Periodontal Disease Treatment

Periodontal treatment methods depend upon the type and severity of the disease.    Dr. Ford and his team of dental hygienists will customize the best non-surgical treatment for you with any adjuncts that are needed to provide the best healing possible for your periodontal condition.   A Complete Periodontal Exam of your mouth will be done before any treatment is performed or recommended.

Periodontal disease progresses as the sulcus (natural space between the tooth and gum) becomes filled with bacterial plaque biofilm, hard calculus, and food debirs, causing irritation to the surrounding tissues.  When these irritants remain in the pocket space, they can cause damage to the gums and eventually, the bone that supports the teeth!  The natural space starts becoming infected and deepens into a Periodontal Pocket and you can no longer reach to the depths of this unhealthy, deep area.  Only our dental hygiene team with our customized hygiene scalers can reach to the definitive depths can reach and meticulously remove the plaque biofilm, calculus and food debris infecting the gum, ligaments and bone.

If the disease is caught in the early stages of Gingivitis, and no permanent damage has been done, depending upon the quantity of calculus above the gum, your dental hygienist will let you know how many hygiene visits are necessary to remove all the calculus.  You will also be given instructions on improving your daily oral hygiene habits so you can maintain the healthy status that you and your dental hygienist have created.  Remember, 50% of your healing is your homecare and your body's natural immune system.  Depending upon your susceptibility of gingivitis, any systemic conditions you may have, how quickly your body produces calculus and your homecare, your dental hygienist will advice a specific interval of time to return for another maintenance hygiene visit.  Some patients need a shorter interval 2,3,4 months, some very healthy patients can go as long as 6 months or longer.  Dr. Ford and your dental hygienist will always recommend what is best for your specific situation.  Our goal is to maintain the healthy state of your teeth and gums for a lifetime.

If the disease has progressed to more advanced stages, a special periodontal visit called Subgingival Scaling and Root Planing will be recommended.  Depending about the quantity of hard calculus, how deep the periodontal pockets are, how tenacious (sticky) the calculus is, how much stain you have and how infected the gingival tissues are, Dr. Ford and your dental hygienist will determine the number of visits needed to thoroughly remove all the calculus above and below the gumline.  It is usually done by dividing up your mouth into specific areas of treatment while the area is numb and you are comfortable.  There are several ways to numb the gum without an injection.  Please ask us how we can make the periodontal procedure more comfortable for you.  Also, we have nitrous oxide gas (laughing gas)for your comfort--you are able to drive home or go back to work after any of these procedures--these are non-surgical periodontal procedures to help control your periodontal disease so it goes into remission and your homecare and immune system controls the active periodontal process.

In the procedure of subgingival scaling and root planing, the plaque biofilm, the hardened calculus and  toxins are removed from above and below the gum line (scaling).  This instrumentation involves hygiene scalers (hand and/or ultrasonics) to move vertically, horizontally and diagonally on the crown and root surface of the tooth to remove the calculus.  The pieces of calculus that have embedded themselves into the roots of the tooth (rough areas) are removed and made smooth by additional instrumentation on the root of the tooth (Root planing).  Your dental hygienist will also accomplish additional instrumentation on the inside lining of the gum (soft tissue curettage); this procedure helps the gum tissue to heal and reattach itself to the roots and pockets to shrink and the periodontal ligaments to hug back to the tooth.  Homecare instructions along with powdered toothbrushes, water irrigators, medicated mouth rinses and prescription medicaments may be recommended to help control infection and healing.  This is all based upon your personalized needs, expectations and diagnosis.

Dr. Ford and your dental hygienist will customize a specific protocol for your hygiene Scaling and Root Planing visits.  We usually like to treat one area at a time (the most involved area first) so as to allow for your immune system to only focus on that area to healing, therefore your healing will be better; very much like wound healing.  Also, we do repetitive scaling and root planing at each visit.  This entails additional time and instrumentation on the first area treated to do additional instrumentation on the root to enhance the healing potential; this allows for better healing and long-term maintenance.  We also need your commitment to homecare with aids to help remove the new additional soft plaque biofilm that continues to grow on your teeth on a daily basis (every 24 hours new growth).  It's a team effort is producing the best clinical results that help ensure long term healing.

After all the scalings and root planings are done a 4-6weeks re-evaluation is an extremely important hygiene appointment that allows Dr. Ford and your dental hygienist to assess the healing.  The healing assessment is important because it allows the dental hygienist to retake all the periodontal measurements to ensure they are 3mm or less and no bleeding.  No bleeding is the critical variable.  Bleeding is a sign of infection--so at this appointment your dental hygienist can take some time and if there are some isolated areas to retreat can do so at this appointment.  Once the scaling, polishing and periodontal measurements are done, she can tell you a good interval (number of weeks/months) that you can go between hygiene visits to maintain your health.  This interval of time is named Balance Point because that is the length of time your body can go between appointment before your gingivitis can flare up again (your gums will bleed during flossing or brushing).

If the pockets do not heal after scaling and root planing, periodontal surgery may be needed to reduce pocket depths, making teeth easier to clean.  Your dentist may also recommend that you see a Periodontist (specialist of the gums and supporting bone).