Treatment of Periodontal Disease

Nonsurgical Treatments

This is done by cleaning plaque and tartar; thus reducing infection. In about 3-6 weeks, your periodontist will usually perform another evaluation. Depending on various factors, surgery may be the next step.

Scaling and Root Planing
This treatment is performed by a dentist or a dental hygienist. Sometimes a special ultrasonic device is used to remove heavy deposits. Then plaque and tartar are removed (scaling) to the extent possible without surgery and the root surfaces are smoothed (root planning). This helps get rid of bacteria and may help ligaments to reattach, reducing pocket depth. Anesthetic may be used where sensitivity is a concern, and relaxant medication may be available for procedures as is desired.

Antibiotics
Infection can be treated with antibiotics, which decrease bacteria. Pills may be prescribed; the antibiotic may be placed directly into infected pockets.

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 method of adjusting the bite can reduce pressure and help control the damage.



Surgical Treatments

Surgery may be needed on one or more teeth. It can be used to reduce pocket size, help regenerate bone and other tissue, or adjust the level of the gumline. Surgery can also be used to reach tartar that can’t be removed with scaling and root planing alone.

Pre-surgical Instructions
Typically, periodontal surgery takes place in the 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) before surgery. You will likely need to arrange in advance for a ride home.

Post- Surgical Instructions

You will have a follow-up visit in 1 to 3 weeks to check your healing. This is when stitches (sutures) and any dressing (protective covering) are removed. Your instructions may include discussion on:
  • Resting for a day or two
  • Taking medication to control pain or prevent infection
  • Using ice or medication to control swelling
  • Smoking
  • Special instructions for cleaning teeth
  • Caring for the surgical area or dressing

Surgical Risks and Complications
These vary depending on surgery. In general, risks and complications of periodontal surgery may include:
  • Pain and discomfort.
  • Increased tooth mobility (often temporary).
  • Swelling and bruising of the check
  • Numbness or tingling, due to temporary or permanent damage to nearby nerves (a rarity).
  • Exposure of more crown or root leading to food impaction and sensitivity.

When to call your Periodontist
Call your dentist if:
  • You have excessive bleeding or swelling.
  • The stitches come undone earlier than your surgeon has told you to expect.
  • Part or all of the dressing comes off or is uncomfortable.
  • You have persistent pain.
  • You have a fever.
  • You have questions about your condition or treatment.
 
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Helpful Links
 
We encourage you to visit the American Academy of Periodontology website at www.perio.org for everything you need to know about periodontal health!