A tremendous amount of improvement in the overall health of the gum and bone structure can be achieved conservatively through non-surgical intervention.
Even in severe cases, non-surgical periodontal therapy often precedes surgical therapy. This is done to improve the overall tissue quality prior to surgery and also to help limit the areas requiring surgery.
Scaling and Root Planing involves the removal of plaque and calculus (tartar) above and below the gum line. The goal is to remove as much of the noxious stimulus as possible, so that a healthier environment for the gum tissue and bone can exist.
This procedure is typically performed over multiple appointments, utilizing a local anesthetic for comfort. Re-evaluation of the gums and bone are performed approximately 4 weeks after the completion of Scaling and Root Planing.
In addition to Scaling and Root Planing, the doctor may recommend the use of antibiotics to assist in Initial Therapy. Certain forms of periodontal disease often involve more aggressive bacteria that respond well to the use of antibiotics in conjunction with Scaling and Root Planing.
Localized antibiotics are placed directly in the space between the gum and tooth. The antibiotics available today are in the form of powders or gels. They are not painful to the patient.
In situations where aggressive disease is seen throughout the entire mouth, a prescription for an antibiotic may be given.
Factors involving excess stress on individual teeth (and in turn localized areas of gum and bone) may be addressed as well during Initial Therapy. A number of techniques may be utilized to aid in correcting a destructive bite.
A bite is considered to be healthy when all or most of the teeth are present and not destroyed by normal daily usage.
It is destructive when teeth show wear, looseness or when TMJ (jaw joint) damage is seen. Bite therapy helps restore a bite that can function without damage and destruction. The therapy may include:
Reshaping the biting surfaces of the teeth and eliminating spots of excessive pressures where the teeth are brought into contact. This is done by carefully dividing bite pressures evenly across all of the teeth.
Bite splint therapy using a custom fitted and adjusted plastic bite guard to keep the teeth apart, day, night or both.
Braces, to reposition mal-aligned or drifted teeth.
Replacement of old, worn out or damaged fillings.
Reconstruction or removal of badly worn and damaged teeth.
Non-surgical therapy continues after periodontal health is restored in the form of Periodontal Maintenance. Patients completing periodontal therapy are advised to continue their care at frequent intervals (initially 3 months) to help prevent recurrence of the disease. Although there is no way to predict if a relapse will occur, periodontal research has shown 3 month periodontal maintenance appointments can help prevent the resurfacing of the disease.