How is Periodontal Disease Treated?

Periodontitis – or periodontal disease – is the medical term that describes how bone and gum tissue supporting teeth come under attack from infection.

The initial stage of periodontal disease is gingivitis – inflammation of the gums resulting from an accumulation of bacterial plaque on your teeth. Without treatment, the problem can escalate to full-blown periodontal disease. Advanced periodontitis can destroy teeth and threaten the bone structure of your mouth.

If periodontitis is detected early, minimally invasive procedures such as scaling and root planing will usually be sufficient to resolve the issue.

In more severe cases, surgery may be required. Surgical options for treating periodontal disease include folding back gum tissue to remove the underlying bacteria. In some instances, a soft tissue or bone graft may be necessary.

Scaling and Root Planing in Periodontal Disease Treatment

The first line of defense in periodontal disease treatment is the in-depth cleaning procedure of scaling and root planing. This treatment is typically carried out over three or four weekly appointments.

In the scaling procedure, a dentist or dental hygienist uses ultrasonic and/or manual instruments to remove plaque and tartar (calcified plaque) from above and below the gum line.

Root planing entails leveling rough spots on a tooth to eliminate accumulated bacteria and help the gums to fasten back onto the teeth. The final step of polishing will remove stains on the crown and create an even surface that bacteria find difficult to cling on to.

After scaling and root planing, your dentist will evaluate the depth of the pockets around your teeth to determine whether further periodontal disease treatment is required.

After-effects of scaling and root planing are generally minor but some patients experience swelling and bleeding.

Surgical Procedures in Periodontal Disease Treatment

If you have periodontal disease that’s become advanced, surgery may be the only solution.

Benefits of periodontal surgery include:

• Allowing recontouring and repositioning of bone, gum and other tissues supporting the teeth.

• Providing easier access for deep cleaning to remove diseased tissue.

Pocket Reduction Surgery

Pocket reduction surgery (aka gingival flap surgery) is the most common surgical periodontal disease treatment. It addresses the affected area of teeth, gums, surrounding tissue and blood vessels to halt the spread of infection.

Local anesthesia is administered to the area and the gums are cut and folded back to give access to get rid of the infected tissue beneath. Any disease-causing bacteria will also be removed. In cases of defective bone, the surgeon can even the edges in a process called osseous recontouring.

The gum flap is then pulled back over your teeth and stitched in place. A dressing called a periodontal pack is then applied.

Graft Surgery

In cases of significant bone loss, bone grafting will promote regrowth. Material for the graft – taken from the patient or an outside source – covers an exposed tooth root to level the gum line and decrease sensitivity.

Bone grafting may also be needed if you want to replace missing teeth with implants but do not have enough bone in your jaw to hold the implants securely in place.

If your gums have receded to a large extent due to periodontal disease, a gum graft may be necessary to repair the damage and protect your teeth.

What is Periodontal Maintenance?

Follow-up care after treatment for gum disease – periodontal maintenance – is needed to keep periodontitis at bay. It typically entails extensive cleanings lasting up to an hour, every few months. These cleanings ensure levels of bacteria are kept under control before they can do more damage.

Unless you have particularly sensitive teeth, no anesthesia is generally required for periodontal maintenance procedures. In rare cases, persistent inflammation is treated with scaling and root planing.

Your dentist can also advise you on oral health care measures, such as:

• Getting regular dental exams.

• Brushing your teeth at least twice a day and flossing regularly.

• Using a toothpaste containing fluoride and an antibiotic to combat plaque.

Periodontal maintenance also helps to keep you in good overall health. Periodontal disease has been associated with heart issues, strokes, and poor blood circulation.

Other benefits of periodontal maintenance include:

• Preventing tooth loss.

• Identifying areas of continuing inflammation.

• Preventing or delaying the progression of periodontitis.

Medications to Treat Periodontal Disease

Your dentist can apply antimicrobial medication below your gum line to kill bacteria that may still be present after periodontal disease treatment.

Alternatively, you may be given a tray delivery system – customized trays made from impressions of your mouth – for use at home.

Antibiotic pills can also be prescribed in conjunction with non-surgical periodontal disease treatment.

Periodontists and Dental Implants

Specialists in periodontal disease treatment are also experts in the surgical procedure of fitting dental implants to replace teeth lost through gum disease, decay or injury.

Implants act as an anchor for artificial teeth. They consist of small posts, usually made from titanium, a lightweight but robust metal now commonly used for prosthetics because of its compatibility with the human body.

The screw-like post is inserted into the socket of a missing tooth. When the bone has fused to the implant, an abutment is attached to hold the artificial tooth securely, and a crown is then fitted to the abutment.

Dental implants have a high success rate – up to 98 percent – and provide a permanent solution to missing teeth, unlike dentures and bridges, which may have to be replaced over time.

Early Intervention is Key in Periodontal Disease Treatment

As with any serious health condition, early intervention is vital for the successful treatment of periodontal disease.

The initial stages of gum disease can be pain-free, so it’s important to be aware of symptoms such as persistent bad breath or bleeding gums. A more serious gum infection may result in loose teeth, receding gums, and pus around the teeth and gums.

The American Academy of Periodontology (AAP) recommends an annual comprehensive periodontal evaluation (CPE) for all adults.

If you have any concerns about the condition of your gums, it’s advisable to get them checked out by a dentist experienced in periodontal disease treatment.