Periodontal Disease - Prevention

Treatment

According to the American Academy of Periodontology, treatment for periodontal disease should focus on achieving oral health in the least invasive and most cost-effective manner. Your dentist or periodontist will usually begin with a non-surgical approach (scaling and root planning) and then reevaluate your condition in follow-up visits. If infection or deep periodontal pockets remain, surgical treatment may be recommended.

Periodontal treatment approaches can basically be categorized as:

• Nonsurgical Approaches. Scaling and root planning (deep cleaning of tartar and bacteria from gum line and tooth root surfaces), which may include the use of topical or systemic antibiotics.
• Surgical Approaches. Periodontal surgical techniques include flap surgery (periodontal pocket reduction), bone grafts, and guided tissue regeneration.
• Restorative Procedures. Crown lengthening is an example of a restorative procedure that may be performed for cosmetic reasons or to improve function. For patients who have already lost teeth to advanced periodontitis, dental implants are another option.

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In addition to treatment in a dentist office, regular dental visits and cleanings (usually every 3 months) are important for maintenance as is practicing good oral hygiene at home (see Prevention section of this report).

Non-Surgical Treatment

Scaling and Root Planing. Scaling and root planning is a deep cleaning to remove bacterial plaque and calculus (tartar). It is the cornerstone of periodontal disease treatment and the first procedure a dentist will use. Scaling involves scraping tartar from above and below the gum line. Root planning smoothes the root surfaces of the teeth.

The dentist may apply a topical anesthetic to numb the area before beginning the procedure. Both ultrasonic and manual instruments are used to remove calculus. The ultrasonic device vibrates at a high frequency and helps loosen and remove tartar. A high-pressure water spray is then used to flush out the debris. The dentist will use manual instruments called scrapers and curettes to scrape away any remaining plaque or calculus and smooth and clean the tooth crown and root surfaces. Finally, the dentist will polish the tooth using abrasive paste applied to a vibrating instrument with a rubber cap. Polishing produces a smooth surface, making it temporarily harder for plaque to adhere.