Do I Really Need Arestin?

by Laurie
(Sarasota FL)

Hello- I want to thank you for your informative website - and ask a question.

I admit that I have simply brushed and flossed and neglected going to the dentist for 4 or 5 years. I just walked out my appointment with a Dentist in my new hometown with a migraine! It started with the dental technitian taking x-rays and then diagnosing my x-rays, and explaining to me that I had some pockets, with calculus, and that the Dental Hygentist would be in to measure the gums. anything 1,2, or 3 was Ok, but higher numbers were problems.

There were 2 or 3 spots with a 6, the same with a 5, and 3, the rest were 0 or 1. However, there were many with low numbers and bleeding, which does not happen when I brush or floss. The Hygenist then told me she would deep clean and put antibiotics in while cleaning. After that, the Dentist came in, looked at the X-rays and my teeth, and said the Dental Technitian would give me my treatment plan....$1166.00 total, with 754.00 not covered by insurance! For 2 deep cleanings, left and right, and Arestin on teeth 2,3,5(2doses) 29,30, (2 doses each) and 31 on my first visit, and then double doses of Arestin on teeth 18 & 19 on my second visit for deep cleaning.

My question is: how do I know if I need Arestin, or can I ask for a different treatment? I tried to speak to the Dental Tech about a plain old antibiotic, and he just said it has to be the one that is placed in the gums.

Do I simply request my records and find another dentist, insist on a less expensive treatment option, or go purchase a hydrofloss and listerine after I get a deep cleaning & refuse the Arestin?

I am stumped and just want healthy teeth. Thank you for any info & guidance!


Hi Laurie, It is possible that you need a deep cleaning but also possible that you only need certain areas deep cleaned. Pockets 4-6mm with moderate to heavy calculus typically do need a deep cleaning. Pockets that are 3mm or less most likely don't need a deep cleaning even though they may bleed when measured. A regular cleaning and possibly a different bruising and flossing technique should improve those areas.

Pocket depth and calculus are what indicate the need for a deep cleaning. Deep cleaning is billed to the insurance provider (or the patient if there is no insurance) by the quadrant...for example lower left, lower right, upper left and upper right.

I think most insurance plans requires 4 teeth in the quadrant to have pockets 4mm or deeper to qualify for deep cleaning coverage. This may be one reason your insurance is not covering more of your costs. There is an insurance code for deep cleaning of 1-3 teeth in a quadrant.

It's important to know why the charges are not being covered. Quite often deep cleaning is covered at 80% but every plan varies and there may be other reasons they're not covering more of your fees.

Regarding Arestin: Arestin is a great product and a useful tool in treating periodontal disease but it is not the only product and it is not a miracle cure. Sometimes it works and sometimes it doesn't. It is also very expensive when placed in more than a few pockets. I find it impractical when there are more than 3 or 4 sites that need treatment. I find it useful for treating stubborn areas that don't improve after a deep cleaning and in spite of the patient having a good home care routine.

It seems unusual to already be planning for a second round of Arestin when you don't know how your gums will respond to the deep cleaning and the first round.

Typically I would not use Arestin until after I re checked the patient's gums 3 months after a deep cleaning. It is common for pockets to return to a healthy measurement after deep cleaning plus daily brushing and flossing.

Deep cleaning alone is extremely therapeutic when combined with meticulous daily home care. Listerine and Hydrofloss or WaterPik Flosser would certainly be a great help!

Of course I don't know enough about your case to give you specific advice but hopefully this general information will help you be more informed.

Thank-You for writing,

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