Gum treatment
Periodontal Treatment
Treating gum disease before it costs you teeth. Deep cleaning, scaling and root planing, and a plan for keeping it from coming back.
What gum disease is
Plaque that is not removed hardens into calculus, which cannot be brushed off. The bacteria in and around it provoke an inflammatory response in the gum. In the early stage, gingivitis, the gums are red, swollen and bleed when brushed, and the condition is fully reversible with cleaning. If it continues, the inflammation reaches the bone holding the teeth, and that bone is lost. This stage is periodontitis, and the bone does not grow back on its own.
The reason it is dangerous is that it is quiet. Bone loss does not hurt. Many people first notice when a tooth becomes loose or a gap opens between teeth, by which point a significant amount of support is already gone. Bleeding when you brush is the most useful early sign, and it is the one most commonly dismissed as brushing too hard.
At the appointment
Assessment involves measuring the depth of the pocket between gum and tooth at several points around every tooth, checking for bleeding and looseness, and taking X rays to see the bone level. Those numbers are the baseline that later visits are compared against.
Scaling and root planing is a deeper clean than a routine one. Deposit is removed from the tooth surface both above and below the gum line, and the root surface is smoothed so that the gum can reattach to it. It is normally done under local anaesthetic, often one half or one quarter of the mouth at a time so you are not numb everywhere at once.
Visits, Recovery and When to Call
Visits and timing
A routine cleaning is one appointment. Scaling and root planing is commonly split across two or more visits by area, followed by a review appointment several weeks later to re measure the pockets and see what has actually improved.
Afterwards
Gums are tender for a few days and may bleed a little when brushing. Teeth can be sensitive to cold for a couple of weeks as cleaned root surfaces are exposed. Keep brushing the area gently rather than avoiding it, because avoiding it is what allows the deposit back.
Call sooner if
Bleeding continues beyond a week, a gum becomes swollen and painful in one spot, which can mean an abscess, or a tooth becomes noticeably looser. Also call if pockets were being monitored and you have skipped the review appointment.
Keeping it from coming back
Periodontal disease is managed rather than cured. Once bone has been lost, the aim is to stop further loss, which means daily cleaning between the teeth as well as brushing, and a maintenance interval shorter than the usual six months. Smoking makes the disease worse and masks the bleeding that would otherwise warn you, and uncontrolled diabetes has a similar effect.
Keep reading
Questions About Periodontal Treatment?
Describe the problem on the phone. That conversation is usually enough to work out the first appointment. Mandarin, Taiwanese, English and Japanese are spoken.