How Is Gum Disease Treated?

Non-surgical Treatment of Gum Disease

  •       Periodontal Scaling. During periodontal scaling, your dentist or dental hygienist will remove the plaque (bacteria) and tartar (calculus) from all the teeth, above the gum line. If there are signs of gum disease (bleeding gums, redness, tenderness), your dentist may recommend periodontal scaling more than twice-a-year. 
  •       Periodontal Scaling and Root Planing. This is a procedure to remove harmful plaque and calculus both above and below the gumline and smooth out the root surfaces to provide a clean surface for the gums to reattach. Scaling and root planing is sometimes referred to as “deep cleaning,” and is often done under local anesthesia to minimize discomfort.

Surgical Treatment of Gum Disease

  •       Pocket Reduction or Flap Surgery.  During this procedure, small gum line incisions are made and the gums are pushed back to allow visualization of the roots to better remove the bacteria and calculus under the gum line. The gums are then repositioned and secured to the teeth.  This procedure also minimizes the areas where harmful bacteria can grow and makes it easier to keep your teeth clean.
  •       Bone Grafts. This procedure is used to replace bone lost to periodontal disease.  Bone graft materials may be derived from your own jaw, donated from human source, bioengineered or synthetic.  Bone grafts serve as a scaffold for the regrowth of bone, which can increase tooth stability and reduce pockets between tooth and gum. 
  •       Soft Tissue Grafts. This procedure is performed to thicken areas of thin gums or replace gum tissue that has receded away from tooth roots. Soft tissue grafts are inserted beneath or on top of the existing gum tissue and secured in place.  Soft tissue grafts can be obtained from your own mouth, donated from human or procured from animals.  Restoring thick, healthy gums around your teeth protects the underlying bone and improves their long-term stability.
  •       Guided Tissue Regeneration. This procedure is performed to stimulate repair in areas where bone has been lost to periodontal disease.  Performed in combination with flap surgery, a small thin sheet of material referred to as a “membrane” is inserted between the bone and gum tissue, creating a barrier around the bone defect. This membrane protected wall keeps the gum tissue from growing into the area, allowing the bone to repair. 
  •       Osseous Surgery.  During flap surgery, the bone around the tooth is reshaped to decrease the irregularities created from gum disease.   This allows for better adaptation of your gums to the tooth roots and underlying bone which reduces the depth of the gum pockets.  Reducing pocket depths makes it harder for bacteria to collect and grow..

Drugs Used to Treat Gum Disease

  •       Various antibiotic and antimicrobial agents can be used to reduce or temporarily eliminate the bacteria associated with gum disease.  Some of these agents can also suppress the destruction of the bone’s attachment to the tooth. Antibiotics or antimicrobials can be used in combination with non-surgical, surgical and other therapies.
  •       Chlorhexidine Gluconate is an antimicrobial used to control plaque in the mouth or within periodontal pockets. The medication can be used as a mouth rinse or found in a gelatin-filled chip that slowly releases the Chlorhexidine within the pockets after root planing. Antibiotics used in low dosages, including doxycycline and minocycline, are also be used to treat gum disease.

  Lasers Used to Treat Gum Disease

What is a laser?

  •       A laser is an instrument that emits light by stimulating emissions of electromagnetic radiation through the process of optical amplification.  The word LASER is actually an acronym for Light Amplification by Stimulated Emissions of Radiation.  Today, lasers are used across a broad spectrum of industries and are commonplace in both medicine and dentistry.  Certain types of lasers are now used to treat gum disease around teeth as well as around dental implants.

How are lasers used for periodontal disease treatment?

  •       Only certain laser devices have been approved for the treatment of periodontitis.  None of these devices however has been approved as stand-alone therapy.  Laser therapy is used as an adjunct to classical treatment procedures such as scaling and root planing (deep cleaning).  The laser is carefully applied below the gum line usually under a local anesthetic.  The energy emitted from the laser is selectively absorbed and reflected by the various structures beneath the gum including the bacteria.  The use of the laser in conjunction with classical treatment leads to improved gum health. 

How effective is laser treatment?

  •       Laser periodontal treatment appears very promising but additional long term studies are needed.

From the American Academy of Periodontology https://www.perio.org/consumer/gum-disease-laser-therapy

Lasers can be used to treat periodontal disease. Current controlled studies have shown that similar results have been found with the laser compared to specific other treatment options, including scaling and root planing alone. Scaling and root planing is a traditional non-surgical therapy used to treat periodontal diseases.

CAN THE USE OF LASERS IN PERIODONTAL THERAPY HARM PATIENTS?

Yes and no. Each laser has different wavelengths and power levels that can be used safely during different periodontal procedures. However, damage to periodontal tissues can result if a laser with an inappropriate wavelength and/or power level is used during a periodontal procedure.

DOES THE RESEARCH ON LASERS SUPPORT THEIR USE IN PERIODONTICS AT THIS TIME?

At this time, there is insufficient evidence to suggest that any specific laser wavelength is superior to the traditional treatment methods of the common periodontal diseases, such as periodontitis.

CAN I TRUST THE CLAIMS IN AN AD FOR PERIODONTAL THERAPY PERFORMED WITH A LASER?

It is important to beware of advertising that sounds too good to be true because it very well may be. A dental professional can help you separate fact from hype.