Periodontal treatment methods depend on the type and severity of the disease. Your dentist and dental hygienist will evaluate for periodontal disease and recommend the appropriate treatment.
Periodontal disease progresses as the pocket or space between the tooth and gums becomes filled with bacteria, plaque, and tartar, which causes irritation to the surrounding tissues. When these irritants remain in the pocket space, they can cause damage to the gums and eventually the bone that supports the teeth.
If periodontal disease is caught in the early stages of gingivitis, and no damage has been done, it is recommended to get one to two regular cleanings. Additionally, you will be given instructions on how to improve your daily oral hygiene habits, including regular dental cleanings.
The main goal of treatment is to control the infection. The number and types of treatment will vary, depending on the extent of the gum disease. Any type of treatment requires that the patient keep up good daily care at home. The doctor may also suggest changing certain behaviors, such as quitting smoking, as a way to improve treatment outcome.
If the disease has progressed to more advanced stages, a special periodontal cleaning–called scaling and root planing (deep cleaning)–will be recommended. Typically, one quadrant of the mouth is done at a time, while the area is numb. In this procedure, tartar, plaque, and toxins are removed from above and below the gum line (scaling), and any rough spots on root surfaces are made smooth (planing). This procedure helps the gum tissue to heal and the pockets to shrink.
As mentioned before, the first signs of periodontal disease usually begin with gingivitis; the gums appear reddened at the margins, slightly swollen and bleed when gently provoked by tooth brushing or flossing. It is often thought that brushing too hard causes bleeding gums — however, bleeding from the gum tissues is not normal and should be taken as a warning sign.
Bad breath and taste are also commonly associated with periodontal disease. As the disease progresses the gum tissues begin to recede, exposing root surfaces which may cause tooth sensitivity to temperature and pressure change. Gum tissues may start to lose their normally tight attachment to the tooth causing pocket formation, detectable by a dentist during periodontal probing. As pocket formation progresses, supporting bone loss may be noted around the teeth.
Abscess formation, the collection of pus pockets denoted by pain, swelling and discharge from the gum tissues is a later sign of disease. Ultimately looseness and drifting of teeth occur as bone is lost in more advanced degrees of disease and may also be apparent as eating becomes more difficult or uncomfortable.
Nonsurgical treatments:
If periodontitis isn’t advanced, treatment may involve less invasive procedures, including:
Medications
Medications may be used with treatment that includes scaling and root planning, but they cannot always take the place of surgery. Medications, special medicated mouth rinses, and an electric toothbrush may be recommended to help control infection, as well as promote the healing process. Depending on how far the disease has progressed, the dentist or periodontist may still suggest surgical treatment.
If the pockets do not heal, after scaling and root planing, periodontal surgery may be needed to reduce pocket depths. This will make it easier to clean the teeth. Your dentist may also recommend that you see a Periodontist–a specialist of the gums and supporting bone.
Deep Cleaning (Scaling and Root Planing)
Plaque is removed through a deep-cleaning method called scaling and root planing. Scaling means scraping off the tartar from above and below the gum line. Root planing gets rid of rough spots on the tooth root where the germs gather, and helps remove bacteria that contribute to the disease. In some cases a laser may be used to remove plaque and tartar. This procedure may result in less bleeding, swelling, and discomfort compared to traditional deep cleaning methods.
Periodontists are dentistry’s experts in treating periodontal disease. They receive up to three additional years of specialized training in periodontal disease treatment in both non-surgical treatments and periodontal plastic surgery procedures. Periodontists are also experts in replacing missing teeth with dental implants.
- Non-Surgical Treatments
- Gum Graft Surgery
- Laser Treatment
- Regenerative Procedures
- Dental Crown Lengthening
- Dental Implants
- Pocket Reduction Procedures
- Plastic Surgery Procedures
If you have periodontal disease all is not lost. Remember, your teeth were meant to last a life time. Early diagnosis and treatment of periodontal disease are also essential in keeping your teeth for life.
While periodontal disease is treatable, vigilance is necessary to prevent recurrence: institute daily plaque removal through brushing and flossing as a part of your oral hygiene; seek treatment to quit smoking; and establish a regular schedule of clinical cleanings and checkups.