Periodontal infection is typically a chronic infection that works way further into the gum and bone over a long period. Bacteria are organized and different from the normal bacteria in the mouth. It invades the gums and affect the bone, many times conventional/routine cleanings do not serve well to control the infection.
This infection is typically without symptoms, such as pain. However, it can give you signs of infection such as swollen gums, bleeding, bad breath and looseness of teeth.
For mild periodontal disease, we will utilize a way to effectively control periodontal infection and help patients heal in a simple, less invasive and less expensive way. The technique is simply called “Scaling and Root Planing.” The results of this technique have been shown to reduce “pockets” and reduce bleeding.
The “Scaling” is typically done using local anesthesia, with very small ultrasonically powered probes (“micro ultrasonics”). This cleaning technique very thoroughly cleans diseased roots and pockets with micro ultrasonic vibrations of the instrument, as well as, with highly energized flushing of water irrigation. Patients that are anxious about treatment can elect to be orally or intravenous sedated before the local anesthesia and during the treatment.
When infection is generalized, it is better to use systemic medications (oral pills). However, when the infection is more localized, antibiotic gels may be placed directly into the pocket to provide the disinfection. These local antibiotics work in the gum for over a month as they dissolve.
After the initial procedure, patients typically have little or no discomfort, and a re-evaluation is performed after 6 weeks to check the initial response to treatment. Subsequently, patients are asked to have supportive periodontal treatments at 3 month intervals for one year. These treatments are micro ultrasonic cleanings (without anesthesia) and are performed to support healing by keeping the teeth above and below the gum as clean as possible. Additionally, we help our patient with their effectiveness in cleaning at home.
After a year, selected x-rays are taken and a reevaluation of the healing response is performed. At that point, long-term management options are discussed. Sometimes, surgical treatment is recommended. However, we estimate that the teeth that originally have mild infection with pockets and bone loss no longer require surgical treatment.
Periodontics has made great strides in the surgical and non-surgical management of periodontal problems. With this conservative technique, we have been able to allow many patients to reach periodontal health in a simple, effective, less invasive and more affordable way.
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Justin M. Schlaikjer DDS MS Periodontics and Implant Dentistry