Periodontal Treatments

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1. Periodontal examination

A periodontal exam consists of measuring the space or pocket (known as sulcus) between the tooth and gum. Periodontal exams are performed by the dentist or one of our dental hygienists who utilize a periodontal probe to measure the sulcus (in millimeters) between the tooth and gums. 

This process allows us to determine whether you have periodontal disease and measure its progression over the course of your regular dental exams. Healthy sulcus is a pocket between the tooth and gums that measures three millimeters or less – the presence of blood is also a determining factor in the health of the gum. A depth of more than three millimeters, inflammation, blood and tooth mobility are all signs of periodontal disease.

The following stages describe the phases of periodontal disease:

Gingivitis is often the initial stage of periodontal disease. Symptoms of gingivitis include: plaque build-up, irritation, tenderness, inflammation and the presence of blood.

Periodontitis is typically the second stage of periodontal disease, signified by substantial plaque build-up that has hardened into calculus which is more commonly known as tartar. Over the course of time, as calculus and plaque build-up continues, the gums begin to recede from the teeth. As deeper pockets form, the sulcus can become filled with bacteria and pus. At this stage, there can be bone loss toward the root of the tooth structure and the gums will bleed easily and can become substantially irritated, inflamed.

Advanced Periodontitis is an accelerated stage of periodontal disease and is categorized by greater irritation, inflammation and presence of blood as well as moderate to severe bone loss. Moreover, the root structure of the teeth in this stage is compromised as the gums fail to provide adequate support (accompanied by the continued destruction of periodontal ligaments). Advanced periodontitis can lead to loose teeth and if untreated, tooth loss. It also can contribute to bad breath.

If you have any of the symptoms associated with the periodontal disease, contact us to schedule an exam.

The treatment of periodontal (gum) disease depends upon the severity of the disease. The dentist or dental hygienists will recommend and implement the appropriate treatments for your stage of periodontal disease.

Treatment in the early stages (confined to gingivitis) and assuming no structural damage has occurred can consist of as little as one to three regular dental cleanings. Effective long term treatment of early stage periodontal disease can only be attained with a combination of regular professional cleanings (at the dental office) and ongoing (at home) oral care.

Treatment of periodontal disease once it has progressed to advanced stages requires a deep cleaning of the gums, a procedure referred to as scaling or root planning. The procedure is typically conducted one quadrant of the mouth at a time while the area is usually numb.

Regular cleaning and periodontal treatments could prevent teeth loss and bad breath.

2. Scaling and Root Planing

The removal of tartar (calculus), plaque and stain with the aid of ultrasonic scalers and hand instruments is called scaling. If there is any tartar underneath of the gum it is called root planing in which the root of the tooth is cleaned and smoothed. In this procedure the dentist or a staff dental hygienist will remove any tartar and plaque build-up both above and below the gum line. This procedure removes rough areas of build up allowing gum tissue to heal and pockets between the gums and teeth to shrink.

Throughout the treatment process the dentist will evaluate and make determinations about the next stage. Depending on the severity of the periodontal disease and whether pockets heal after scaling and root planning, periodontal surgery may be necessary

3. Periodontal surgery

The procedure by which the deformities of the gum or surrounding bones of a diseased area is reshaped or reduced to create a normal functional form. The periodontal surgery is indicated when the gum disease is extensive and can not be treated by usual dental scaling and cleanings.

Sometimes it would be necessary to refer out the complicated or advanced periodontal treatments to a Periodontal specialist (Periodontist), after the dentist initial examination.

4. Periodontal maintenance

In a mere 24 hours, plaque that is not removed from your teeth begins to turn into tartar. While daily home cleaning can help control plaque and tartar formation, regular dental cleanings are necessary to remove any significant tartar build-up and to address hard to reach areas.

After the initial tretament phases of the periodontal disease, scaling, root planning or surgery, we recommend a regular maintenance cleanings (periodontal cleanings) four times a year during which the dentist will monitor pocket depths and address problem areas where plaque and calculus have developed.

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