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TREATMENT OF PERIODONTAL (GUM) DISEASE

Gum (or periodontal) disease is caused by bacteria that attach to the teeth next to the gums. The gums become inflamed. This begins a process that can destroy the soft tissue and bone supporting the teeth. Almost half of U.S. adults have some gum disease and about one in ten adults have severe periodontitis.

If left untreated, gum disease can lead to tooth loss. Depending on the stage of gum disease, treatment ranges from a thorough cleaning to surgery.

You and your dental care team can stop gum disease from getting worse. These efforts can prevent further tissue damage. The main goals of periodontal treatment are to:

  • Destroy the bacteria that cause gum disease
  • Control inflammation to protect the gums and jawbones that hold teeth in place
  • Create and maintain a healthy environment in the mouth

TREATMENT OF GINGIVITIS

The earliest stage of gum disease is gingivitis. Your gums may be red or puffy. They may bleed when you brush or floss.

At this stage, gum disease often can be reversed. If not, treatment at least will usually stop it from getting worse. This prevents major damage to soft tissue or bone.

Treatment of gingivitis includes:

  • Cleanings in a dental office
  • Brushing and flossing at home

Your dentist also may prescribe an antiseptic rinse such as chlorhexidine to control the growth of bacteria.

TREATMENT OF EARLY PERIODONTITIS

Some people develop a more advanced stage of gum disease. This is known as periodontitis. "Pockets" develop between the gums and the teeth. At this point, the disease can begin to destroy the tissue that anchors the teeth in the jawbones.

Periodontitis usually requires more aggressive treatment than gingivitis. Your dentist probably will refer you to a periodontist (a gum specialist). Any damage caused by periodontitis can't be reversed. But treatment and good home care can bring the disease under control.

The first step is scaling and root planing. This is a deep cleaning technique. Scaling removes plaque and tartar from under the gum line. Root planing smooths any bumps or rough areas on the tooth roots. This helps to prevent plaque build-up on the roots.

Some people may need another type of cleaning before scaling and root planing. This is called debridement. It is used to remove a heavy build-up of plaque and tartar. Chlorhexidine rinses have also been found to be helpful in reducing periodontal pockets in combination with scaling and root planing.

TREATMENT OF MODERATE OR ADVANCED PERIODONTITIS

Pockets around teeth grow deeper. Teeth may become loose. More intense treatment is needed to bring the disease under control and prevent more damage.

Treatment at these stages of periodontitis may include:

  • Antibiotic gels or powders applied to the periodontal pockets in affected areas of the mouth
  • Laser treatments to kill bacteria in the pockets around teeth
  • Surgery to the gums, bone or both, to remove inflamed tissue, repair damage, protect roots and prevent tooth loss
  • Extraction of teeth that can't be saved

MAINTENANCE TREATMENT

Periodontal disease is a chronic (long-lasting) problem. Once under control, it can come back. The main aim of maintenance care is to reduce the chance that this will happen.

Maintenance usually includes two to four dental visits a year.

You'll need the most visits if you:

  • Have severe gum disease
  • Have disease that tends to come back
  • Are a smoker
  • Have poor brushing and flossing habits
  • Take certain medicines
  • Have certain diseases

If your disease does return, it is likely to be less severe if you have received regular care.

At home, pay careful attention to brushing and flossing.

 

Last updated May 7, 2021

 

References:

  • https://www.cdc.gov/oralhealth/fast-facts/gum-disease/index.html (Accessed 05-07-21)
  • da Costa LFNP, Amaral CDSF, Barbirato DDS, Leão ATT, Fogacci MF. Chlorhexidine mouthwash as an adjunct to mechanical therapy in chronic periodontitis: A meta-analysis. J Am Dent Assoc. 2017 May;148(5):308-318. doi: 10.1016/j.adaj.2017.01.021. Epub 2017 Mar 9. PMID: 28284417.