Periodontal Treatment may be performed by a periodontist, a dentist or a dental hygienist. The goal of periodontitis treatment is to thoroughly clean the pockets around teeth and prevent damage to surrounding bone. You have the best chance for successful treatment when you also adopt a daily routine of good oral care and stop tobacco use.
Nonsurgical treatments
If periodontitis isn’t advanced, treatment may involve less invasive procedures, including:
- Scaling. Scaling removes tartar and bacteria from your tooth surfaces and beneath your gums. It may be performed using instruments, a laser or an ultrasonic device.
- Root planing. Root planing smoothes the root surfaces, discouraging further buildup of tartar and bacteria, and removes bacterial byproducts that contribute to inflammation and delay healing or reattachment of the gum to the tooth surfaces.
- Antibiotics. Topical or oral antibiotics can help control bacterial infection. Topical antibiotics can include antibiotic mouth rinses or insertion of gels containing antibiotics in the space between your teeth and gums or into pockets after deep cleaning. However, oral antibiotics may be necessary to completely eliminate infection-causing bacteria.
Surgical treatments
If you have advanced periodontitis, treatment may require dental surgery, such as:
- Flap surgery (pocket reduction surgery). Your periodontist makes tiny incisions in your gum so that a section of gum tissue can be lifted back, exposing the roots for more effective scaling and root planing. Because periodontitis often causes bone loss, the underlying bone may be recontoured before the gum tissue is sutured back in place. After you heal, it’s easier to clean these areas and maintain healthy gum tissue.
- Soft tissue grafts. When you lose gum tissue, your gumline recedes. You may need to have some of the damaged soft tissue reinforced. This is usually done by removing a small amount of tissue from the roof of your mouth (palate) or another donor source and attaching it to the affected site. This can help reduce further gum recession, cover exposed roots and give your teeth a more pleasing appearance.
- Bone grafting. This procedure is performed when periodontitis has destroyed the bone surrounding your tooth root. The graft may be composed of small fragments of your own bone, or the bone may be synthetic or donated. The bone graft helps prevent tooth loss by holding your tooth in place. It also serves as a platform for the regrowth of natural bone.
- Guided tissue regeneration. This allows the regrowth of bone that was destroyed by bacteria. In one approach, your dentist places a special piece of biocompatible fabric between existing bone and your tooth. The material prevents unwanted tissue from entering the healing area, allowing bone to grow back instead.
- Tissue-stimulating proteins. Another technique involves applying a special gel to a diseased tooth root. This gel contains the same proteins found in developing tooth enamel and stimulates the growth of healthy bone and tissue.
Post-Surgical Instructions
To avoid bleeding problems:
- DO NOT rinse, gargle, spit, brush, or suck out of a straw for the 1st 24 hours. The more you do this, the more you disturb the clotting mechanism. Oozing and a small amount of blood in the saliva is NORMAL. You can either swallow it or dab it with a 2×2 gauze square. Profuse bleeding should be addressed by folding several 2×2 gauze squares in half and either biting on the gauze in the area of bleeding or apply pressure. If that doesn’t stop it in 20 minutes, try a dampened tea bag applied to the area with pressure.
- Please notify our office of continued bleeding by calling our main number (248) 357-3100 twenty four hours a day.
- You may eat something following the surgery, but keep it soft, lukewarm, and on the light side, unless advised to do otherwise by the doctor or assistant.
- It is NORMAL to be numb for several hours post-surgery.
- You may be drowsy for the first 24 hours after the surgery, depending on how you were sedated.
- Make sure to continue to take all regularly prescribed medications, as well as the antibiotic and pain medications prescribed for your surgery, unless an alternative medication plan has been discussed with you’re the doctor.
- Swelling and bruising may occur. Applying ice for 20 minutes on and 20 minutes off during the first 24 hours is helpful.
- You may or may not have a dressing in your mouth. This is basically for your comfort and may not fall out before your post-operative visit. If you are uncomfortable, let us know and we can replace it for you.
- You may notice in a few days some strings hanging. These are dissolvable sutures. If the strings bother you, call our office for further instruction. Do not clip any sutures if you have had any tissue grafting procedures.
- It is NORMAL to have some increased sensitivity to hots and colds for a period of time after the surgery. You will also notice space between your teeth. Both these situations will improve but may be evident for several months post-surgery.
One day post-surgery:
- You may begin to rinse with Peridex or Rincinol.
- You can also begin to brush your teeth with the soft surgical brush, unless you have been told otherwise.
- You can begin to eat normally; however, you will probably be much more comfortable if you stick to foods with a softer consistency. If you have had a tissue grafting procedure, you will be instructed to eat ONLY soft foods.