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Treatment of Periodontal Disease

Periodontal (gum) disease is one of the leading causes of tooth loss. Plaque and tartar that build up on the teeth contain bacteria, which cause tissue inflammation and destroy the supporting bone around the roots of the teeth. Periodontal disease can be treated by either a surgical or non-surgical approach, depending on how advanced the disease process is.
Initial Phase
In most cases removal of this bacteria using a non-surgical approach is the initial step in treatment. This initial phase in the treatment of periodontal disease is scaling and root planning. Scaling involves removal of the bacteria and other debris from the crown and root surfaces of the teeth. Root planning involves smoothing the root surfaces of the teeth, in areas where they have become rough due to tartar. Antibiotics are sometimes used in addition to this non-surgical therapy and may be given in oral systemic doses or can be placed directly into the gum pocket. Depending on the severity of the disease process, some individuals require local anesthetic for the scaling and root planning appointment. This treatment involves a deep and thorough cleaning around the roots of the teeth, and although this deep cleaning cannot restore the lost bone and tissue, it can prevent the disease process from advancing and help to prevent tooth loss. Once the teeth have been thoroughly cleaned, the disease process is slowed, however, proper home care is a vital component of successful treatment.
Surgical Phase
If advanced bone and tissue destruction has occurred from periodontal disease, or if the initial scaling and root planning have not adequately removed all the bacteria, plaque and tartar from the tissue pockets around the teeth, periodontal surgery may be required. Flap surgery is performed to further clean the roots of the teeth and to reduce the depth of the tissue pockets that may exist around the teeth with advanced bone loss. Flap surgery involves pushing back the gum tissue away from the supporting bone and teeth, to allow the dentist to gain access to the root of the tooth for the removal of plaque, calculus and diseased tissue. The gum is then carefully sutured back into place. This is done with local anesthetic. Guided tissue regeneration (GTR) may be performed to help rebuild tissue that has been lost. This is usually performed in conjunction with flap surgery, and may be performed in an attempt to restore or regenerate missing bone and tissue around teeth subjected to long- standing gum disease. GTR refers to procedures that attempt to regenerate lost bone, periodontal ligament and connective tissue that support our teeth. This is accomplished using biocompatible membranes, often in combination with bone grafts and /or tissue stimulating proteins.