Periodontal Treatments

Treatment Options

If you've been diagnosed with gum disease, there are a variety of treatment options depending on the details of your situation and the severity of the problem. We always start with the least invasive options, which are non-surgical. However, in more serious cases, surgery may be necessary.

Non-Surgical Treatment

The first line of defense against gum disease is a unique type of cleaning called “scaling and root planing.” In this procedure, an ultrasonic cleaning device is used to remove plaque and tartar from your teeth where regular cleaning devices can't reach: under the gum line, on the tooth, and around the root. Then, the rough surface of the tooth and the root are smoothed out (planed). This provides a healthy, clean surface that makes it easier for the gum tissue to reattach to the tooth.

If you address your gum disease before it becomes severe, scaling and root planing may be the only treatment you need. However, as with any dental procedure, after-care is vital. In order to keep your teeth in good shape and resist future occurrences of gum disease, you must brush and floss daily, eat a healthy diet, avoid tobacco use, and have regular dental checkups. Even after a successful scaling and root planing, if you don't attend to your teeth properly, it's quite likely that you'll develop gum disease again.

Surgical Treatment Options

If the tissue or bone surrounding your teeth is too damaged to be repaired with non-surgical treatment, several surgical procedures are available to prevent severe damage and to restore a healthy smile. We will recommend the procedure that is best suited to the condition of your teeth and gums. Following is a list of common types of periodontal surgery:

• Pocket Depth Reduction
  In a healthy mouth, the teeth are firmly surrounded by gum tissue and securely supported by the bones of the jaw. Periodontal disease damages these tissues and bones, leaving open spaces around the teeth that we call pockets. The larger these pockets are, the easier it is for bacteria to collect inside them, leading to more and more damage over time. Eventually the supportive structure degrades to the point that the tooth either falls out or needs to be removed.

  During pocket reduction procedures (also known as “flap surgery”), we fold back the gum tissue and remove the bacteria hiding underneath, as well as the hardened plaque and tartar that have collected. We may also remove any tissue that is too damaged to survive. We then sew the healthy tissue back into place. Now that the tooth and root are free of bacteria, plaque, and tartar, and the pockets have been reduced, the gums can reattach to the teeth.

• Regeneration
  When the bone and tissue supporting the teeth have been lost due to severe gum disease, we can restore these areas with a regeneration procedure. During this process, we begin by folding back the gum tissue and removing the bacteria, plaque, and tartar. Depending on your situation, we may then perform a bone graft to stimulate new bone growth, or we may apply a special kind of protein that stimulates tissue growth to repair the areas that have been destroyed by the disease.

• Soft-Tissue Graft
  A frequent symptom of gum disease is gum recession (also called gingival recession). As the gums recede, more of the roots are revealed. This can make teeth appear longer and can also create sensitivity to hot or cold liquids or food. It also exposes the tooth to increased damage from gum disease, as bacteria, plaque, and tartar attack the surface of the tooth and the root.

  During a soft-tissue graft, tissue from the top of your mouth or another source is sewed to the gum area, covering the roots and restoring the gum line to its original, healthy location. This procedure can also be performed for cosmetic reasons.

Scaling and Root Planing

Scaling and root planing is one of the most effective, non-surgical ways to treat gum disease before it becomes severe. Scaling and root planing cleans between the gums and the teeth down to the roots.

Scaling is basically the process of removing dental tartar from the surfaces of the teeth. Root planing is the process of smoothing out the root surfaces and removing any infected tooth structure. If you have gum disease or gum pocketing, the gum pockets around the teeth will have deepened, thereby allowing tartar deposits to form under the gum line. A careful cleaning of the root surfaces to remove plaque and calculus (tartar) from deep periodontal pockets and smoothing the tooth root to remove bacterial toxins will help ensure that your gum disease is controlled.

Helpful Hints to Keep in Mind

• Scaling and root planing does not usually cause much discomfort, but you might experience some soreness afterwards, since deeper regions under the gums have been cleaned.
• Your teeth themselves may become a bit more sensitive to temperature, and bleeding might occur for a little while after your procedure.
• Over-the-counter painkillers, such as ibuprofen, work very well to alleviate discomfort, as do ice packs applied to the outside of the face around the treated area.
• Brushing and flossing will have to be done more gently to avoid aggravating any bruised or tender gum areas. We'll show you the best methods for keeping your teeth clean during this time.

