Periodontal treatment methods depend upon the type and severity of the disease. Your Periodontist will evaluate for periodontal disease and recommend the appropriate treatment. Periodontal (gum) disease is one of the leading causes of tooth loss. Plaque and calculus that build up on the teeth contain bacteria, which cause tissue inflammation and destroy the supporting bone around the roots of the teeth. Periodontal disease progresses as the sulcus (pocket or space) between the tooth and gums gets filled with bacteria, plaque, and calculus, causing irritation to the surrounding tissues. When these irritants remain in the pocket space, they can cause damage to the gums and eventually, the bone that supports the teeth! Removal of this bacteria is the initial step in treatment, and although deep cleaning cannot restore the lost bone and tissue, it can prevent the disease process from advancing and help to prevent tooth loss. The initial phase in the treatment of periodontal disease is scaling and root planing.
If the disease is caught in the early stages of gingivitis, and no damage has been done, one to two regular cleanings will be recommended. Scaling involves removal of the bacteria and other debris from the crown and root surfaces of the tooth. Root planing involves smoothing the root surfaces of the teeth, in areas where they have become rough due to calculus. Depending on the severity of the disease process, some individuals require local anesthetic for the scaling and root planing appointment. Once the teeth have been thoroughly cleaned, the disease process is slowed, however, proper home care is a vital component of successful treatment. You will also be given instructions on improving your daily oral hygiene habits and having regular dental cleanings.
If the disease has progressed to more advanced stages, a special periodontal cleaning called scaling and root planing (deep cleaning) will be recommended. It is usually done one to two quadrants of the mouth at a time while the area is numb. In this procedure, tartar, plaque, and toxins are removed from above and below the gum line (scaling) and rough spots on root surfaces are made smooth (planing). This procedure helps gum tissue to heal and pockets to shrink. Medications, special medicated mouth rinses, and instructions in proper home care may be recommended to help control infection and healing.
If the pockets do not heal after scaling and root planing, periodontal surgery may be needed to reduce pocket depths, making teeth easier to clean. Pockets that are still deeper than 5 mm's after the root planing generally require surgical therapy because the remaining bacteria is to deep to remove. Bacteria left at the base of the pocket will destroy the bone and lead to tooth loss.