Reprinted from the American Academy of Periodontology website.
Following are some of the procedures that periodontists use to treat patients diagnosed with a periodontal (gum) disease. The main cause of periodontal disease is bacteria in the form of a sticky, colorless plaque that constantly forms on your teeth; however, many other factors can cause periodontal (gum) disease or influence its progression.
AAP treatment guidelines stress that periodontal health should be achieved in the least invasive and most cost-effective manner. This is often accomplished through non-surgical periodontal treatment, including scaling and root planing (a careful cleaning of the root surfaces to remove plaque and calculus [tartar] from deep periodontal pockets and to smooth the tooth root to remove bacterial toxins), followed by adjunctive therapy such as local delivery antimicrobials and host modulation, as needed on a case-by-case basis. Most periodontists would agree that after scaling and root planing, many patients do not require any further active treatment, including surgical therapy. However, the majority of patients will require ongoing maintenance therapy to sustain health. Non-surgical therapy does have its limitations, however, and when it does not achieve periodontal health, surgery may be indicated to restore periodontal anatomy damaged by periodontal diseases and to facilitate oral hygiene practices.
If you're diagnosed with periodontal disease, your periodontist may recommend periodontal surgery. Periodontal surgery is necessary when your periodontist determines that the tissue around your teeth is unhealthy and cannot be repaired with non-surgical treatment. Following are the four types of surgical treatments most commonly prescribed:
- Pocket Reduction Procedures
- Regenerative Procedures
- Crown Lengthening
- Soft Tissue Grafts
If you've already lost a tooth to periodontal disease or other reasons, you may be interested in dental implants – the permanent tooth replacement option.
In addition to procedures to treat periodontal disease, many periodontists also perform cosmetic procedures to enhance your smile. Oftentimes, patients who pursue cosmetic procedures notice improved function as well. Cosmetic procedures include:
- Crown Lengthening
- Soft Tissue Grafts
- Ridge Augmentation
Ask a periodontist near you for a smile consultation. He or she can evaluate your smile and provide a range of treatments available to help achieve the look you want.
Frequently Asked Questions (FAQ)
What are the advantages of dental implants?
Dental implants look and feel like your own teeth. They can help prevent the bone loss and gum recession that often accompany bridgework or dentures. In addition, they don't sacrifice the quality of your adjacent teeth like a bridge because neighboring teeth are not altered to support the implant. Implants are secure and offer freedom from the clicks and wobbles of dentures. The success rate of implants is highly predictable.
How do I care for my dental implants?
Dental implants are like your own teeth and will require the same care. In order to keep your implant clean and plaque-free, brushing and flossing still apply.
How can I avoid surgery for my periodontal disease?
Depending on how far your periodontal disease has progressed, treatment can vary widely. If the disease is caught early, simple procedures can be done that will remove the plaque and calculus from below the gum line and eliminate the infection-causing bacteria. If the disease has advanced to the point where the periodontal pockets are deep and the supporting bone is lost, surgery might be necessary. You may have heard about new products on the market that claim to cure periodontal disease. However, they do not replace traditional periodontal therapy. Rather, the intent of these products is to improve the effectiveness of traditional therapies.
Will periodontal surgery hurt?
New treatment options using refined techniques can be performed comfortably as office procedures. Improvements in medications, local anesthesia, anxiety and pain control, and, in some cases, conscious sedation are available to make your treatment more pleasant and comfortable.
What is maintenance therapy?
Maintenance or supportive periodontal therapy is an ongoing program designed to prevent periodontal disease from recurring in patients who have undergone periodontal treatment. This ongoing phase of treatment will allow your periodontist to assess your periodontal health and make sure infection stays under control. During maintenance therapy, your mouth is examined, new calculus and plaque are removed, and, if necessary your teeth are polished and your bite is checked.
How often do I need maintenance therapy?
The answer varies from person to person. Your dentist or periodontist will recommend a schedule that is best tailored to protect your periodontal health. The intervals between visits may range from every few weeks to four times per year, in addition to checkups by your general dentist.
What are root scaling and planing?
These are non-surgical procedures in which the periodontist removes plaque and tartar from below the gum line. Tooth root surfaces are cleaned and smoothed with specially designed instruments. It is important to remove the plaque and tartar from the pockets, because aside from the bacterial toxins that irritate the gums, plaque and the rough surfaces of tartar make it easier for bacteria to get a foothold.
Cosmetic Periodontal Procedures
What can be done to improve the look of my "gummy" smile?
Crown lengthening is a procedure to remove excess gum tissue to expose more of the "crown" of the tooth. Your gumline can be sculpted to give your new smile just the right look.
What can be done to correct my "long" teeth or receding gums?
Soft tissue grafts and other root coverage procedures are designed to conceal exposed roots, reduce further gum recession, and protect your vulnerable roots from decay. During this procedure, your periodontist takes gum tissue from your palate or another donor source to cover the exposed root. This can be done for one tooth or several teeth to even your gum line and reduce sensitivity.
Will insurance cover periodontal procedures?
Many insurance plans pay a portion of periodontal services. Your periodontal health is important, so talk to your periodontist about payment options. Often the office staff will work with your insurance company to secure maximum benefits.