“But I already have periodontal disease! What do I do NOW????”

If you already have periodontal disease, then maintenance is key to keeping your teeth! In order to keep your teeth, you’ll want to have a dentist evaluate your gum disease and make a treatment plan to slow the damage.

Initially, treating periodontal disease typically begins with non-surgical therapy to stabilize your gum tissue and control the infection. This key step temporarily stops the damage that causes tooth loss. Non-surgical treatments for gum disease may include deep cleaning, also known as “scaling and root planning.” In addition, your dentist may prescribe laser therapy and antibiotics delivered under your gums. Finally, more frequent follow-up cleanings (called periodontal maintenance cleanings) are key to controlling periodontal disease.

Sometimes non-surgical treatments need to be followed up with surgical treatments such as pocket reduction or gum grafting. These treatments repair specific problem areas where the infection has already caused deeper damage. (Read more about Gum Disease on Mayo Clinic website.)

Non-Surgical Periodontal Therapies: Keeping Teeth Healthy from the Outside

Periodontal therapies are for all patients. Whether you have healthy gums or severe periodontal disease, you need a type of regular periodontal therapy to stay healthy. In fact, there are five different types of periodontal therapies, otherwise known as dental cleanings. Each cleaning type treats a different level of gum health.

— Fun Fact: The word “Periodontal” actually just means “around the tooth.” In other words, periodontal therapy is a fancy phrase for “therapy around the outside of tooth.” Simplified further, it just means “dental cleaning.” These doctors LOVE their fancy phrases! —

1. Preventative Perio Therapy – The “Every-6-Month Dental Cleaning”:

This routine cleaning is the most effective way to prevent periodontal disease and tooth loss. These are the twice a year dental treatment that everyone calls “a cleaning.” They are also the key to keeping gums healthy.

Why so important? This therapy cleans up the plaque, tartar and debris that everyday brushing and flossing miss. Even the best brusher leaves plaque in the cracks. That plaque protects the bacteria that cause periodontal disease. When plaque builds up, bacteria build up. Eventually they start destroying the bone and gum tissue around the tooth.

2. Gum Inflammation (Gingivitis) Therapy:

At the beginning stages of bacterial infection, gums get red and puffy. We call that gingivitis. This happens when it’s been more than six months since the last cleaning or when home care is poor. Pregnant women are also more prone to gingivitis.

When gingivitis occurs, infection has started; however, it is still reversible. Having gingivitis does not mean you have periodontal disease. Getting gingivitis therapy in time prevents periodontal disease.

Gingivitis Therapy involves a thorough cleaning PLUS a follow-up cleaning several weeks later. This double cleaning process insures that no plaque and bacteria were missed in the mess. The redness and puffiness can hide infection the first time around and make it difficult to see the full extent of the infection.

Based on how the gums respond to these cleanings, a dentist designs personalized recommendations for home care products and techniques to get gums healthy and keep them that way.

3. “Let’s Clean Things Up So We Can See” Therapy:

When plaque build up is heavy, it is impossible to accurately see what is going on with the gums and bone. The first step in these situations is an initial “power-washing” called a debridement.

A debridement clears away the surface build-up and makes it possible to see around the gums and teeth. The dentist must be able to see in order to make  accurate diagnoses and recommendations.

Skipping debridement and jumping to treatment recommendations is one of the main reasons people end up incorrectly diagnosed with periodontal disease that they don’t actually have! NOBODY wants that!

4. Bone Infection (Deep Cleaning) Therapy:

Without treatment, gingivitis spreads down the tooth root and becomes periodontal disease. As the infection enters the bone, it loosens the gums creating pockets in the gum tissue. These pockets get stuffed with bacteria, food and pus.

Treating periodontal disease begins with a bone level therapy called “Root Planing and Scaling.” The hygienist scales the tooth and root removing plaque, tartar and calculus as well as infected tissue. This scaling smoothes the tooth roots and slows bacteria from building-up again.

Laser therapy follows root planing and scaling. It cleans away dead gum tissue so that gums can re-attach. This reattachment is key to healing the gums and protecting the bone.

Once roots, teeth, gums and pockets are cleaned, keep the bacteria count down is key to preventing damage. This is done through Maintenance Therapy.

5. Maintenance Therapy:

The bacteria that cause periodontal disease are always growing. After a thorough cleaning, it takes them 3-4 months to re-multiply to near-damaging levels.

The exact time it takes for a periodontal infection to begin doing damage again after a cleaning varies from person to person. It depends on homecare quality, the immune system, genes and other factors.

After the initial root planing and scaling therapy, maintenance therapy cleanings are prescribed every three to four months depending on how quickly the mouth gets re-infected.

Perio Lasers and Adjunctive Therapies:

If lasers and special antibiotics delivered directly into the gum pockets around the teeth sound space age, that’s because they are the most modern advances in Periodontal Dentistry.

Lasers are light emitting devices with applications in dentistry that greatly benefit patients suffering from gum infections.

Similarly, antibiotics also improve the outcome of non-surgical gum treatments.

These adjunctive therapies give our patients a better chance of keeping their teeth. We make use of them both in our clinic as clinical cases dictate.