Gum (Periodontal) Disease
Treatments
Controlling the Infection
The main goal of treatment is to control the infection. The number and types of treatment will vary, depending on how far the disease has advanced. Any type of treatment requires the patient to 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.
Treatments may include deep cleaning, medications, surgery, and bone and tissue grafts.
Deep Cleaning (Scaling and Planing)
In deep cleaning, the dentist, periodontist, or dental hygienist removes the plaque through a 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 can result in less bleeding, swelling, and discomfort compared to traditional deep cleaning methods.
Medications
Medications may be used with treatment that includes scaling and root planing, but they cannot always take the place of surgery. Depending on how far the disease has progressed, the dentist or periodontist may still suggest surgical treatment. Long-term studies are needed to find out if using medications reduces the need for surgery and whether they are effective over a long period of time.
Surgery
Surgery might be necessary if inflammation and deep pockets remain following treatment with deep cleaning and medications. A dentist or periodontist may perform flap surgery to remove tartar deposits in deep pockets or to reduce the periodontal pocket and make it easier for the patient, dentist, and hygienist to keep the area clean. This common surgery involves lifting back the gums and removing the tartar. The gums are then sutured back in place so that the tissue fits snugly around the tooth again. After surgery to reduce the pockets and make the teeth and gums easier to clean, the gums will shrink to fit more tightly around the tooth. This sometimes results in the teeth appearing longer.
In addition to flap surgery, your periodontist may suggest bone or tissue grafts. Grafting is a way to replace or encourage new growth of bone or gum tissue destroyed by periodontitis. A technique that can be used with bone grafting is called guided tissue regeneration, in which 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 regrow.
Treatment Results
Treatment results depend on many things, including how far the disease has progressed, how well the patient keeps up with home care, and certain risk factors, such as smoking, which may lower the chances of success. Ask your periodontist what the likelihood of success might be in your particular case.
Consider Getting a Second Opinion
When considering any extensive dental or medical treatment options, you should think about getting a second opinion. To find a dentist or periodontist for a second opinion, call your local dental society. They can provide you with names of practitioners in your area. Also, dental schools may sometimes be able to offer a second opinion. Call the dental school in your area to find out whether it offers this service.
