Traditional treatments methods for gum disease typically involve one or a combination of several of the following procedures: deep cleaning/scaling and root planning, periodontal maintenance/prophylaxis, gum flap surgery, crown lengthening, local antibiotic therapy, prescription medications, orthodontic therapy or gum and bone grafting.
Deep Cleaning/Scaling And Root Planing
Most dental patients with moderate to severe gum disease will undergo deep cleanings at their dental office. A deep cleaning allows the patient to have their mouth numbed in order to allow the hygienist to comfortably remove all of the biofilm and tartar deposits deep below the gums. This procedure can be moderately uncomfortable, but local or topical anesthetics are usually used to alleviate any discomfort. Some soreness may follow the procedure for a day or two.
Most deep cleanings are only partially covered under dental insurance plans, leaving you responsible for the remainder of the charges. Deep cleaning procedures are performed and charged as four different quadrants (upper right, upper left, lower right, lower left).
Periodontal maintenance and routine cleaning appointments are the best methods for maintaining gum health or managing cases of mild gum disease. Prophylaxis appointments are typical cleaning visits that you have every six months, but a periodontal maintenance visit is the term for a similar recall cleaning after a deep cleaning has been performed. These allow your hygienist to monitor your gum health and remove any new areas of bacteria.
Gum Flap Surgery
If gum disease is severe enough, you may need to see a periodontal specialist. The gums will be retracted to allow access for the removal of all bacteria that lies deep below on far portions of the root surface. Because this is an actual surgery there will be some recovery time needed for healing and discomfort.
Another treatment for severe gum disease is crown lengthening. This procedure follows a gum flap surgery, but when your gums are put back in place, a portion of the tissue is removed in order to create a shallower gum pocket around the tooth. Shallower pockets are easier to keep clean, allowing you to better care for the diseased area. The result is a tooth that is longer in appearance with some exposed root surfaces. While it may be easier to care for the gum disease condition, it can result in aesthetic concerns and tooth sensitivity.
Local Antibiotic Therapy
Some types of locally-administered antibiotics can help areas of advanced gum disease respond quicker to deep cleaning or surgical procedures. After the medication is put in place you may need to wait up to two weeks before flossing the area. A separate dosage must be placed in each area of concern, so it cannot be used for more than a few locations. Some commonly used topical medications include:
Prescription medications such as mouthwash or oral antibiotics may be prescribed and are relatively inexpensive. You'll want to be careful with mouthwash containing alcohol, because it can dry out the mouth. A dry mouth can be a breeding ground for bad bacteria the very kind that can lead to gum disease and other oral health problems. Some commonly used prescription medications include:
Topical drugs like mouthwash, such as chlorhexidine, may be used for approximately two weeks to help reduce inflammation and bacteria in the mouth. Rinses can be used throughout the entire mouth or placed on a toothbrush and used at the site of infection. Long-term use of chlorhexidine can cause staining of the teeth.
Correcting misaligned teeth with orthodontic therapy (braces) has been shown to be part of a comprehensive treatment for periodontal disease. This is because it makes your teeth straighter and easier to keep clean. Crowded areas are more difficult to clean as they often harbor bacteria and are more likely to develop gum disease than areas where your teeth are aligned correctly.
Gum And Bone Grafting
Surgical procedures such as gum grafts or bone grafts may help to stabilize the support structures around your teeth. Gum grafting is typically best for areas of recession that suffer from tooth sensitivity and can at times be a moderately invasive procedure. Bone grafting is useful when there is advanced bone loss and you are at increased risk to lose teeth. Both of these grafts may be taken from your own body or from a donor bank.
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