Periodontal Therapy
Feb 01

Periodontal Therapy [Surgical & Non-Surgical] - What to expect Before and After the Treatment?

Feb 01

Did you know that regular dental check-ups can save you from non-dental diseases? Modern-day dentists can help identify conditions like diabetes, osteoporosis, and other existing health conditions with a simple routine checkup.

Periodontal therapy is a dental treatment to identify and cure any such conditions in their early stages and eliminate the need for surgery.

This guide will answer all the concerns, including what is periodontal treatment/periodontal therapy and what to expect before and after periodontal treatment.

What is Periodontal Treatment?

Periodontal treatment is a type of conservative therapy for gum diseases. The goal of this treatment is to retain the gum health and prevent them from periodontal diseases without requiring to go for surgery.

When do you need Periodontal Therapy?

Periodontal therapy is considered the first line of treatment for the initial symptoms of periodontitis. A dentist generally recommends this therapy when a patient has one or more teeth with 3mm gum pockets.

According to research, periodontitis in adults is measured by the presence of 4mm of gum pockets and 30% of the adult population have 4mm of gum pockets, indicating the presence of the disease.

Moreover, 40% of the population has 3mm of gum pockets, and 5% with advanced stages of periodontitis with 6mm size of gum pockets.

Apart from that, periodontal therapy can also help treat gingivitis, a mild form of gum disease that leads to periodontitis.

Some researchers also claim that periodontal treatment has proven effective in treating moderately choric periodontitis, which is more prevalent among US residents. Periodontal therapy provides patients with non-surgical treatment for chronic gum diseases.

Is Periodontal Disease that SCARY?

Periodontal disease in its early stages is usually curable, requires no surgery, and leaves no side effects. You can achieve a healthy lifestyle by following a healthy oral hygiene routine and making a few dietary changes.

On the contrary, severe gingivitis, also called periodontitis in its late stage, can wreak havoc on your oral health. The bacteria in your gums cause them to pull away, making gum pockets while eroding the bone supporting the teeth. As a result, the affected teeth eventually fall out.

Even though gum conditions like periodontitis are preventable, they are widespread, especially in the US. In fact, CDC reports that every American in their later 30s suffers from periodontitis.

Researchers even suspect that the bacterial infection due to periodontitis can spread to the bloodstream if not treated and pose the risk of heart failure, diabetes, stroke, etc. This makes it crucial to receive periodontal therapy before it turns into a bigger problem.

What Causes Periodontitis?

Periodontal disease has multiple causes. Some controllable causes include:

  • Poor oral hygiene
  • Smoking
  • Tobacco use
  • Poor diet

Other less controllable risk factors that lead to periodontitis may include:

  • Hereditary
  • Hormonal fluctuations (puberty or pregnancy)
  • Diabetes
  • Cancer
  • Medications
  • Respiratory disease
  • Alzheimer's

Symptoms of Periodontal Disease

One of the reasons periodontal diseases are considered a big deal is that, even in their advanced stages, the patient wouldn’t know that they have it. Moreover, they are hard to spot as they are generally painless.

This is when periodontal therapy comes into play. Being consistent with your dental checkups can help avoid the occurrence of periodontal disease. Here are symptoms that you can look for to identify the presence of gum disease:

  • Bad breath
  • Bad taste in the mouth
  • Red, swollen gums
  • Bleeding while brushing teeth

If you notice the following symptoms, know that you are in the advanced stages of periodontitis:

  • Receding gums
  • Loose or shifted teeth
  • Gum Pockets of more than 4mm

Non-Surgical Periodontal Therapy

Non-Surgical Periodontal Therapy

Step 1 - Physical Examination

In most cases, the periodontist diagnoses the disease via a detailed physical examination. This will help them identify if there are any gum pockets around the teeth.

Typically, a tool is used to measure the size of the gum pockets, if there are any.

Nowadays, dentists use an intraoral camera to show patients the inside of their mouths so they can also check the condition of their gums and teeth. Also, using this tool, your dentist may point out areas of improvement.

If the dentist spots any signs of periodontitis or gum disease at this stage, they may take x-rays - instant digital images of your mouth- to produce more accurate and precise results.

