PERIODONTAL DISEASE

Non-Surgical Periodontal Therapy

The emphasis of our practice is conservative periodontal therapy. Very often, early stages of periodontal disease are effectively treated with nonsurgical therapy. This involves the removal of bacterial plaque and tartar which is present at and below the gum line.

Periodontal “gum” disease is typically a chronic infection caused by bacteria that works its way under the gum line destroying the gum and eventually the bone that supports the teeth. Because the bacteria can firmly attach to the tooth roots under the gum line, regular dental cleanings may be inadequate to resolve the infection and therefore root planing commonly referred to as “deep cleanings” becomes necessary. Unfortunately, periodontal infections are usually silent, and can be present for many years, without any significant symptoms including pain. This is why regular visits to your Periodontist are important especially if other health problems are present such as heart problems or diabetes. However, subtle signs such as red or swollen gums, gums that bleed when brushed or flossed, chronic bad breath or loose teeth can alert you to the presence of gum disease and the need to see a Periodontist.

Our practice has made great strides in non-surgical management of periodontal problems. With the following innovative techniques, we are able to achieve periodontal health for many of our patients in a simple, non- invasive and affordable manner.

Scaling and Root Planing

Scaling and Root Planing is usually the first treatment performed to remove tartar at/or below the gum line in order to combat periodontal disease. A professional polish or “prophy” only removes the soft sticky plaque above the gum line and is insufficient in treating gum disease. “Scaling” refers to the removal of plaque and calculus deposits above the gum line using special instruments called “scalers”. Patients with periodontal disease often have deep gum pockets which requires access under the gum line to remove these same deposits, a process referred to as “Root Planing”. Scaling and root planing is one of the most basic approaches for giving the mouth a fresh start at healing of the gum and bone around the teeth and the cornerstone of non-surgical periodontal therapy. For your comfort, a local anesthetic is typically used to “numb” up the gums to properly perform this procedure.

Following proper scaling and root planing, patients should expect little to no discomfort. A re-examination is then performed after approximately 6 weeks to check the response to treatment. At that time, long term management options are discussed. If non-surgical therapy was effective in eradicating the gum disease, patients then simply need to have periodontal maintenance treatments at 3-4 month intervals to keep their gums healthy. These treatments include dental scaling and ultrasonic cleanings along with proper home care instructions.

Localized placement of medications under the gum line to combat “gum” disease

Your dentist or hygienist may also recommend the simple placement of medications under the gum line to help kill the bacteria that may still exist following a dental cleaning or root planing procedure. Research has shown that patients that have advanced periodontal disease can benefit from the use of these antimicrobial medications but only following scaling and root planing. These products are not effective as standalone treatment and are also not effective for long term control of advanced periodontal disease or with patients who have chronically deep gum pockets. Your periodontist is best trained to determine if this treatment approach will help your specific condition.

Systemic Antimicrobials

For some patients, systemic antibiotics or antimicrobials may be prescribed to be taken orally, to help treat their periodontal disease. Various antibiotics have been used in the past with some degree of success. Research has made a drug available called Periostat™ which can be used to help treat periodontal disease but only when combined with conventional non-surgical therapy. Your periodontist is best trained to determine if this treatment approach will help your specific condition.

Laser Therapy

Laser periodontal therapy is one of the latest and most exciting techniques being developed for the treatment of periodontal disease. Unfortunately at the current time, and according to our doctors, there is inadequate research available to recommend laser therapy for the treatment of periodontitis. Laser periodontal therapy should never be considered as a substitute for conventional non surgical therapy or as a replacement for periodontal surgery. In addition, research has shown that the use of a laser can damage teeth and gums. Unfortunately, the use of lasers for periodontal therapy is often used as a marketing ploy by uninformed, undiscerning, or unscrupulous dentists, including periodontists.

Damage to the gums and bone support around the upper front teeth following the use of a laser. Notice the loss of gum and bone, which has exposed the tooth roots.