Periodontal Treatment

The initial stage of treatment for periodontal disease (commonly known as gum disease) is usually a thorough cleaning that may include scaling and root planing. The objective of these non-surgical procedures is to remove etiologic agents such as dental plaque and tartar, or calculus, which cause gingival inflammation and disease. Scaling and root planing can be used as a stand-alone treatment, or a preventative measure. They are commonly performed on cases of gingivitis and moderate to severe periodontal disease.

What Do the Procedures Entail?

A hygienist will only perform scaling and root planing after a thorough examination of the mouth, which may include taking x-rays and visually examining the mouth. Depending on the condition of the gums, the amount of tartar present, the depth of the pockets, and the progression of periodontitis, Dr. Hastings and your hygienist may recommend scaling and root planing. In some cases, a local anesthesia may be used during the procedure.

An animated illustrion showing the process of scaling

Scaling:

When scaling is performed, calculus and plaque that attaches to the tooth surfaces is removed. The process especially targets the area below the gum line, along the root. Scaling is performed with a special dental tool called an ultrasonic scaling tool. The scaling tool usually includes an irrigation process that can be used to deliver an antimicrobial agent below the gums to help reduce oral bacteria.

An animated depiction of a root planning procedure

Root Planing:

Root planing is performed in order to remove cementum and surface dentin that is embedded with unwanted microorganisms, toxins and tartar. The root of the tooth is literally smoothed, which promotes healing, and also helps prevent bacteria from easily colonizing in the future.

In some cases, your hygienist may place a dose of an antibiotic in the periodontal pockets after scaling and root planing. This may be done to control infection and to encourage normal healing.

When deep pockets between teeth and gums are present, it is difficult for your hygienist to thoroughly remove plaque and tartar. Patients can seldom, if ever, keep these pockets clean and free of plaque. Consequently, surgery may be needed to restore periodontal health.

Benefits of Treatment

If treatment is successful, scaling and root planing may have many periodontal benefits. One is that it can help prevent disease. Research has proven that bacteria from periodontal infections can travel through the blood stream and affect other areas of the body, sometimes causing heart and respiratory diseases. Scaling and root planing remove bacteria that cause these conditions.

Another benefit of treatment is protecting teeth against tooth loss. When gum pockets exceed 3mm in depth, the risk for periodontal disease increases. As pockets deepen, more bacteria are able to colonize, eventually causing a chronic inflammatory response by the body to destroy gingival and bone tissue. This leads to tooth loss.

Finally, scaling and root planing may make the mouth more aesthetically pleasing, and should reduce bad breath caused from food particles and bacteria in the oral cavity. Superficial stains on the teeth will be removed during scaling and root planing, adding an extra bonus to the procedures.

Periodontal Disease Is Unpredictable

Periodontal disease left untreated can cause serious overall health problems. Research has linked periodontal disease to heart disease, stroke, osteoporosis, premature births and low birth weight. Diabetics can have far more difficulty controlling their diabetes as well.

With such serious effects, we must do everything we can to help find and control periodontal disease. It can be a challenge to predict when the symptoms of periodontal disease may recur because frequently it does not cause any pain. It is also a challenge to determine where, as sometimes only isolated areas are affected. The only way to find and control periodontal disease is with a professional exam specifically aimed at targeting the disease.

Periodontal Maintenance Therapy visits help us break the stronghold of bacteria in your gums and slow or eliminate their destructive effects. When necessary we may also re-treat the teeth with scaling and root planing more than once or even prescribe an antibiotic.

Despite all of our best efforts to treat and control periodontal disease, sometimes it is not enough. Based on the desired response of treatment and patient follow through, the patient still may need to be referred to a Periodontist (gum specialist) as the next line of treatment.