Periodontal Treatment

The first non-surgical step usually involves a special cleaning, called scaling and root planing, to remove plaque and tartar deposits on the tooth and root surfaces. This procedure helps gum tissue to heal and periodontal pockets to shrink. This is sometimes referred to as "periodontal" or "deep cleaning." A local anesthetic may be used to make you more comfortable. And the treatment may be scheduled for one or more visits.

Your dentist also may recommend medications to help control infection and pain, or to aid healing. These medications could include a pill, a mouthrinse, or a substance that the dentist places directly in the periodontal pocket after scaling and root planing. Your dentist may also stress the need to control any related systemic disease, like diabetes.

At the next visit, the dentist checks the pocket depth to determine the effect of the scaling and root planing. At this point, many patients do not require any further active treatment, only preventive care. However, if the disease has advanced to the point where the periodontal pockets are deep and the supporting bone is lost, surgery may be necessary to help prevent tooth loss. You may be referred to a periodontist, a dentist who specializes in the treatment of diseases that affect the supporting structures of the teeth-the gum and bone tissue-for treatment.

Periodontal Surgery

When periodontal pockets do not heal after scaling and root planing, surgery may be needed to better remove inflamed tissues and reduce the damage to the bone that has formed around the teeth. As the pockets enlarge, they provide a greater place for bacteria to live and attack the bone and tissue.

Surgery allows the dentist to access hard-to-reach areas under the gum and along the roots where tartar and plaque have accumulated. Eliminating this bacterial stronghold and regenerating bone and tissue help to reduce pockets and repair damage caused by the progressing disease.

During the procedure, the dentist turns back the gum tissue and removes tartar and smoothes the roots so that gum tissue can reattach. The gums are sutured back into place or into a new position to make gum tissue snug around the tooth.

Your dentist may recommend additional procedures to regenerate lost bone and tissue. Bone surgery, including bone grafts, is used to rebuild or reshape bone destroyed by periodontal disease.

Membranes (filters), bone grafts or tissue-stimulating proteins may be used to encourage your body's natural ability to regenerate bone and tissue.

Splints, bite guards or other appliances may be used to stabilize loose teeth and to aid the regeneration of tissue during healing. If excessive gum tissue has been lost, a soft tissue graft (gum graft) may be performed. A soft tissue graft can reduce further gum recession and bone loss.

Soft tissue grafts can be used to cover tooth roots or develop gum tissue where excessive gum recession has occurred. During this procedure, gum tissue is taken from your palate or another donor source to cover the exposed root. This can be done for one tooth or several teeth to even your gum line and reduce sensitivity.

After surgery, the dentist may apply a protective dressing over teeth and gums. A special mouth rinse may be recommended or prescribed. Your dentist may also recommend applying cold packs to the outside of your cheeks to reduce any swelling. And an antibiotic and mild pain reliever may be prescribed.

Prevention

Once your periodontal treatment is completed, your dentist will want to see you at regular intervals. Your appointments may alternate between your general dentist and a periodontist. Daily cleaning helps keep the plaque biofilm under control and reduces tartar formation, but it won't completely prevent it. More frequent checkups and cleanings may be needed to keep your gums disease free.

If you use tobacco, ask your dentist or physician for information about how to successfully stop the habit. Tobacco contains chemicals that can slow the healing process and cause gum diseases to become more severe, thus making the treatment results less predictable.

Good oral hygiene at home is essential to help keep periodontal disease from becoming more serious or from recurring. It just takes a few minutes twice a day to care for your teeth and gums.

You don't have to lose teeth to periodontal diseases. Brush, clean between your teeth, eat a balanced diet, avoid tobacco and schedule regular dental visits for a lifetime of healthy smiles.