Dental advice please

Blue_Mermaid

I accept that neither of you have had a patient complain of it before but that doesn't mean it's overkill imho. Also, I would have thought if a practitioner prescribes something, they would have read the label themselves, so would have been aware of any possible side effects before any patient experienced it. That's what seems even stranger to me. Then again, the same can happen with doctors and drugs. Usually, it seems only pharmacists are knowledgeable about possible side effects.

Blue_Mermaid

I had the filling and saw the hygienist on Wednesday. Neither hurt, as I was so numb from the injection and hygienist topped it up as well. Have to go back next week, so she can do the rest of my mouth.

She said to phone with any questions, as she didn't have much time that day. I do have a question but couldn't get hold of her today, so thought I'd ask here again please.

She's given me some bigger tepe brushes to use and some Corsodyl gel to dip them into (incidentally, no soreness doing it this way so far). She said it was best to do this before bed, so the Corsodyl will be undisturbed overnight.

She's also advised me when brushing with toothpaste, not to rinse afterwards. Not to rinse after using tepe brushes/corsodyl either. In fact not to rinse after doing anything.

On the Corsodyl gel instructions though, it says toothpaste can stop Corsodyl working, so to rinse thoroughly after brushing with toothpaste and then wait at least 5 mins before using the Corsodyl gel.

So, what should I do Mr Dentists or hygienists who are here on this site please? I'm not supposed to rinse after brushing with toothpaste but if I don't, then the Corsodyl won't work.

Does say, you could use the gel at a different time of day to brushing but hygienist said I should use it at bedtime.

Any advice please?

justme111

Never heard of corsodyl not working due to toothpaste. In any case I think you are getting a bit clogged in details which don't matter too much. Your gum health is not going to be drastically affected depending on time of the day you use corsodyl and whether you use it at all or use toothpaste on tepe or use nothing on tepe. Re black and white she probably referred to the way xray was processed , nothing for you to be concerned of.

Apollonia

Dental Hygienist here.

I always recommend using Corsodyl (Chlorhexidine digluconate) at a different time to toothpaste. Depending on the toothpaste ingredients it can inhibit the action of the Corsodyl.

This online paper is from 2000 but I have also attended lectures more recently and the advice hasn't changed.

http://www.oralhealthgroup.com/news/periodontics-a-rationale-for-combining-chlorhexidine-and-fluoride/1000107479/?&er=NA

Table 3: Practical Recommendations for Combined Use of Fluoride and Chlorhexidine
1. When toothpaste containing sodium lauryl sulphate is used, CHX rinse should be used a minimum of 30 minutes before or after brushing with the toothpaste.
2. When toothpaste containing sodium fluoride and no sodium lauryl sulphate is used, brushing can immediately follow the CHX rinse.

NB - the 30 minutes gap between toothpaste and Corsodyl use is the minimum, the body of the article says 120 minutes is preferred.

I generally recommend a 'leapfrog' approach: brush as normal before breakfast, use Corsodyl at lunch time. Brush 2 hours before bedtime, use Corsodyl at bedtime.


The Corsodyl website has patient information here: http://www.corsodyl.co.uk/treat-gum-disease/

Blue_Mermaid

Thanks for your replies Justme and Appollonia.

You're right Justme, I am getting clogged in details but that's the type of person I am. Always try to follow instructions to the letter and worry about getting it right!

Thanks for the links Appollonia. I read the article. Going by that, Corsodyl need to change the instructions on their products, as they only recommend a 5 minute gap.

I'd find the regime you advise difficult because of my eating habits (usually need a snack before bed for instance).

It seems like the easiest solution, would be to use a toothpaste that doesn't contain sodium lauryl sulphate. I just looked at the ingredients of Corsodyl toothpaste and it doesn't appear to have it in it or would you recommend a different one? I'm currently using Oral B Pro Expert but I've just checked and it does contain sodium lauryl sulphate.

It seems a strange way round, to use the Corsodyl first with the tepe brushes and then brush with toothpaste but a lot of the instructions I've been given are alien to me. For instance, not rinsing. Whenever I've rinsed, some food comes away with the water, so I thought that was a good thing, rather than leaving it in your mouth.

Also, brushing before meals, rather than after. I understand the science behind it but then I'm left with my gums hurting when the food attacks them for hours after meals and it doesn't seem good enough to just rinse with water or mouthwash. Yesterday, I brushed a 2nd time with toothpaste a couple of hours after lunch and used the tepe brushes.

