Periodontal (gum) disease treatments
Gum disease (or periodontal disease) is a serious infection that destroys the gums around teeth, as well as the supporting bone underneath. This disease has several stages. It usually begins with an initial phase called gingivitis, which is a superficial infection of the gums that can often be controlled with good oral hygiene. This condition can progress to a state called periodontitis where there is destruction of the alveolar bone (bone that surrounds teeth), and it becomes more difficult to treat. If no treatment is done, teeth move more and more, and may eventually fall out.
Periodontal disease can be treated by different ways, often depending on how severely the condition has progressed to. But the earlier the disease is intercepted, the better will be the results.
Treatment of gingivitis
Gingivitis is the first stage of infection and inflammation of the gums. It causes bleeding of the gums and a change of their colour (red or purple instead of pink). Gingivitis is a stage of gum disease that has not yet reached the bone that supports teeth.
Gingivitis can be treated by:
- strict oral hygiene care at home, including brushing at least twice daily and flossing at least once a day; rinsing with salt water or a disinfectant mouthwash (Chlorhexidine, Listerine, etc.) may be also advised; long-term use of a mouthwash should be discussed with your dentist;
- a dental cleaning, which includes scaling and polishing of teeth, every six months, to remove plaque and tartar; if a person who is susceptible to periodontal disease may be recommended to have dental cleanings more frequently, every three or four months;
- your dentist may advise you to brush with a mixture of baking soda and hydrogen peroxide (3% solution), by dipping the toothbrush in that mix and then slightly massaging the gums; this should be done twice daily; this kind of treatment is usually temporary, and used only until the condition of the gums improves.
Treatment of periodontitis
Periodontitis is a more advanced gum inflammation and infection, which has reached the periodontium. The complex we call periodontium is a group of tissues including the gingiva, the periodontal ligament, the cementum and the alveolar bone. Periodontitis may cause bleeding gums to varying degrees, bad breath, and also teeth that move slightly or severely. The dentist, or the dental hygienist can detect this stage of the disease by examining X-rays, or by detecting periodontal pockets (deep spaces between teeth and gum).
There are several procedures to treat periodontitis:
- scaling and root planing is a non-surgical procedure that is also called deep cleaning and is performed under local anaesthesia; it removes dental plaque and tartar located above and below the gums; scaling and root planing makes a tooth smooth and free of any bacterial debris or diseased tissues, helping the gums establish a healthy state;
- soft Periodontics is similar procedure of deep cleaning, but requiring before a phase of gum disinfection through antibiotic cream and / or antibiotic mouthwash; the gums, which have undergone antibiotic treatment, will make the tartar easier to detect and remove; scaling is therefore faster and easier to perform;
- open scaling is a surgical procedure that requires opening the gums with a flap, performing the scaling, and then closing it by means of sutures and dressings; sometimes an antibacterial agent is placed to help healing; this procedure is recommended only if the stage of the disease is very advanced, or if nonsurgical treatments have not helped healing the gums; open scaling can be performed by either a dentist, or a gum specialist called a periodontist;
- gum graft surgery reinforces gums that are too thin; it can also increase the gum volume where there is gingival recession (receded gums); most times the origin of the grafted gingiva is the palate; this procedure does not replace the lost bone around a tooth, but only the gum; graft treatments can be performed by a dentist or a periodontist;
- bone graft surgery requires the use of bone fragments that come from the patient him or herself, from a donor, or even from synthetic bone; those fragments replace bone destroyed by periodontal disease; the grafted bone serves as a platform for new bone to regenerate; this procedure is not always successful and requires ideal conditions to work;
- guided regeneration is a surgical procedure that helps creating new bone around teeth where bone was lost; following open scaling, a barrier membrane is inserted between the gum and the bone; this barrier prevents the gum to reform in the area where the bone should be regenerated, allowing the bone that heals slower to properly occupy the space; just like bone grafting, guided regeneration requires special conditions and does not always work;
- regeneration by growth factors is a procedure that is being developed recently, and is still more or less in a trial phase; it requires a blood sample from the patient to isolate growth factors, and then incorporating them under the gums following open scaling; this procedure, in many cases, allows to regenerate bone around teeth;
- laser dentistry is also a recent technique that has been developing for more than 2 decades and is becoming widely used by dentists; one of the laser's uses is to reshape gums and to kill harmful microorganisms that cause periodontal disease;
- tooth extraction, if periodontitis is too advanced and the tooth moves a lot, no treatment will save that tooth and it will need to be extracted.
Success rate for gum treatments
Gingivitis heals well by improving your oral hygiene methods as recommended by your dentist or your hygienist.
Regular scaling or surgical scaling does not heal periodontitis completely. They significantly slow down the disease and gums become more stable. After treatment, in order for periodontitis not to be active again, it is important to keep a regular post-treatment maintenance regimen:
- a patient must maintain good oral hygiene at home by brushing and flossing every day;
- regular cleanings and tartar scaling in a dental office every three to four months;
- smokers must stop smoking because it slows down the healing of the gums;
- some dentists and periodontists believe that if a patient's spouse also suffers from gum disease, he or she must go through treatment in order to prevent the transfer of germs.
- WebMD (Gingivitis and Periodontal Disease (Gum Disease)).
- Il Dentista Moderno (Aumento verticale di cresta mediante innesto autologo in zona estetica).
The information above should be used as a reference only. Any medical decision should not be done before consulting a health care professional.
The masculine gender has been used without prejudice to make reading easier.