Periodontal therapy is care of the gums to promote healthy support for the teeth. Treatment can range from a simple cleaning every six months to surgical treatment of advanced gum disease. The goal of periodontal therapy is to make home care easier for you and to encourage optimal health of the gums.
The chart on the right shows healthy gums, gingivitis (with no bone loss), and moderate to severe gum disease (with bone loss). Gum disease is caused by plaque. You are more likely to get gum disease if you have poor home care, smoke, have diabetes, or poor nutrition.
Healthy gums do not bleed with brushing or flossing. Healthy gums have a shallow collar of gum tissue surrounding each tooth.
Gingivitis is mild irritation of the gums that may result in bleeding. If your gums bleed when you brush, this gingivitis can be eliminated with thorough, gentle toothbrushing and flossing. After two or three days of good home care, gingivitis will disappear.
If gingivitis advances to chronic gum disease the collar of gum tissue around the tooth gets deeper, creating an area where plaque and bacteria can hide, too deep for toothbrush and floss to clean out. If left untreated, chronic gum disease leads to bone loss around the teeth. As the bone level recedes, teeth lose their support, become loose, and can be lost.
For patients with healthy gums or mild gingivitis, a cleaning and dental exam are recommended every six months.
Calculus, or tartar, builds up on the inside of the lower front teeth and in other areas. This hard, crusty build-up cannot be removed with toothbrush and floss. Plaque sticks more easily to calculus than to a smooth, clean tooth. Calculus and plaque irritate the gums and cause gingivitis and gum disease. Our hygienists are skilled at gently removing the calculus with instruments that clean better than home care.
For patients with chronic gum disease there is a phase of treatment to get the disease under control, and there is a phase of treatment to prevent the gum disease from returning.
The initial treatment for gum disease is a deep cleaning or scaling. Bacteria hiding in deep pockets is removed. The gums are numbed so there is no discomfort during this treatment. The gum tissue health will improve after this scaling treatment. About a month later the health of the gums is re-evaluated. If healthy, cleanings may be recommended every three or four months instead of every six months. This will ensure maintenance of healthy gums. If the gums are not healthy after scaling the next level of treatment may be local antibiotics or surgery. In specific areas of deep pockets, an antibiotic powder can be placed to kill bacteria and improve gum health.
Periodontal surgery allows for a clear view of the full root surface for better cleaning, and also removes excess gum tissue to make pockets around the teeth more shallow. Once you’ve had gum surgery it is recommended to have more frequent cleanings – every three or four months instead of every six months.
We also offer laser treatment in conjunction with periodontal therapy. This laser is directed into the pocket of gum tissue around the tooth to kill more bacteria. Our hygienist will let you know if laser treatment is recommended in your case.
All these treatment options have the goal of changing deep pockets of gum tissue into more shallow pockets of gum tissue. Shallow gums can then be cleaned and maintained on a daily basis with toothbrush and floss. Healthy gums will support the teeth for a lifetime.
Recession often happens in people without gum disease. The most common cause of recession is scrubbing too aggressively when using a toothbrush. Recession can lead to sensitivity of the teeth where root surfaces are exposed.
Gingival grafting can correct recession and restore the height of gum tissue. Covering root surfaces will reduce or eliminate tooth sensitivity in these areas, and improve the esthetics of your smile.