Pick A Peck Of Periodontal Procedures

Procedures associated with periodontal disease fall into three categories: prevention, treatment, and the maintenance of the treatment. Each depends on the extent or severity of the disease in the patient.

Prevention

It is far better at the onset of periodontal disease to “nip it in the bud”. Because 80% of the population has some form of periodontal disease, there is a good chance that you or a member of your household has it. (And it is contagious.) Prevention requires diligent and thorough at-home oral care at least twice daily. (Meaning do a good job every day.) Getting professional cleanings at the dental office at least twice a year is also a prerequisite to prevention. (Make and keep those appointments.) And finally, preventing periodontal disease also requires getting the restorations to your teeth that the dentist recommends. (Don’t let even the smallest cavity go.)

Treatments: Non-Surgical

It is best when treating periodontal disease to find the least invasive and most cost-effective treatment. Root planing and scaling are considered non-surgical treatments and are recommended for early stages of the disease. The dentist removes the plaque and calculus (or tartar) from the root surfaces, smoothing the root surface and removing the bacterial toxins. This removal can be done mechanically with a scraping tool that is often uncomfortable to the patient. Some dentists may numb the gums with a local anesthetic.

An ultrasonic tool can also be used to root plane and scale. This method uses a high speed wand to break up and remove the plaque. It is less uncomfortable but not effective on all plaque. A combination of the two methods sometimes is needed.Antibiotics, before and after the procedure, can be prescribed for some patients that are high risk for infection.

Treatments: Surgical

For more severe periodontal disease involving gums that are loose and receding, surgical treatment is necessary. A gingivectomy is a surgical procedure to get rid of pockets between the teeth and gums. The surgery removes portions of the gum that are loose or grown over the tooth.This surgery is usually done with laser. Laser can also be effectively used to augment root planing and scaling. Lasers can provide less bleeding, swelling and discomfort to the patient.

More intensive treatment, called “flap surgery” is required for the next level of severity for periodontal disease. In this case, gums are cut away from the tooth root, flapped back and the root cleaned and treated with topical antibiotics. The gums are then stitched back up. A local anesthetic is used for this procedure.

Another more extensive type of surgery that can be done in conjunction with the flap surgery is bone and tissue grafting. Synthetic or natural bone can be grafted to the root. Soft tissue from the roof of the mouth or another area of gum can be grafted to the receded tissue or a special fabric can actually be used. Bone and tissue grafting are used when bone and soft tissue have begun to erode.

If a tooth has actually been lost due to periodontal disease but the jaw bone is still intact, an implant can be done. An artificial steel tooth root resembling a tiny screw is implanted into the jaw. This is the anchor for an artificial tooth. Although an excellent alternative for missing teeth, the high cost and length of treatment time is a major deterrent.

Maintenance

Unfortunately, periodontal treatment requires ongoing maintenance. This entails increasing the number of visits and cleanings to the dentist anywhere from every few weeks to every three months. However, it is imperative that once periodontal disease begins, the patient should arrest its progress. The link between periodontal disease and other systemic diseases such as heart, COPD, cancers, prostatitis, diabetes, arthritis, and low birth weights in children make it crucial that periodontal disease be treated.