Even when periodontal disease is in a fairly advanced stage, it is possible to improve or even reverse the condition with non-surgical procedures. Depending on the type of disease and its severity, one of these approaches may be suggested by your doctor.
This process can be done above or below the gum line and involves the scraping and removal of plaque and calculus (tartar) from the tooth. Scaling done at regular teeth cleanings usually involves the crown of the tooth. However, in more extreme circumstances, it is necessary to go further below the gum line to thoroughly remove disease-causing bacteria and its by-products on the root surface. In very advanced cases, flap surgery or gingivectomy may be necessary to allow the doctor free access to the infected tooth root.
After the thorough cleaning of the tooth surface has been completed above and below the gum line, the root of the tooth undergoes a process called planing. This is a process of smoothing the root of the tooth so that any remaining tartar is removed. This also serves two other purposes: it clears away any rough areas that bacteria below the gum line thrive in, and it makes it much easier for the gingival (gum) tissue to re-attach itself to the tooth, effectively reducing the size of the pockets that the plaque and bacteria hide in. This re-growth of tissue is key in stopping a recurrence of gum disease and happens very quickly once the calculus has been removed.
With either of these procedures, your periodontist may prescribe you either local or systemic antibiotics and a specially indicated mouth rinse.
Periodontal disease destroys supporting tissue and bone around the teeth, forming deep pockets for bacteria to potentially live in. As bacteria develops around the teeth, they can accumulate and advance under the gum tissue. Once under the gum tissue, these bacteria can further bone and tissue loss. If too much bone is lost, teeth may need to be extracted.
Used to treat moderate to severe periodontal disease, osseous surgery is an effective procedure to reduce pockets and control infection. During osseous surgery, the gum tissue is folded back and the disease-causing bacteria is removed before the gum tissue is put back into place. In addition to bacteria removal, damaged bone may be smoothed to limit areas where bacteria can hide – allowing gum tissue to better reattach to healthy bone.
Osseous surgery is typically performed in the office under a local anesthetic. In most cases, patients are able to return to normal activity the following day.