Gum (periodontal) diseases are treated in different
ways depending on the stage of disease, how you may have responded to previous
treatments, and your overall health.
First, your gum tissues and areas around and
supporting your teeth will be thoroughly examined. This is called a periodontal
exam. Based on the results of the exam, non-surgical therapies (to control the
growth of bacteria) or surgical procedures (to restore tissues surrounding and
supporting the teeth) are considered.
Non-surgical treatments
- Professional dental cleaning. During a typical checkup, your dentist
or dental hygienist removes plaque and tartar that build up and harden on
the tooth surface. When plaque and tartar reach this level of build up, they
can only be removed with professional cleaning. Cleaning removes plaque and
tartar from above and below the gum line of all your teeth. If you have some
signs of gum disease, your dentist may recommend professional dental
cleaning more than twice a year.
- Scaling and root planing. This is a deep-cleaning, non-surgical
procedure that is done under local anesthesia. Hardened plaque and tartar
(also called calculus) are scraped away (scaling) from above and below the
gum line. Also, any rough spots on the tooth root are made smooth (planing).
Smoothing the rough spots removes bacteria and provides a clean surface for
the gums to reattach to the teeth.
Surgical treatments
- Flap surgery/pocket reduction surgery. During this procedure, the
gums are lifted back and tartar is removed. In some cases, irregular
surfaces of the damaged bone are smoothed. This limits the areas where
disease-causing bacteria can hide. The gums are then placed so that the
tissue fits snugly around the tooth. Reducing the space between the gum and
tooth also limits the areas where harmful bacteria can grow. The chance of
serious health problems that can arise from periodontal disease is also reduced.
- Bone grafts. Bone grafts use fragments of your own bone, synthetic
bone, or donated bone. Grafts replace bone – and help bone regrow – in areas
destroyed by periodontal disease. This restores the secure attachment of the
teeth to the bone. Another procedure, called tissue engineering, prompts
your own body to create new bone and tissue at a fast rate.
- Soft tissue grafts. This procedure strengthens thin gums or fills in
places where gums have receded (areas where the root of the tooth is
exposed). Grafted tissue, most often taken from the roof of the mouth, is
then stitched in place.
- Guided tissue regeneration. Performed when the bone supporting your
teeth has been destroyed, this procedure stimulates bone and gum tissue
growth. Done in combination with flap surgery, a small piece of mesh-like
fabric is inserted between the bone and gum tissue. This keeps the gum
tissue from growing into the area where the bone should be, allowing the
bone and connective tissue to regrow to better support the teeth.
- Bone surgery. Bone surgery smoothes shallow craters in the bone due
to moderate and advanced bone loss. Following flap surgery, the bone around
the tooth is reshaped to decrease the craters. This makes it harder for
bacteria to collect and grow.