Methods of Periodontal Disease Treatment
The number and types of treatment will vary, depending on the extent of the periodontal disease. Successful periodontal treatment starts with establishing excellent oral hygiene. The doctor may also suggest changing certain behaviors, such as quitting smoking, as a way to improve treatment outcome. It must be realised that periodontits is a chronic inflammatory disease and a lifelong regimen of excellent hygiene and professional maintenance care is required to maintain affected teeth.
Initial Therapy – Deep cleaning (Root Surface Debridement)
The first step in the treatment of periodontitis involves non-surgical cleaning below the gumline with a procedure called scaling and debridement. Local anaesthesia and multiple visits are often required.
Surgical Therapy
If initial therapy is found to have been unsuccessful in managing signs of disease activity, periodontal surgery may be needed to minimize further bone loss. Regeneration of lost bone in certain situations may be possible.
Depending on the severity of your periodontal disease, some of the following periodontal disease treatments may be prescribed:
Flap surgery - Open flap debridement for definitive removal of tartar and surgical management of bony irregularities which have resulted from the disease process
Pocket reduction surgery - This is to reduce the depth of the periodontal pocket and make it easier for the patient, dentist, and hygienist to keep the area clean.After surgery the gums will heal and fit more tightly around the tooth. This sometimes results in the teeth appearing longer.
Bone and Tissue Grafts - In addition to flap surgery, procedures are available to help regenerate any bone or gum tissues lost due to periodontitis. Bone regeneration may be promoted by placement of natural or synthetic bone in the area of bone loss, a process called osseous grafting. This is usually accompanied by placing a small piece of mesh-like material inserted between the bone and gum tissue to protect the grafted bone; a technique that is called Guided Tissue Regeneration (GTR).
In cases where gum tissue has been lost, a soft tissue graft, in which tissue taken from another area of your mouth is used to augment the deficient area.
It is difficult to predict which grafts will be successful over the long-term. Treatment results depend on a number of variables, including the extent and severity of the disease, how efficient the patient keeps up with oral care at home, and certain risk factors, such as smoking, which may lower the chances of success.
Maintenance/Review – Periodontal Supportive Therapy
Once periodontal disease has been stabilised, an ongoing regimen of “periodontal maintenance” is required. This involves regular examinations (periodontal charting and/or X-ray radiographs) by your periodontist and detailed cleanings every three to six months to prevent re-population of periodontitis-causing microorganisms. Close monitoring of affected teeth are necessary as disease activity may recur.