Scaling and root planing is a simple procedure that can work very well to stop gum disease. If you maintain good dental care after the procedure, the progression of your gum disease should stop, and your gums will heal and become firm and pink again in no time!

Osseous Surgery

Osseous surgery, also known as pocket depth reduction, is a surgical procedure intended to restore your gums to a healthier, more natural state. If your periodontist has recommended osseous surgery, it is because you have pockets that are too deep to clean with daily at-home oral hygiene and a professional care routine. Your bone and gum tissue should fit snugly around your teeth, creating a protective cover from bacteria. If you have periodontal disease, the supporting tissue and bone are destroyed, and this forms pockets around the teeth. Over time, these pockets become deeper and provide a larger space for bacteria to live. As bacteria develop around the teeth, they can accumulate and advance under the gum tissue. These deep pockets collect even more bacteria, resulting in further bone and tissue loss. To reduce the need for extractions, osseous surgery may be recommended.

Reducing pocket depth and eliminating existing bacteria are important in preventing damage caused by the progression of periodontal disease and in helping you maintain a healthy smile. Eliminating bacteria alone may not be sufficient to prevent disease recurrence. Deeper pockets are more difficult for you and your dental care professional to clean, so it's important to make them as small as possible. Small pockets and a combination of daily oral hygiene and professional maintenance care increase your chances of keeping your natural teeth as well as decrease the chance of serious health problems associated with periodontal disease.

How is osseous surgery performed?

During this procedure, your periodontist will fold back the gum tissue and remove the disease-causing bacteria before securing the tissue back into place. If the underlying bone has been damaged, the irregular surface will be smoothed out to limit areas where disease-causing bacteria can hide. This will also allow your gum tissue to reattach to healthy bone more effectively.

You may experience some swelling after the surgery, so applying an ice pack to the outside of your face over the treated area can help with any discomfort. In some cases, antibiotics are given before, during, and after the treatment in order to prevent any infections. After a week or two, you'll come back to our office so that your periodontist can check the surgical area and ensure your mouth is healing properly.

Periodontal FAQs

What is periodontics?

Periodontics is one of the nine dental specialties recognized by the American Dental Association, focusing on the study and treatment of the soft tissue and bone supporting the teeth and jaw.

Who is a periodontist?

A periodontist is a dental specialist who has the training and experience required by the American Dental Association to diagnose, treat, and prevent different forms of periodontal/gum disease.

What is periodontal disease?

Periodontal disease, also known as gum disease, often begins as a buildup of plaque on the tooth's surface near the gum line. If this plaque is not removed by brushing and flossing regularly, it can harden into what your dentist calls tartar. Plaque will continue to build up over the tartar, eventually causing the gums to become red, swollen, and irritated. This is known as gingivitis and is the first stage of periodontal disease. If left untreated, gingivitis can turn into periodontal disease.

What are the symptoms of periodontal disease?

• Red, swollen, sore gums
• Gums that bleed when brushing and flossing
• Teeth that appear longer or become loose
• Large spaces that form between the teeth
• Gums that begin to pull away from the teeth
• Chronic bad breath

Periodontal disease, if left untreated, can contribute to other health problems including heart disease and diabetes. If you're pregnant, having periodontal disease is also linked to premature birth or low birth weight. Your smile's health affects the overall health of your body.

Is periodontal disease treatable?

Gum disease is both preventable and treatable. Today's periodontal treatments provide you with a variety of options that are gentle, safe, and effective. If you have been diagnosed with gingivitis or gum disease, your periodontist can help you determine what treatment best meets your needs. Periodontal treatments include:

• Non-surgical treatment
• Periodontal surgery
• Periodontal therapy
• Dental implants
• At-home care (special toothpaste, mouthwash, toothbrushes, and prescription treatment trays)

Am I at risk of having periodontal disease?

You may be at risk of having periodontal disease if you smoke or use tobacco products, you do not brush your teeth and floss regularly, you have health conditions such as diabetes, heart disease, or osteoporosis, or if several of your family members have had gum disease as it can, in some cases, be genetic. If you are experiencing any of the symptoms of gum disease, schedule an appointment with your dentist, who can help determine if treatment is necessary.

Will my insurance cover my periodontal treatment?

Many insurance plans will provide assistance for periodontal treatment. Our practice understands how important your dental health is, and we want you to get the most out of any dental treatment you receive. We will help you work with your insurance provider to make sure that your treatment is easy on your budget, and your peace of mind.