Treatment of Periodontal Diseases - Nonsurgical Therapy:
Scaling and Root Planing:
Scaling is a cleaning procedure that removes plaque and calculus from the teeth at or slightly below the gumline. Root Planing removes deposits to the bottom of the pocket. The root surfaces are also smoothed which allows for tightening of the gum tissue and reduces the pocket depth.
At Dr. Layport's office, Scaling and Root Planing is typically done in two 1-1/2 hour appointments by Dr. Layport or by one of her hygienists. The deep areas will be numbed with local anesthetic. An ultrasonic scaler (Cavitron) is used as well as hand instruments (scalers).
This type of treatment may be all that's needed, especially when periodontal disease is caught early enough.
Occlusal Therapy:
An imbalanced bite may increase or speed up bone destruction. Adjusting the bite (carefully grinding a thin layer of the teeth that are hitting too hard) allows the teeth to meet properly and distributes stress to stronger teeth.
A biteguard is a removable appliance that is typically worn at night to protect the teeth and to relax the jaw muscles. These are usually needed by people who clench or grind their teeth (bruxism), which is a common habit associated with stress or TMJ problems.
Splinting is occasionally needed to attach loose teeth together, making you feel more comfortable.
Maintenance Following Active Therapy:
Sticking to a regular oral hygiene regimen is crucial for patients who want to sustain the results of therapy. Patients should visit the dentist every 3-4 months (or more, depending on the patient) for scaling and root planing and an overall exam.
Treating and preventing gum disease brings great health benefits. By retaining your natural teeth, you can chew more comfortably and enjoy better digestion. You can have a healthy smile, a natural asset to your appearance. You can save money and avoid discomfort by preventing future dental problems. For looking good and feeling good, nothing works better than your natural teeth.
Antibiotics:
Because bacteria cause periodontal disease, antibiotics are used if scaling and root planing alone are not enough to control the disease.
Systemic antibiotics are used by Dr. Layport primarily for Early-Onset Periodontitis (bone loss before age 35) and for Refractory cases (disease that is only slowed and not stopped by our usual treatments). Typically Doxycycline, a tetracycline type of antibiotic, is used. Metronidazole (Flagyl) and Amoxicillin or Augmentin are commonly used together in aggressive cases. Periostat is a low-dose form of doxycycline which is primarily used for long-term use in Refractory patients. The dosage is low enough that the bacteria are not killed, and do not form resisitance to the antibiotic. The beneficial effect derives from a side effect that helps prevent collagen (gum tissue fibers) breakdown by enzyme suppression.
Localized antibiotic placement is an actively changing part of periodontal therapy. Currently Dr. Layport uses Arestin, which is minocycline in a powder form, in localized problem areas. A metronidazole chip is expected to be approved for use soon. Chlorhexidine is an antibacterial mouthwash which can be used for irrigation in localized problem pockets as well as a general mouthwash in certain circumstances.