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Treatment of Periodontal Disease

Aesthetic Procedures

Gingival Grafts and Crown Lengthening

While the main goal of periodontal therapy is to preserve the health of the supporting structures of the teeth, there are several procedures that we perform to enhance dental aesthetics and improve the look of a patient’s smile. For patients presenting with gum recession or a “toothy” smile, gum grafting procedures may be performed to cover the areas of recession. For patients with a “gummy” smile or teeth that appear to be short, crown lengthening procedures are a relatively simple answer to solve this aesthetic problem.

Periodontal Scaling & Root Planing

Periodontal disease is caused by the buildup of plaque and calculus around the gum line and between the teeth. In order to prevent disease, it is imperative to remove these etiologic agents. This will prevent bacterial growth which leads to bone breakdown and advancement of the disease process. The objective of scaling and root planing is to physically remove the plaque and calculus which causes the disease. Scaling and root planing is a non-surgical procedure which is particularly effective in dealing with gingivitis and early stages of periodontitis. If performed effectively at these stages, no further periodontal treatment may be necessary.

What do scaling and root planing treatments involve?

After conducting a thorough examination of the oral tissues and viewing radiographic findings, we may suggest scaling and root planing treatments. Depending on the severity of the disease process and the amount of plaque and calculus, local anesthesia may be used to make the treatment more comfortable.

Scaling involves the removing of debris from the crown and root surfaces. This may be accomplished with the use of a combination of ultrasonic and hand scalers. After all the plaque and calculus are “scaled” away, root planing may be undertaken using hand instruments to smooth the root surfaces of the tooth. Smooth root surfaces help prevent the buildup of the agents which cause periodontal disease.

After scaling and root planing procedures eliminate the causative factors, the remaining pockets may be treated with antibiotics.

Antibiotic Treatment

Periodontal disease is caused by bacterial growth. This bacteria breaks down the periodontal lining of the gum and as the disease progresses, bacteria will begin to break down the supporting tooth structure which surrounds the teeth. One of the most effective ways to kill bacteria is to introduce antibiotics. These antibiotics may be prescribed orally, in pill form, or may be applied locally directly to the areas of the mouth that are periodontally infected.

Over the past several years, direct application of antibiotic into the periodontal pocket has proven to be very effective in halting the disease process if done in combination with other periodontal procedures.

Systemic antibiotics can be prescribed at a low dose for long term periodontal use, or as a short term medication to treat acute periodontal infections.

Oral and Locally Delivered Antibiotics

Several different antibiotics have proven to be useful and particularly effective in the treatment of periodontal disease.

  • Tetracycline antibiotics: The tetracycline family of antibiotics, which include tetracycline hydrochloride, doxycycline, and minocycline are generally thought of as the primary drugs used in periodontal treatment.
  • Macrolide antibiotics: Known for their effectiveness in reducing gingival inflammation, this family of antibiotic is often used for patients suffering from periodontitis.
  • Metronidazole: This antibiotic is generally used in combination with amoxicillin or tetracycline to combat inflammation and bacterial growth in severe or chronic periodontitis.
  • Arestin®: This antibiotic, which is delivered right into the gingival sulcus (pocket within the gum) has proven very effective in slowing the disease process and inhibiting bacterial growth.

Periodontal Surgery

Periodontal disease is caused by bacteria which infect the periodontal lining of the gum. If not removed, this bacterial growth will spread and will begin to destroy the bone that supports the teeth. As bone is destroyed by the bacteria that is found on plaque and calculus, pockets form between the teeth and gums. As these pockets become deeper, it is almost impossible to clean the bottom of the pockets using toothbrushing and flossing techniques. If the pockets are not adequately cleaned and debrided, they will continue to deepen and more bone will be destroyed. This destructive cycle will continue and will eventually lead to tooth loss. The goal of all periodontal surgical procedures is to eliminate the pocket and to allow the patient to keep the gums and teeth clean using proper brushing and flossing techniques.

What does pocket reduction surgery involve?

While a surgical procedure, periodontal surgery is generally very well tolerated by patients and in most cases can be performed under local anesthesia.

An incision will be made to allow us to gently pull the gum tissue away from the teeth. All calculus and plaque will be meticulously removed and all root surfaces will be smoothed. Antibiotic may be placed in the surgical site. The gum tissue will then be sutured back into place eliminating the pocket. In many cases a protective packing may be placed to keep the area clean and to facilitate faster healing.

The suture material (stitches) generally will remain in the mouth for 7-10 days

Though the gums will be more sensitive immediately following the procedure, there will be a significant reduction in pocket depth and a vast improvement in the condition of the teeth and gums.

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Frequently Asked Questions

What is the first step in treating periodontal disease?

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The first step is often scaling and root planing, which removes plaque and tartar from the teeth and gums to eliminate the infection.

How long does it take to heal after periodontal surgery?

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Recovery time varies, but most patients begin to heal within a few days to a week. Full recovery can take several weeks to months, depending on the extent of the surgery.

Are there any alternatives to traditional gum surgery?

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Yes, laser periodontal therapy is a minimally invasive alternative to traditional surgery. It offers less discomfort and quicker healing times.

How can I prevent periodontal disease from recurring after treatment?

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Regular periodontal maintenance visits, proper oral hygiene, and avoiding risk factors like smoking are crucial to preventing the disease from coming back.

Can periodontal disease cause tooth loss?

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Yes, if left untreated, periodontal disease can lead to the destruction of the bone and tissue that support the teeth, which can result in tooth loss.

What can I expect during my first periodontal visit?

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During your first visit, your periodontist will evaluate your oral health, review your medical history, and discuss the best course of treatment based on your condition.

Is periodontal disease reversible?

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Early stages of periodontal disease are reversible with proper treatment, but advanced stages may require surgical intervention and may not be completely reversible.

Can I still receive treatment if I have other health conditions?

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Yes, we take all aspects of your health into account when designing a treatment plan, ensuring that any underlying health conditions are managed properly.

How often should I see a periodontist for maintenance care?

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Most patients need to see their periodontist every 3 to 4 months after treatment for cleanings and exams to ensure their gums stay healthy.

Are there any side effects of periodontal treatments?

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Some patients may experience mild discomfort, swelling, or bleeding after treatment, but these side effects typically subside within a few days to a week.

Battle Born Periodontics | Causes of Periodontal Disease, Pocket Reduction and LANAP reg

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