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Once a diagnosis has been made and a treatment plan formulated between the patient, their dentist, and the periodontist, the actual periodontal treatment is often performed in two phases, although a 3rd phase (surgery) is sometimes required.

Phase 1 - initial preparation & scalings

The first phase is the initial preparation. All patients need to complete this initial phase. This is when the patient learns which tools to use, and how to properly brush their teeth and clean in between their teeth.

In addition, during these visits, the dental hygienist/dentist/periodontist performs multiple scalings (cleanings) of the teeth, attempting to remove all the plaque and tartar (calculus) stuck to the teeth. Often, changes can be seen right away. Bleeding reduces and the pockets get smaller.

Phase 2 - re-evaluation & possible further scalings

The second phase of periodontal treatment consists of re-evaluating the pocket depths and seeing if gums still bleed after the initial scalings. The more the patient exercises effective oral hygiene techniques, the more they can improve their condition.

There are times when additional scalings help attain the goal of smaller pockets. However, if the pockets are still too deep at the time of re-evaluation, patients need more treatment before returning to periodontal health.

Phase 3 - gum surgery

Surgery is indicated when non-surgical methods are not enough to stop the disease process. Periodontal surgery helps save teeth. When the pockets are so deep that scalings will not effectively clean them out, the dentist or periodontist gently separates and peels back the gums from the underlying structures.

Tartar and plaque can then be scraped off the roots, much the same way splinters need to be removed when they are stuck under the skin. However, periodontal surgery accomplishes more than just scraping off tartar and plaque.

We know that bacteria impart chemicals, called endotoxins, onto the root surface. These endotoxins must be removed if gums are to reattach to the roots, in the quest of making pockets smaller. Without removing the endotoxins, periodontal treatment is hampered.

One way to remove endotoxin is to leech it out of the roots with mild acids…citric acid and tetracycline being two that are often used. Surgical access is essential to accomplish this. The other way to get the endotoxins off the roots is to scrape them off with careful scaling. Both are effective techniques performed during periodontal surgery.

Surgical treatment results in cleaner roots, shallower pockets, and healthier gums. The patient and dental professional who treats them, can effectively maintain their periodontal health in this new and improved environment.

Guided tissue regeneration (GTR) involves the use of a biocompatible membrane material, often in combination with a bone graft, which promotes the growth of lost tissue and bone around your tooth. Not every case is suitable for grafting.

Contact us today to request additional information or to make an appointment with our gum treatment specialist (periodontist).

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Share a Smile specialist dental centre is based in Romford, Essex and offers high quality dentistry in a friendly caring environment to both the general public and patients referred by their dentists. Our dental specialists are experienced dentists who have undergone up to four years of additional post-graduate education to become experts in specific areas of dentistry including gum disease (periodontitis) which is a serious infection affecting the tissues surrounding the teeth and the provision of cosmetic gum surgery.