to 'get over it' you could try some behaviour management ("This stuff is the best, it really works well, why don't we try this? That's much better isn't it? Doesn't that work great?, etc."). If they believe it works (whether or not it does) then theoretically it shouldn't matter what you use. I know some people think this is a load of BS but if you can pull it off it is really the best option for the patient.

I like the Nitrous idea, it wouldn't provide any pain relief but at least they wouldn't care as much

If they are deeper pockets then the above probably wouldn't work as well (except N2O) so you may want to "carry" some topical anesthetic on a curette into the pocket and let sit for a few seconds.
 
Nitrous does increase the pain threshold. So it will indeed provide pain relief as stated previously. But it is expensive just for probing.

If it is your first few times probing, have an instructor probe, then you probe, and ask the patient if there is a large difference. Then work with the instructor on your form. Of course, do this with a non-phobic patient who can handle it well.

If it is not your form, there are definitely very anxious patients out there. Behavior management works for adults and children for this reason: People do not like a lack of control, and they want to know that you care about them.
 
backaction said:
I think there's something from the same company (Collagenex Pharmacueticals) that makes Atridox. They have special syringes that are used to inject the material into the periodontal pocket. I think it's a combination of lido and benzo. The company claims that it provides sufficient anesthesia for SRP. While it may work during probing, I highly doubt that it provides adequate anesthesia for root planing pockets. I don't know the cost. Sorry, don't remember the product name.
Click to expand...

My bad, it's the same company that makes Arestin. It's called Oraqix and from the company OraPharm. and it's useless. It's lido/prilo 2.5/2.5%
www.oraqix.com
 
Putting regular topical on the gingiva can reduce it a little bit, but it still hurts for those inflammed. Preferably, lidocaine topical. That stuff is potent as far as topicla goes...👍
 
Practice, practice, practice. I remember probing that first patient, I felt like my hands weighed 3 tons. Now, I zip right through it. Of course, if the patient is hypersensitive, then it won't matter how gentle you are with the probe.
 
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