During periodontal maintenance for a patient with desquamative gingivitis, which hygiene procedure should be AVOIDED to prevent trauma to the fragile gingiva?

Correct answer: C. Air-polishing/prophy jet

• A. Manual or low-power ultrasonic scaling can be carefully performed in desquamative gingivitis patients with appropriate precautions and patient tolerance. It is less traumatic than air-polishing.
• B. Chlorhexidine gluconate rinse is often beneficial for desquamative gingivitis patients — it reduces the bacterial burden that exacerbates gingival inflammation.
• C. CORRECT. Air-polishing (prophy jet) uses a high-pressure stream of abrasive powder (sodium bicarbonate or glycine) that can traumatize the already fragile, friable gingiva of a desquamative gingivitis patient. This can cause blistering, bleeding, and pain. It should be AVOIDED in these patients.
• D. Gentle rubber cup prophylaxis with mild abrasive paste can be used cautiously in desquamative gingivitis if tissue integrity allows.