Diagnosis

In creating a treatment that is tailored specifically for you, a proper diagnosis must be formed. Your PerioLife Periodontist in Dallas, Irving, Keller, and Fort Worth will:
Review your medical history to see if any factors that could be contributing to your symptoms, such as smoking, diabetes, or dry mouth.
Evaluate your teeth and mouth to look for plaque and tartar buildup and check for easy bleeding.
Measure the pocket depth of the space between your gums and teeth by placing a dental probe beside your tooth beneath your gumline, usually at several sites throughout your mouth. In a healthy mouth, the pocket depth is usually between 1 and 3 millimeters (mm). Pockets more than 4 mm may indicate gum disease and inflammation.
Take dental X-rays to check for the amount of bone loss to determine the right treatment for you.

Treatment

The goal of periodontal treatment is to remove the tartar and harmful bacteria 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, manage health conditions that may impact dental health, and stop tobacco use.

Nonsurgical treatments

If the gum disease is mild or in its early stages, 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 smooths 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.
Initial Therapy. However, in some more severe cases, scaling and root planing is required as the initial step for removal of heavy plaque and calculus deposits. Surgical treatment may still be required after this initial therapy.

Surgical treatments

If you have moderate to advanced periodontitis, treatment may require periodontal surgery, such as:
Flap/Osseous surgery (pocket reduction surgery). Your PerioLife 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 gums recede. 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 using tissue from 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 periodontal disease has destroyed the bone surrounding your teeth. The graft may be composed of small fragments of your own bone or donated from a tissue bank. 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 the 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 to increase the healing and optimize successful periodontal regeneration.

Frequently Asked Questions