Your Treatment Plan -
In many cases, nonsurgical treatments are performed first. This may be the only treatment needed. Or it may be a first step in preparing for surgery. In some cases, surgery is planned from the outset. After any kind of treatment, ongoing maintenance is needed to keep the disease under control.
Nonsurgical Treatments -
The goal of these treatments is to create conditions that enable tissues in the mouth to heal. This is done by reducing plaque, infection, and other causes of periodontal disease. In about 4 to 8 weeks, you’ll have another evaluation. Depending on various factors, surgery may be the next step.
Scaling and Root Planing -
Scaling and root planing removes heavy deposits. Plaque and tartar are removed (scaling), and the root surfaces are smoothed (root planing). This helps keep the area free of bacteria and may help ligaments to reattach, reducing pocket depth.
Antibiotics -
Infection can be treated with antibiotics, which decrease bacteria. Pills maybe prescribed. Or the antibiotic may be placed directly into the infected pocket.
Bite Correction -
Bite problems such as an uneven bite can worsen bone loss. Grinding or clenching the teeth may contribute to the problem. A splint or other ways of adjusting the bite can reduce pressure and help control the damage.
If You Need Surgery -
Surgery may be needed to save one or more teeth. It can be used
to reduce pocket size, help regenerate bone and other tissue, or adjust the gumline. Surgery can also be used to reach tartar that can’t be removed with scaling and root planing.
Your Surgical Experience -
Periodontal surgery takes place in our office. You will go home soon after it
is completed. To control pain you’ll be given local anesthesia. You may also
have a sedative (medication to help you relax). Be sure to arrange in advance
for a ride home if you are given a sedative.
Pocket Reduction Surgery -
If nonsurgical treatments can’t reduce pocket depth, surgery may be needed. Surgery on gum and bone can reduce pocket depth and save a tooth or teeth. It also allows tartar
to be removed deep below the gumline. In some cases, pocket reduction surgery is combined with regenerative procedures.
Reshaping Gum and Bone -
Pocket reduction begins with flap surgery. The gum is separated from the tooth and later reattached in a new position. In most cases, osseous surgery is also performed. This involves reshaping and smoothing the bone. After treatment is complete, the gumline will most likely be lower, leaving more of the tooth exposed. If the root is exposed, ongoing treatment with fluoride or another material may be needed to reduce sensitivity.
Regenerative Procedures -
Certain procedures can be used to stimulate growth of new bone. This increases the height of the bone around the tooth, giving it more support. Getting back even half the lost bone height extends the life of the tooth.
Bone Replacement Graft -
A graft helps your body replace lost bone. The graft consists of your own bone, synthetic material, or bone from a tissue bank. A gel containing growth factors may also be used to stimulate tissues to grow.
Guided Tissue Regeneration (GTR) -
A special membrane is placed between gum and bone. This prevents gum tissue, which grows quickly, from filling the space where bone was lost. That way, new bone has time to grow where it’s needed.
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