The main goal of treatment is to control the infection. The number and types of treatment will vary, depending on the extent of the gum disease. Any type of treatment requires that the patient keep up good daily care at home. The doctor may also suggest changing certain behaviors, such as quitting smoking, as a way to improve treatment outcome.
Early treatment of gum disease is very important. The goals of treatment are to prevent gum disease from permanently damaging tissues, control infection, and prevent tooth loss. For treatment to be effective, you will need to:
If you have a milder type of gum disease (gingivitis), you may be able to reverse the damage to your gums:
The dentist, periodontist, or dental hygienist removes the plaque through a deep-cleaning method called scaling and root planing. Scaling means scraping off the tartar from above and below the gum line. Root planing gets rid of rough spots on the tooth root where the germs gather, and helps remove bacteria that contribute to the disease.
Once all the surfaces are smooth, the dental worker may polish your teeth. Polishing is done using a slow speed handpiece with a soft rubber cup that spins on the end. Prophylaxis (short for prophy) paste – a special gritty toothpaste-like material – is scooped up like ice cream into the cup and spun around on the teeth to make them shiny smooth.
Medications may be used with treatment that includes scaling and root planning, but they cannot always take the place of surgery. Depending on how far the disease has progressed, the dentist or periodontist may still suggest surgical treatment. Long-term studies are needed to find out if using medications reduces the need for surgery and whether they are effective over a long period of time. Listed on the next page are some medications that are currently used.
|Medications||What is it?||Why is it used?||How is it used?|
|Prescription antimicrobial mouthrinse||A prescription mouthrinse containing an antimicrobial called chlorhexidine||To control bacteria when treating gingivitis and after gum surgery||It's used like a regular mouthwash.|
|Antiseptic chip||A tiny piece of gelatin filled with the medicine chlorhexidine||To control bacteria and reduce the size of periodontal pockets||After root planing, it's placed in the pockets where the medicine is slowly released over time.|
|Antibiotic gel||A gel that contains the antibiotic doxycycline||To control bacteria and reduce the size of periodontal pockets||The periodontist puts it in the pockets after scaling and root planing. The antibiotic is released slowly over a period of about seven days.|
|Antibiotic microspheres||Tiny, round particles that contain the antibiotic minocycline||To control bacteria and reduce the size of periodontal pockets||The periodontist puts the microspheres into the pockets after scaling and root planing. The particles release minocycline slowly over time.|
|Enzyme suppressant||A low dose of the medication doxycycline that keeps destructive enzymes in check||To hold back the body's enzyme response — If not controlled, certain enzymes can break down gum tissue||This medication is in tablet form. It is used in combination with scaling and root planing.|
|Oral antibiotics||Antibiotic tablets or capsules||For the short term treatment of an acute or locally persistent periodontal infection||These come as tablets or capsules and are taken by mouth.|