Treatment of Periodontal Disease
Treatment for periodontitis is customized for each patient and to the severity of the disease. In all forms of periodontitis, we try to treat the disease with the most conservative treatment option. With more established periodontal infections, the calculus that forms beneath the gumline requires that the patient’s teeth and gums be anesthetized with a local anesthetic in order to thoroughly remove it without discomfort. This procedure is called scaling and root planing, which is considered a non-surgical treatment. Sometimes locally applied, time released antibiotics are placed in the pockets to further improve the results obtained with root planing.
It should be understood that to stop periodontal disease, it is essential to remove the calculus from the teeth. This cannot be done with medication, baking soda, toothpaste, or nutritional supplements. Currently, the only method proven to rejuvenate diseased, infected root surfaces involves calculus removal with specialized instruments. When a patient has very deep pockets (beyond 5 millimeters), non-surgical root planing cannot consistently reach the accumulated calculus. In some cases, other procedures, sometimes including minor gum surgery, may be indicated.
To allow for complete removal of calculus in deep pockets, the patient’s gums and teeth are anesthetized. The gums are elevated so the periodontist can see and treat the entire root surface and surrounding areas. Sometimes, the underlying bone is reshaped and smoothed to allow the gum to heal and reattach properly without forming new pockets. Under certain circumstances, the lost bone can be regenerated to strengthen the support for the teeth. This is an exciting and rapidly improving possibility in our field, particularly with the substantial research and development activity in the biotechnology industry. After final healing, the treated areas can be more easily cleaned by the patient and hygienist to prevent future bone loss.
It only takes twenty four hours for plaque that is not removed from your teeth to turn into calculus (tartar). Daily home cleaning helps control plaque and tartar formation, but those hard to reach areas will always need special attention.
Once your periodontal treatment has been completed, your periodontist will recommend that you have regular maintenance cleanings (periodontal cleanings). At these cleaning appointments, the pocket depths will be carefully checked to ensure that they are healthy. Plaque and calculus that is difficult for you to remove on a daily basis will be removed from above and below the gum line.
Good oral hygiene practices and periodontal cleanings are essential in maintaining dental health and keeping periodontal disease under control.