The goal of treating periodontitis is to clean bacteria from the tooth and gum surface and from below the gums, preventing and reducing inflammation and infection. Depending on how advanced the disease is, treatments may be non-surgical or surgical. The type of treatment depends on the size of your pockets.
Normally there isn't much of a gap between the tooth and the gum tissue that surrounds it -- usually 3 millimeters or less in a healthy mouth. When plaque build-up begins to cause gum inflammation, the gap begins to widen, creating what dentists call a "periodontal pocket" between the tooth and the gum. If a pocket deepens to 3 to 5 millimeters it can usually be managed with non-surgical treatments at a visit to the dentist, followed by good, ongoing at-home oral hygiene. These non-surgical treatments may include:
- Scaling to clean plaque, tartar and bacteria below the gum line
- Root planing to prevent further bacteria growth by smoothing the surface of the tooth below the gum line, and
- Antibiotics (topical or oral)
All of these treatments aim to reduce the number of bacteria in the pockets and the associated inflammation of moderate periodontitis.
When pockets grow deeper than 5 millimeters, the condition is considered advanced periodontitis, and surgical treatments may be needed to clean out the bacteria and restore damaged soft tissue and bone when possible. Surgical treatments may include:
- Pocket reduction surgery to deeply clean and tighten the periodontal pockets
- Soft-tissue grafts to cover exposed roots with tissue (often donated from the roof of the mouth)
- Bone grafts to restore bone lost to the bacterial infection
- Guided tissue regeneration to regrow soft tissue, connective tissue and bone lost to the bacterial infection, and
- Enamel matrix derivative application, where a gel is applied to the root of the tooth to encourage bone and tissue regrowth
Following professional periodontal care it's important to maintain good oral care at home to prevent another infection. If you're recovering from periodontal treatment, both non-surgical and surgical, brushing at least twice a day along with daily flossing will help prevent plaque from re-gaining the upper hand. For best results, ask your dentist if your brushing and flossing technique is correct.
More Great Links
- American Dental Association - Cleaning Your Teeth & Gums
- Colgate Oral and Dental Health Resource Center - What is Plaque?
- WebMD - Human Anatomy: The Teeth
- Colgate Oral and Dental Health Resource Center. "Gingivitis." (Nov. 18, 2011) http://www.colgate.com/app/CP/US/EN/OC/Information/Articles/Oral-and-Dental-Health-Basics/Common-Concerns/Gum-Disease/article/Gingivitis.cvsp?cid=ppc_gg_nb_stan_gingivitis_&kw=gingivitis
- Colgate Oral and Dental Health Resource Center. "Periodontitis." 2006. (Nov. 18, 2011) http://www.colgate.com/app/CP/US/EN/OC/Information/Articles/Oral-and-Dental-Health-Basics/Common-Concerns/Gum-Disease/article/Periodontitis.cvsp
- Colgate Oral and Dental Health Resource Center. "What are the Stages of Gum Disease?" (Nov. 18, 2011) http://www.colgate.com/app/CP/US/EN/OC/Information/Articles/Oral-and-Dental-Health-Basics/Common-Concerns/Gum-Disease/article/What-are-the-Stages-of-Gum-Disease.cvsp
- Demmer, RT; PN Papapanou. "Epidemiologic patterns of chronic and aggressive periodontitis." Periodontology 2000. Vol. 53. Pages 28 - 44. 2010. (Nov. 18, 2011) http://www.ncbi.nlm.nih.gov/pubmed/20403103
- Freeman, David. "Flossing Teeth for Dummies: No More Excuses!" WebMD. 2010. (nov. 18, 20110 http://www.webmd.com/oral-health/healthy-teeth-10/flossing-floss-sticks
- Lovegrove, JM. "Dental plaque revisited: bacteria associated with periodontal disease." Journal of the New Zealand Society of Periodontology. 2004. (Nov. 18, 2011) http://www.ncbi.nlm.nih.gov/pubmed/15143484
- Mayo Clinic. "Periodontitis." 2010. (Nov. 18, 2011) http://www.mayoclinic.com/health/periodontitis/DS00369
- The Merck Manual Home Health Handbook. "Periodontitis." 2008. (Nov. 18, 2011) http://www.merckmanuals.com/home/mouth_and_dental_disorders/periodontal_diseases/periodontitis.html
- National Institute of Dental and Craniofacial Research (NIDCR). "Study Finds Direct Association Between Cardiovascular Disease and Periodontal Bacteria." 2005. (Nov. 18, 2011) http://www.nih.gov/news/pr/feb2005/nidcr-07.htm
- Rosen, Paul S. "Treatment of Plaque-induced Gingivitis, Chronic Periodontitis, and Other Clinical Conditions." American Academy of Pediatric Dentistry Endorsements. Reference Manual. Vol. 33, no. 6. Pages 11 - 12. 2004. (Nov. 18, 2011) http://www.aapd.org/media/Policies_Guidelines/E_Plaque.pdf
- University of Maryland Medical Center. "Periodontal disease - Introduction." 2009. (Nov. 18, 2011) http://www.umm.edu/patiented/articles/what_periodontal_disease_000024_1.htm