John C. Chao, D.D.S.

Research Associate Professor, University at Buffalo, SUNY
Adjunct Assistant Professor, Ostrow School of Dentistry, USC

(626) 308-9104

Endoscopy



John C. Chao, D.D.S., M.A.G.D
Anxiety Management,
Behavior Science,
Faculty, USC School of Dentistry

Like arthroscopic surgery, dentists can now use a new miniature camera system to non-surgically treat gum disease.

Arthroscopic surgery is a minimally invasive surgical procedure in which treatment of damage of the interior of a joint is performed using an arthroscope, a type of miniature fiber optic camera inserted into the joint through a small incision. A new technology employing a dental fiber optic camera, called a “perioscope,” is now being used non- surgically to treat gum disease. The advantage of the “perioscopic system” is that it provides real-time visualization of bacterial deposits (plaque) underneath the gums, enhanced by intense illumination and 24-48x magnification. In contrast, the traditional method of “deep cleaning” involves removal of plaque without visualization and only by "feel." Perioscopic technology allows the dentist to see and fully and consistently remove plaque, the main culprit in gum disease. In a vast majority of cases gum surgery can be avoided using perioscopic therapy. Where surgery is necessary, perioscopic surgery has been shown by studies to be just as effective as the traditional approach.

The use of technology requires a new level of training and skill on the part of the dentist or hygienist. This is because the perioscopic system integrates the miniature camera with a light source, water irrigation, digital processor and a flat panel video monitor that captures real-time images. The illumination and water are controlled by a foot- activated control system while the micro camera placed under the gum by the left (non-dominant) hand. Miniaturized, ultra-sonic instruments are used by the right hand to remove plaque. The image is projected onto the screen. The dentist/hygienist visualizes the area underneath the gums by watching the screen, not looking at the mouth. When the system is in use, both hands and both feet are used simultaneously.

Various studies published in prestigious journals, such as the Journal of Periodontology, have shown that the results of perioscopic treatment were quantifiably more effective than traditional methods. The disadvantage of this novel approach is that perioscopy is "technique sensitive," and therefore the learning curve is steep. Perioscopy is projected to be more available in the near future.

If you have gum disease, ask your dentist about this new mode of non-surgical treatment. If you do not have gum disease, see your dentist regularly to prevent the disease. Gum disease is the number one cause of tooth loss in adults. To keep your smile beautiful, keep seeing your dentist every six months.