It's all so confusing!

Apollonia

Blue_Mermaid wrote: »

Corsodyl need to change the instructions on their products, as they only recommend a 5 minute gap.

No, they don't. It says to rinse thoroughly with water AND a 5 minute gap.

So the water will remove any toothpaste residue before using the Corsodyl. But then you get very little benefit from your toothpaste. As you said, the recommendation is to brush and then spit out the excess foam/toothpaste, and not to rinse after brushing.

I want my patients to benefit from both the toothpaste and the Corsodyl so that's why I recommend the 'leapfrogging' of the two substances. Also, if they have active disease, the extra cleaning and attention (four x daily instead of two) is only going to help.

I'd find the regime you advise difficult because of my eating habits (usually need a snack before bed for instance).

But if you want to improve your dental health then good eating habits are important too.

Blue_Mermaid

Apollonia wrote: »

No, they don't. It says to rinse thoroughly with water AND a 5 minute gap.

So the water will remove any toothpaste residue before using the Corsodyl. But then you get very little benefit from your toothpaste. As you said, the recommendation is to brush and then spit out the excess foam/toothpaste, and not to rinse after brushing.

I want my patients to benefit from both the toothpaste and the Corsodyl so that's why I recommend the 'leapfrogging' of the two substances. Also, if they have active disease, the extra cleaning and attention (four x daily instead of two) is only going to help.

But if you want to improve your dental health then good eating habits are important too.

Do you recommend the same regime with dipping the tepe brushes in the Corsodyl gel, like I've been instructed to do? Trouble with that is it is only cleaning the interdental bits (I know they are most important) but what about the gumline that curves above the teeth? I could see a crumb of food still trapped there for instance. I had swished with water immediately before using the tepe brushes and Corsodyl gel. This was a couple of hours after lunch.

You are making an assumption there about my eating habits. They are good eating habits for me. Gum disease is not my only health problem. I suffered with peptic ulcers in the past and when I'm hungry I need to eat or risk severe pain and the ulcers returning. I need a snack before bed for this reason. Sometimes, I also need to eat between meals if I'm getting hunger pangs, for the same reason. So, it's difficult to keep my stomach healthy and help my gums at the same time.

Apollonia

Blue_Mermaid wrote: »

Do you recommend the same regime with dipping the tepe brushes in the Corsodyl gel, like I've been instructed to do?

Yes.

Blue_Mermaid wrote: »

what about the gumline that curves above the teeth? I could see a crumb of food still trapped there for instance.

Ask your hygienist at the next visit to show you how to clean effectively in this area.

Blue_Mermaid wrote: »

You are making an assumption there about my eating habits.

No, I'm not making assumptions. You were the one who stated that you "needed a snack before bed", I didn't asssume anything. If I'd started banging on about healthy diet out of the blue, that would be an assumption.

But again, ask your hygienist. She has access to your medical history and can discuss options. That is why this board is quite strict about giving personal medical advice; we can't examine you and we don't have a full picture of what's going on. You're paying the hygienist for all that.

PasturesNew

I see my hygienist every 3 months and have a clean and an injection of gel called Dentomycin. The gel is expensive but they only inject the pockets and so the syringe is kept in the fridge until my next appointment; I am on the first syringe and it looks like there'll still be enough for my 3rd injection. I can't give prices as I'd signed up for Denplan and am now stuck with that until this is all over before I drop it....... but on top of Denplan I paid £64 for the gel.

The dentist says the pockets are reducing and what I am doing is "right/working". I use the interdental brushes daily.

Last visit I also had an extraction due to the bone having disappeared and infection settling in behind the tooth.

This year I am getting more out of Denplan than I paid in, thank goodness!

Blue_Mermaid

Apollonia wrote: »

Yes.



Ask your hygienist at the next visit to show you how to clean effectively in this area.



No, I'm not making assumptions. You were the one who stated that you "needed a snack before bed", I didn't asssume anything. If I'd started banging on about healthy diet out of the blue, that would be an assumption.

But again, ask your hygienist. She has access to your medical history and can discuss options. That is why this board is quite strict about giving personal medical advice; we can't examine you and we don't have a full picture of what's going on. You're paying the hygienist for all that.

I will discuss it all with her but she didn't have time last week and probably won't have this week either, as she's concentrating on getting all the deep cleaning done at the moment.