1. Scaling and Root Planing – Deep Cleaning Procedure
Scaling and root planing are non-surgical techniques utilized to treat and prevent the progression of periodontal disease. These non-invasive periodontal procedures, also collectively known as deep cleaning, involve the thorough cleaning of the root surfaces to eliminate plaque and tartar (calculus) situated in deep periodontal pockets. Deep cleaning also eliminates bacterial toxins. It is important to note that, while both are geared towards the elimination of plaque, standard cleaning is different from deep cleaning. Standard or routine cleanings are only able to remove plaque found above the gum line.
In patients with periodontal disease, cleaning only above the gum line gives rise to problems such as the development of periodontal abscess and the progression of the disease.
Deep cleaning begins with the measurement of the depth of the pockets. Following this, scaling or the scraping off of calculus on the surfaces of the teeth (above and below the gum line) is done. This step is primarily meant to clear the path and allow for deeper cleaning to happen. Meanwhile, root planing’s focus is on removing bacterial deposits on the root surface and smoothing rough surface on the roots of teeth. Elimination of these rough spots, known to trap bacteria, is essential in the prevention of gum disease. Generally, these procedures cause minimal discomfort or pain, especially if the pockets aren’t too deep. Still, topical anesthetics may be applied to numb the area and make the procedure more comfortable for you. Also, while the entire procedure can be done in a single visit, the usual practice is to treat a quadrant or half of the mouth per appointment.
After the scaling and planing procedures, irrigation of the pockets using antiseptic solution of chlorhexadine takes place. Typically, for the dentist to ascertain your response to the treatment, a follow up visit to the clinic is required. In most cases, further treatment isn’t necessary after patients undergo scaling and planing procedures. Still, periodic maintenance therapy every three to four months is necessary to keep the gums healthy.
You may experience soreness and sensitivity to hot and cold food after undergoing deep cleaning. There may also be episodes of slight bleeding. These are all temporary, though; you can expect them to go away in a few days. It is best to avoid hot, hard, sticky and crunchy food for several days. Refrain from brushing or flossing the treated area until it’s fully healed. To manage the pain, you may take pain medications as prescribed by your dentist.
2. Laser Therapy
Laser therapy is one of the most current techniques employed in the treatment of periodontal disease. Minimally invasive, this procedure offers several benefits. One of them is that, during this procedure, there is minimal blood loss allowing the speedy completion of the process. Also, unlike in traditional gum surgery, laser therapy results in little gum recession, thereby minimizing the exposure of more root structure. This is a good thing given that exposed root structures leads to increased sensitivity to hot and cold foods. Furthermore, they are also very susceptible to decay. Some of the few side effects associated with this treatment are sensitivity on the treated area, dizziness and nausea. These effects are just mild and go away in a few days.
3. Gum Antibiotic Therapy
Gum antibiotic therapy is basically the placement of medications to eliminate bacteria that causes periodontal disease. Performed following scaling and root planing procedures, this adjunctive therapy benefits those with advanced periodontal disease. It is important to note, though, that this is not a standalone procedure. This means that it should be used in conjunction with non-surgical treatments to ensure its efficacy. Also, using gum antibiotic therapy for the long term control of severe or advanced periodontal disease is not recommended.
PERIODONTAL SURGICAL TREATMENTS
1. Flap Surgery
Flap surgery, also called periodontal pocket reduction surgery, is recommended when pockets are too deep and incredibly difficult to clean with brushing and standard dental cleaning. The reduction of the pocket depth and elimination of existing bacteria are essential to prevent the progression of the periodontal disease and the damages it may cause. In addition, flap surgery aims to halt bone loss, lessen the inflammation and save the teeth. Performed under local anesthesia, the procedure begins with the dentist making an incision and folding back the gum tissue away from the surrounding bone. Then, to remove deposits, the diseased root surface is cleaned thoroughly with scaling and planing to ensure the total elimination of calculus from the tooth root. Meanwhile, in some cases, smoothing of damaged bone is done to minimize the hiding areas for disease-causing bacteria. Once the area is thoroughly cleaned, the gum tissue is sewn back into position in such a way that they fit snugly around the tooth. Feeling mild discomfort after the surgery is normal. The pain or discomfort can be managed with medications or the application of ice packs. Gauze pads will be used to cover the gum. These should be changed as needed. Rinsing with warm salt water should be done for several days to reduce the swelling and keep the mouth sanitized. Observing proper oral home care practices and getting regular professional oral maintenance are also integral in the success of the treatment and the elimination of the periodontal disease.
2. Bone Grafting
Scaling and root planing are non-surgical techniques utilized to treat and prevent the progression of periodontal disease. These non-invasive periodontal procedures, also collectively known as deep cleaning, involve the thorough cleaning of the root surfaces to eliminate plaque and tartar (calculus) situated in deep periodontal pockets. Deep cleaning also eliminates bacterial toxins. It is important to note that, while both are geared towards the elimination of plaque, standard cleaning is different from deep cleaning. Standard or routine cleanings are only able to remove plaque found above the gum line.
This membrane’s purpose is to seal the bone and prevent the migration of the gum between the tooth surface and the bone. This procedure is called Guided Tissue Regeneration (GTR), a minimally invasive surgical procedure that focuses on the regeneration of periodontal structures (gum and bone) destroyed or lost due to the disease. Following the placement of the membrane, the gum is sewn back in place. If a non-resorbable membrane was used, it will be removed surgically after a few weeks. After the surgery, swelling and discomfort may be experienced. The swelling may be managed with the use of ice packs. Place them outside your face on the treated area. For the pain, medications may be taken as prescribed by your dentist. Antibiotics may also be given to prevent infections. You must strictly take them as instructed. In addition, you must keep your mouth clean to avoid complications and ensure the proper healing of the treated area. Lastly, don’t miss your scheduled appointments with your periodontist.
3. Dental Implants
Periodontal disease, when left untreated, may lead to tooth loss. Getting dental implants is an option for patients who want to replace a lost tooth due to periodontal disease or injury. A dental implant, which is an artificial tooth root, is screwed into the jawbone to hold a replacement or prosthetic tooth or bridge.
