Drs. Anastasia Kelekis-Cholakis and John B. Perry from the University of Manitoba spoke with Dr. John O’Keefe about a recent article they published in the Journal of the American Dental Association: Successful treatment of generalized refractory chronic periodontitis through discontinuation of waxed or coated dental floss use: A report of 4 cases.
Dr. Anastasia Kelekis-Cholakis is associate professor, the division head, and the postgraduate program director of periodontics, Department of Dental Diagnostic and Surgical Sciences, College of Dentistry, University of Manitoba. (Bio at the end of this post)
Dr. John B. Perry is an associate professor and the division head of oral pathology, Department of Dental Diagnostic and Surgical Sciences, College of Dentistry, University of Manitoba, Winnipeg, Manitoba, and private practitioner, Southwest Specialty Group, Winnipeg, Manitoba. (Bio at the end of this post)
Highlights
Generalized refractory chronic periodontitis is a periodontal condition that is resistant to conventional therapy. Management of this condition often is frustrating to both the patient and the clinician.
Case Descriptions
The authors present 4 cases of generalized refractory chronic periodontitis characterized by an inflammatory gingival response and progressive bone loss that did not respond to extensive periodontal treatments and regular periodontal care. Histologic examination of affected gingival tissue revealed an abundance of plasma cells, a feature seen in certain oral contact hypersensitivity reactions. The authors suspected that waxed or coated dental floss was the offending contactant, and its removal from the patients’ oral hygiene regimens resulted in a dramatic improvement of the periodontal characteristics.
Conclusions and Practical Implications
In cases of periodontal disease as described in this report, dental practitioners should consider the possibility of a contact hypersensitivity reaction to waxed or coated dental floss, whereby the floss exacerbates the condition instead of assisting in its resolution.