How are gum diseases treated?

Gum (periodontal) diseases are treated in a variety of ways depending on the stage of disease, how you may have responded to earlier treatments, and your overall health.

After a thorough periodontal evaluation, recommendations for treatment range from non-surgical therapies to surgical procedures. Non-surgical approaches control the growth of bacteria. Surgical procedures restore the tissues surrounding and supporting the teeth.

What causes gum disease?

Our mouths are full of bacteria. These bacteria, along with mucus and other particles, constantly form a sticky, colourless “plaque” on teeth. Brushing and flossing help get rid of plaque. Plaque that is not removed can harden and form calculus that brushing doesn’t clean. Only a professional cleaning can remove calculus.

How do I know if I have gum disease?

Like gingivitis, periodontitis is usually painless, and by the time people become aware of problems, usually teeth becoming loose or drifting out of alignment, serious damage has been done. If caught early enough, most periodontal disease can be treated.

Symptoms include

Bad breath that won’t go away

Red or swollen gums

Tender or bleeding gums

Painful chewing

Loose teeth

Sensitive teeth

Receding gums or longer appearing teeth

Non-surgical Treatments for Gum Disease?

Treatments for gum disease that don't involve surgery include:

Professional dental cleaning. During a typical checkup your dentist or dental hygienist will remove the plaque and tartar (plaque that builds up and hardens on the tooth surface and can only be removed with professional cleaning) from above and below the gum line of all teeth. If you have some signs of gum disease, your dentist may recommend professional dental cleaning more than twice-a-year. Dental cleanings are not a treatment for active gum disease. They are, though, an important preventive measure that can help you stave off its development.

Scaling and root planing. This is a deep-cleaning, nonsurgical procedure, done under a local anesthetic, whereby plaque and tartar from above and below the gum line are scraped away (scaling) and rough spots on the tooth root are made smooth (planing). Smoothing the rough spots removes bacteria and provides a clean surface for the gums to reattach to the teeth. Scaling and root planing is done if your dentist or periodontist determines that you have plaque and calculus (hardened plaque, also called tartar) under the gums that needs to be removed.

What are surgical treatments for gum disease?

Flap surgery/pocket reduction surgery: During this procedure, the gums are lifted back and tartar is removed. In some cases, irregular surfaces of the damaged bone are smoothed. This limits the areas where disease-causing bacteria can hide. The gums are then placed so that the tissue fits snugly around the tooth. Reducing the space between the gum and tooth also limits the areas where harmful bacteria can grow. The chance of serious health problems that can arise from periodontal disease is also reduced.

Bone grafts: Bone grafts use fragments of your own bone, synthetic bone, or donated bone. Grafts replace bone – and help bone regrow – in areas destroyed by periodontal disease. This restores the secure attachment of the teeth to the bone. Another procedure, called tissue engineering, prompts your own body to create new bone and tissue at a fast rate.

Soft tissue grafts: This procedure strengthens thin gums or fills in places where gums have receded (areas where the root of the tooth is exposed). Grafted tissue, most often taken from the roof of the mouth, is then stitched in place.

Guided tissue regeneration: Performed when the bone supporting your teeth has been destroyed, this procedure stimulates bone and gum tissue growth. Done in combination with flap surgery, a small piece of mesh-like fabric is inserted between the bone and gum tissue. This keeps the gum tissue from growing into the area where the bone should be, allowing the bone and connective tissue to regrow to better support the teeth.

Bone surgery: Bone surgery smoothes shallow craters in the bone due to moderate and advanced bone loss. Following flap surgery, the bone around the tooth is reshaped to decrease the craters. This makes it harder for bacteria to collect and grow.

In some patients, the non-surgical procedure of scaling and root planing is all that is needed to treat gum diseases. Surgery is needed when the tissue around your teeth is unhealthy and cannot be repaired with non-surgical options.

After treatment / What is next?

The aim of treatment is to slow the gum disease down as much as possible. To achieve this, regular dental examinations are required by your dentist to evaluate your gum health and routine hygiene appointment necessary to help maintain your improved smile.