Treatment for Periodontal Disease

If gum disease is diagnosed, your dentist may refer you to a periodontist, a dentist who specializes in the diagnosis, prevention and treatment of periodontal disease. Treatment is dependent on the severity of periodontal disease, but should never be an unpleasant experience.

Treatment of Periodontal Disease

Typically our patients go through the following steps:

Step 1: Scaling and Root Planing

Scaling and root planing is a method of treating periodontal disease when pockets are greater than 3 mm. Scaling is used to remove plaque and tartar beneath the gum line. A local anesthetic may be given to reduce any discomfort. Using an instrument called a small scaler or an ultrasonic cleaner, the dentist carefully removes plaque and tartar down to the bottom of each periodontal pocket. The tooth’s root surfaces then are smoothed or planed. This allows the gum tissue to heal. It also makes it more difficult for plaque to accumulate along the root surfaces.

Step 2: Periodontal Surgery

If you still have deep pockets after scaling and root planing, your dentist will recommend surgery to reduce the deep pockets. You may also need surgery to remove diseased tissue, reshape bone or regenerate new gum and bone tissue.

  • Pocket reduction surgery/Flap surgery — During pocket depth reduction, which is also called flap surgery, your periodontist folds the gum back away from the tooth. After scraping away the bacteria-laden plaque and tartar, the dentist removes diseased tissue and smoothes the surface of damaged bones then the dentist sews the tissue back into place. Removing or smoothing damaged tissue allows the gum tissue to better reattach to healthy bone.
  • Bone Replacement Graft — Involves using fragments of your own bone, synthetic bone, or donated bone to replace bone destroyed by periodontal disease. The grafts serve as a platform for the regrowth of bone, which restores stability to teeth.
  • Guided Tissue Regeneration (GTR) — Performed when the bone supporting your teeth has been destroyed, this procedure stimulates bone and gum tissue growth. Done in combination with flap surgery, a small piece of mesh-like fabric is inserted between the bone and gum tissue. This keeps the gum tissue from growing into the area where the bone should be, allowing the bone and connective tissue to re-grow to better support the teeth.

Maintenance

After your active treatment, you must see your dentist for ongoing maintenance therapy to prevent recurrence of the disease. During these visits your dentist will examine your gums, check your bite and remove new plaque and tartar. How often you have to visit the dentist depends on how well controlled your gum disease is. A big part of this ongoing maintenance program is practicing good daily dental care at home. Essentially it’s back to the basics: brush, floss and rinse to maintain that healthy smile.