Treating Advanced Gum Disease and Periodontitis
The NIDCR describes three ways of treating gum disease if it is past the point of personal care – deep cleaning, medications and surgery.
A deep dental cleaning involves scaling, using either dental instruments or an ultrasonic scaling device, to remove tartar, plaque and bacteria from tooth surfaces and from beneath the gums. It also involves root planing to smooth the root surfaces, discouraging further buildup of tartar, plaque and bacteria.
Medication usually means antibiotics to attempt to clear up an infection. Your dentist might recommend topical antibiotics, such as a prescription mouthrinse or an antibiotic solution that is placed in the spaces between your teeth and gums. Oral antibiotics in the form of capsules, while less invasive, serve to treat stubborn, but more severe forms of gum disease.
Surgery is usually reserved for periodontitis that hasn't responded to other treatment. Discuss surgical options with your periodontist and understand the benefits and risks. Here are a few options:
- Flap (pocket reduction) surgery involves making tiny incisions in your gum to clean deep pockets of tartar through scaling and root planing. After you heal, cleaning these areas and maintaining healthy gums is much easier.
- If you have lost gum tissue, a soft tissue graft can reinforce this deficiency. The graft usually involves removing a small amount of tissue from the roof of your mouth or another location, and attaching that tissue to the affected gum tissue. The goal is to prevent your gums from receding more, cover exposed roots, and improve the appearance of your teeth.
- If periodontitis has destroyed the bone around the root of a tooth, a bone graft can be placed around the tooth providing a platform for natural bone to regrow. The procedure uses a bone graft material that is placed in the area where the bone loss has occurred. This process can also include guided tissue regeneration, which uses a biocompatible barrier membrane that is placed between existing bone and the tooth to help grow new tissue around the tooth and bone in the area that has been destroyed by periodontitis.