If your gums bleed when brushing your teeth, you might have gum disease. Frequently early stage periodontal disease can be treated with nonsurgical periodontal therapy. This is generally accomplished by a procedure called scaling and root planing. Scaling and root planing is a meticulous gum disease treatment designed to remove toxins and bacteria from root surfaces of the teeth allowing the body’s immune system to begin the healing process. It is designed to eliminate bacteria that cause gum disease and to shrink periodontal pockets that harbor bacteria. We use ultrasonic and hand instrumentation to remove plaque and calculus from root surfaces, irrigants to disinfect these areas, and fluoride to de-sensitize root surfaces and prevent decay.
In severe cases of periodontal disease, this therapy often precedes surgical therapy. This is done to improve overall tissue quality prior to surgery and also to help limit the areas requiring surgery. Antibiotics may be used to help control the growth of bacteria that lead to gum disease. In some cases, Dr. Wiland may place a small amount of antibiotic (Arestin®) in the periodontal pocket after therapeutic scaling and root planing. This is done to control infection and to encourage normal healing, and studies have shown that it may be effective at shrinking the size of infected periodontal pockets.1-4
Sometimes surgical intervention is necessary when periodontal pockets become very deep and are not accessible to cleaning. As periodontal disease progresses, supporting tissue and bone is destroyed, forming “pockets” around the teeth. Over time, these pockets become deeper, providing a larger space for bacteria to live. These deep pockets continue to collect bacteria, resulting in further bone and tissue damage. If untreated, continued bone deterioration will occur resulting in eventual tooth loss.
Pocket reduction can be successfully accomplished through a procedure known as osseous surgery. During this periodontal procedure, the pockets are eliminated or reduced by removing gum tissue and reshaping uneven bone. Reduced pockets and a combination of daily oral hygiene and professional maintenance care are critical in preventing the further progression of periodontal disease, and helping to maintain your healthy smile!
1. Socransky SS, Haffajee AD, Cugini MA, Smith C, Kent RL. Microbial complexes in subgingival plaque. J Clin Periodontol. 1998;25:134-144.
2. Socransky SS, Haffajee AD. Dental biofilms: difficult therapeutic targets. Periodontol 2000. 2002;28:12-55.
3. Page RC. Periodontal diseases: a new paradigm. J Dent Educ. 1998;62(10):812-821.
4. Goodson JM, Gunsolley JC, Grossi SG, et al. Minocycline HCl microspheres reduce red-complex bacteria in periodontal disease therapy. J Periodontol. 2007;78(8):1568-1579.
5. Williams RC. Medical progress: periodontal disease. N Engl J Med. 1990;322(6):373-382.
Bruce B. Wiland, DDS, MSD is board certified in the specialty of periodontics which includes the placement of dental implants. Other services include laser periodontal therapy, esthetic tissue contouring and nonsurgical treatment.
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