Step 2: Treatment

Once your physical examination is done, your dentist will recommend moving forward with the treatment.

The treatment step itself comprises three parts:

  • Scaling
  • Root Planning
  • Medications

The treatment begins with an in-depth professional cleaning that your dentist gives you during your routine dental checkup, followed by root planning and medications.

  • Scaling

Plague and debris can accumulate on the surfaces of the teeth beneath the gum line. It is more common when gums pull away from the teeth making gum pockets. And once the gum pockets are formed, bacteria become easier to enter.

This is when scaling comes into play. It cleans up hidden plaque and tartar build-ups using either hand tools or ultrasonic cleaners. The latter is more effective in crumbling hardened dental calculus.

  • Root Planning

Root planning is a part of periodontal therapy in which the dentist smoothens the rough parts of the tooth to get rid of the bacteria residing in crevices. Moreover, root planning helps the gums to reattach to a cleaner surface.

After scaling and root planning, the gums begin to restore to their healthy state. The procedure's length depends on the case's severity and the amount of plaque buildup on the teeth. That said, it may not take more than one to two visits.

  • Medications

 Dentists may sometimes use antibiotic gels or other medicines as part of the treatment. Not just these medications ease swelling but lessen the bacterial count in the mouth and shrink the gum pockets.

Besides that, your dentist may also prescribe some after-treatment painkillers and antibacterial mouthwash for a swift recovery and prevent future bacterial infections.

Surgical Periodontal Treatments

Surgical Periodontal Treatments

After a physical examination, if the dentist concludes you have advanced periodontitis, you must undergo a surgical procedure. Following are the different types of periodontitis surgical procedures.

  • Flap Surgery

Flap surgery, also called pocket reduction surgery, is a periodontal treatment where the dentist makes small incisions in your gumline so that a part of gum tissue can be elevated, uncovering the roots for better cleaning and root planning.

Since advanced periodontitis can cause bone damage, the underlying bone may require restructuring before the gum tissues are reattached.

  • Soft Tissue Grafts

It is a procedure done to stop the gum recession and restore the aesthetics of your gum line. It is typically done by taking a small amount of healthy tissue from another healthy part of your mouth or donor source and attaching it to the impacted area. The procedure also helps cover exposed teeth roots for future damage.

  • Bone Grafting

 It is a periodontal surgery that dentists perform when periodontitis completely destroys the bone adjoining the tooth root. The damaged bone is replaced by the bone graft fragments taken from the patient’s own body or a synthetic bone.

Bone grafting strengthens the tooth and prevents tooth loss by holding it in its place.

  • Guided Tissue Regeneration

 It is another dental surgical procedure performed to promote bone regeneration destroyed by bacteria. During the surgery, your dentist will place a biocompatible fabric between your tooth and the existing bone to stop unwanted tissue from penetrating the healing area, letting the bone grow restoratively.

  • Tissue-Stimulating Proteins

This one is less invasive than others and involves applying a special gel to the impacted tooth root. The protein-rich gel stimulates the healthy growth of the bone and tissue.

Before and After Periodontal Treatment

After Care Tips

After scaling, you may feel teeth sensitivity and swollen gums for a week or more. The key to managing pain and inflammation is religiously using mouthwash and taking medications prescribed by your dentist.

Show up for your scheduled appointment to check if your healing process is smooth and your gum pockets are getting smaller.

Apart from that, you must make some lifestyle changes and follow a healthcare routine to prevent the disease from becoming recurring.

Things you should do at Home:

  • Brush your teeth twice a day - after every meal or snack
  • Replace your brush every three months
  • Floss regularly
  • Use an anti-bacterial mouthwash to prevent plaque and debris buildup between your teeth.
  • Get routine dental checkups
  • Don’t smoke or chew tobacco (if you do)
  • Increase your fruit and vegetable intake

Wrap Up

Periodontal therapies are generally safe. However, a few risks may be associated with them, depending on your treatment type. Some people may experience an infection or accidental mechanical injury as a reaction to the work done on the gum.

We recommend that you consult a dentist before getting any periodontal therapy. He/she is in a better place to advise you of the possible risks with the treatments that you should know.

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