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If you have periodontal disease, your choices are limited. Since in many cases, periodontal disease is not accompanied by pain, you might choose to delay treatment. However, this is very risky because periodontal disease never goes away on its own. It is episodic in nature, with flare-ups and periods of calm.
Periodontal disease is not curable, but new conservative treatments exist that are very effective. In contrast to classical periodontal treatment that often involves cutting away infected gum and bone, we provide a research-based approach for non-surgical gum therapy. If gum disease is detected, either at the first stage or when further breakdown has taken place, we employ non-surgical therapies to eliminate bleeding, reduce pocket depth, and regain gum support.
Non-surgical gum therapy is divided into 4 parts:
This technique is used to remove plaque and tartar below the gumline. First, to keep you comfortable, an anesthetic ointment is placed in the pockets. We use either a small scaling instrument or an ultrasonic scaler to carefully and meticulously remove plaque and tartar from the top of your teeth all the way down to the bottom of the pockets. Then, we will plane, or smooth, the root surfaces so the gums can heal and reattach to the teeth. Normally, we'll spread scaling and root planing over several appointments. The number of appointments varies with the depth of the pockets and the extent of the disease. This will maximize your comfort, allow us to check on the healing, and help you fine-tune your homecare efforts.
The second objective of non-surgical gum therapy is to reduce bacteria. Medications are placed in the pockets to control infection and promote healing. Antibiotics, like Arestin, may be used to further combat the infection. Once the source of infection has been removed, the gums will begin to heal, and will once again tighten around the teeth.
You will be given instructions on how to remove the plaque, as well as the instruments necessary to accomplish this, like an electric toothbrush and/or an oral irrigator. Appropriate toothpastes, rinses, or other medications will be prescribed, and the homecare regimen will be explained. Effective homecare is an important part of non-surgical therapy.
The health of your gums must be monitored closely so that we can prevent recurrence.
Periodontal disease can never be cured; it can only be controlled.
Following initial office therapy, you will come to see us every 3 months for ongoing care, which may include x-rays, re-evaluation of your periodontal health and the effectiveness of your homecare, removal of plaque above and below the gumline, and re-treatment with scaling and root planing if necessary. These frequent check-ups are vital for controlling your periodontal disease.
Periodontal disease is site-specific. This means you may experience a flare-up of the infection in just one periodontal pocket out of the possible total of 192 that exist in your mouth. Bone and tissue loss may occur in only this isolated area, or may be more widespread. If we aren't checking regularly for this type of damage to your gums and bone, you might not notice that it's occurring, and the destruction would continue unchecked.
Some bacteria do remain after treatment and may settle back into the pocket. Within ninety days the bacteria can again reach destructive levels. Because of the episodic nature of periodontal disease, and the fact that the disease process can re-establish itself so quickly, the typical 6-month re-care appointment just isn't enough. Statistics confirm that re-evaluation at intervals of at least every 3 months is critical for periodontal patients. This allows us to break the cycle of bacterial invasion, and minimizes the recurrence of the infection and its destructive effects on the teeth and gums.
For those patients with advanced disease, more aggressive treatment may be indicated. When necessary, we consult with several accomplished periodontal specialists and are happy to work with them on these types of cases.
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