Periodontal Disease & Treatment

Periodontal diseases are infections of the gums, which gradually destroy the support of your natural teeth. There are numerous disease entities requiring different treatment approaches. Dental plaque, a colorless film which constantly forms on your teeth, is the primary cause of gum disease in genetically susceptible individuals. Bacteria found in plaque produces toxins or poisons that irritate the gums, which may cause them to turn red, swell and bleed easily. If this irritation is prolonged, the gums separate from the teeth, causing pockets (spaces) to form. As periodontal diseases progress, the supporting gum tissue and bone that holds teeth in place deteriorate. If left untreated, this leads to tooth loss. Daily brushing and flossing will prevent most periodontal conditions.

Periodontal diseases can be accelerated by a number of different factors:

  • Smoking
  • Diabetes
  • Stress
  • Clenching and grinding teeth
  • Medication
  • Poor nutrition

Preventing Gum Disease

The best way to prevent gum disease is effective daily brushing and flossing as well as regular professional examinations and cleanings. If not carefully removed by daily brushing and flossing, plaque hardens into a rough, porous substance known as calculus (or tartar). Unfortunately, even with the most diligent home dental care, people still can develop some form of periodontal disease. Once this disease starts, professional intervention is necessary to prevent its progress.

Symptoms of periodontal disease may include but are not limited to:

  • Generalized pain, tenderness, and swelling in gums and teeth
  • Bleeding of gums when brushing or eating
  • Odor even after brushing teeth
  • Multiple loose or sensitive teeth
  • Foul taste in mouth
  • Stubborn stain

Scaling and Root Planing Overview

For a brief narrated overview of the scaling and root planing, please click the image below. It will launch our flash educational MiniModule in a separate window that may answer some of your questions about scaling and root planing.

Scaling and Root Planing Overview

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TREATMENTS

The initial stage of treatment for periodontal disease is usually a thorough cleaning that may include scaling or 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.

Dr. Chan and Dr. Priesand will only perform scaling and root planing after a thorough examination of the mouth, which may include x-rays and a visual examination of the mouth. Depending on the condition of the gums, the amount of tartar present, the depth of the pockets, and the progression of periodontitis, scaling and root planing may be recommended. In some cases, a local anesthesia may be used during the procedure.

  • 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.
  • 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.

An animated illustrion showing the process of scaling

An animated depiction of a root planning procedure

Antibiotics or irrigation with anti-microbials (chemical agents or mouth rinses) may be recommended to help control the growth of bacteria that create toxins and cause periodontitis. In some cases, Doctors Chan and Priesand may place antibiotic fibers in the periodontal pockets after scaling and 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 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 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 5mm 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 planing, adding an extra bonus to the procedures.