If you have been diagnosed with gum disease, there are a variety of treatment options depending upon the severity of your problem or bone loss around your teeth.   The most important thing to remember when treating periodontal disease is that the objective of treatment is to help you preserve your teeth by preserving or regenerating the bone which holds the roots.  If you lose the bone around the roots you will lose the teeth even if the teeth are free of decay.  Many people speak of conservative periodontal treatment meaning nonsurgical procedures such as root planing or using a laser.  People refer to surgical procedures as being aggressive techinques.  The truth is the most conservative procedure is not determined by the technique used.  The most conservative procedure is in fact that procedure or technique which helps you keep your teeth for the longest period of time with the best predictability.  

Dr. Sinks will always make a thorough and comprehensive evaluation of your periodontal condition and overall dental health.  From this evaluation he will present a sequence of treatment  designed specifically for your needs.  Generally we will begin with nonsurgical procedures and then make a re-evaluation to see if additional treatment is necessary.  

Non-Surgical Treatment

The first line of defense against the presence of gum disease is a unique type of cleaning called "scaling and root planing".  In this procedure, an ultrasonic cleaning device is used to remove plaque and tartar from your teeth where regular cleaning devices can not reach: under the gum line on the tooth and the root. Then the rough surface of the tooth and the root are smoothed out (planed). This provides a healthy, clean surface that makes it easier for the gum tissue to reattach to the tooth.

If you address your gum disease before it becomes severe, scaling and root planing may be the only treatment you need. However, as with any dental procedure, after-care is vital. In order to keep your teeth in good shape, and resist future occurrences of gum disease, you must brush and floss daily, eat a healthy diet, avoid tobacco use, and have regular dental checkups. Even after a successful scaling and root planing, if you do not attend to your teeth properly, it is quite likely that you will develop gum disease again.

Surgical Treatment Options

If the tissue or bone surrounding your teeth is too damaged to be repaired with non-surgical treatment, several surgical procedures are available to prevent severe damage and restore a healthy smile. We will recommend the procedure that is best suited to the condition of your teeth and gums. Following is a list of common types of periodontal surgery.

Pocket Depth Reduction

In a healthy mouth, the teeth are firmly surrounded by gum tissue and securely supported by the bones of the jaw. Periodontal disease damages these tissues and bones, leaving open spaces around the teeth that we call pockets. The larger these pockets are, the easier it is for bacteria to collect inside them, leading to more and more damage over time. Eventually the supportive structure degrades to the point that the tooth either falls out or needs to be removed.

During pocket reduction procedures (also known as “flap surgery”), we fold back the gum tissue and remove the bacteria hiding underneath, as well as the hardened plaque and tartar that have collected. We may also remove any tissue that is too damaged to survive. We then sew the healthy tissue back into place. Now that the tooth and root are free of bacteria, plaque and tartar, and the pockets have been reduced, the gums can reattach to the teeth.

Regeneration

When the bone and tissue supporting the teeth has been lost due to severe gum disease, we can restore these areas with a regeneration procedure. During this process, we begin by folding back the gum tissue and removing the bacteria, plaque and tartar. Depending on your situation, we may then perform a bone graft to stimulate new bone growth, or we may place a special kind of protein that stimulates tissue growth, to repair the areas that have been destroyed by the disease.

Soft-Tissue Graft

A frequent symptom of gum disease is gum recession (also called gingival recession). As the gums recede, more of the roots are revealed. This can make teeth appear longer and can also create sensitivity to hot or cold liquids or food. It also exposes the tooth to increased damage from gum disease, as bacteria, plaque and tartar attack the surface of the tooth and the root.

During a soft-tissue graft, tissue from the top of your mouth or another source is sewed to the gum area, covering the roots and restoring the gum line to its original, healthy location. This procedure can also be performed for cosmetic reasons.