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Periodontics/4-5mm pockets on two teeth - SRP? Arestin?


Hello, my question is about periodontal disease. My wife was told by her hygenist (not the dentist) that she had 4-5mm pockets on just two of her molars. The dentist didn't even see her. She immediately recommending a scaling procedure and an expensive Arestin treatment.  I know Arestin can potentially be a huge money-maker for dental practices so I am quite leary.  She has no pain, seepage, or bleeding.  We feel like maybe they are just trying to get their money out of us because she missed two cleanings.  Am I way off base here?  Her "condition" seems mild to me; a slightly invasive procedure and a "drug of the day" treatment just seems like a little much for mild pocketing.  Also the hygenist told her it was safe to take if she thought she could be pregnant (and she could be) and I researched and found Arestin to be Category D.  Any help would be appreciated.

Dear Nic,

Since Arestin (minocycline) is in the tetracycline family of antibiotics, I would not use it in pregnant or nursing women.
I believe most dental professionals use Arestin because their patients may benefit from it and is a conservative way to treat mild forms of periodontal disease as an adjunct to Scaling/Root Planing.
If your wife did have 4-5mm pockets, a case can certainly be made for recommending S/RP with or without the use of Arestin (if she was not pregnant or nursing);   Please be aware that all mild periodontal disease untreated become moderate, than severe.
I hope this helps.



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John Kong, DDS,


I am a board-certified periodontist and an expert on dental implants. I am currently in private practice at Better Living through Dentistry. I can answer questions related to the treatment of periodontitis (gum disease), dental implants, sinus lifts, bone grafts, gum grafts, surgical exposure of teeth, and minor orthodontics.


I have been practicing periodontics and placing dental implants since 2006 on the Upper West Side, Manhattan, NY and in Forest Hills, Queens, NY at Better Living through Dentistry. I am currently an attending and Chief of Implantology at Flushing Hospital Medical Center.

American Board of Periodontology, American Academy of Periodontics, American Dental Association, New York State Dental Association

Wesleyan University / Amherst College, BA; SUNY Stony Brook Dental School, DDS; University of Medicine and Dentistry of New Jersey, Certificate in Periodontics; New York University, 1-year program in Full-Mouth Reconstruction; Certified in Invisalign

Awards and Honors
Northeast Society of Periodontists Achievement Award

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