Periodontal Disease

Periodontal disease is a chronic problem, like diabetes, high blood pressure, and cold sores. We understand how to keep these conditions under control but most people have flair ups. After Dr. Nicholson has completed active treatment, and your periodontal disease is stable, keeping true to your recommended cleaning interval is the best way to stay in control. Careful professional monitoring will help you treat flair ups early on before they become a serious problem.


Daily brushing and flossing will keep dental plaque & calculus to a minimum, but a professional cleaning will remove plaque, calculus and flush out bacteria in places your toothbrush and floss have missed. Studies show that toxic bacteria can grow and cause problems for people with periodontal disease in as little as 3-months. Therefore, a professional cleaning is an important part of your support program. Keep periodontal disease under control, prevent gum disease, and protect your teeth for your lifetime. Make sure to stay current with your recommended cleaning schedule and ask us if you have any questions about the importance of professional cleaning.


Basic Periodontal Treatment

Periodontal disease is an infection that gets under the gums and causes inflammation. It then starts dissolving the jawbone which supports your teeth. Periodontal inflammation leads to tooth loss and contributes to other medical conditions. This infection must be removed and the area given a chance to heal.
There are generally two accepted treatments for this condition depending on the severity of your infection:

Sub-gingival Scaling and Root Planing

Sub-gingival scaling and root planing is a non-surgical procedure in which the therapist removes calculus (tartar) on the roots of the teeth below the gum line  that causes periodontal infection. Scaling and planing effectively remove upper level periodontal infections where the pockets around your gums are not too deep. Tooth root surfaces below the gum line are cleaned of calculus (tartar) and smoothed with specially designed instruments. This removes the calculus (tartar) and bacteria under the gums, smooths the tooth roots, and makes it more difficult for bacteria to grow under the gums in the future.
Sub-gingival scaling and root planing is usually done an area of the mouth at a time using local anesthesia (novocaine) and are quite different from the routine dental cleaning.
If pockets are small, sub-gingival scaling and root planning may be the only treatment required. If pockets are deep, sub-gingival scaling and root planning may be an initial procedure done to remove some calculus (tartar) and reduce the periodontal infection temporarily in order to provide healthier gum tissue to allow pocket reduction surgery (described below) to be done.

Pocket Depth Reduction

If the pockets around your teeth are too deep to thoroughly clean with scaling and root planing, then a minor surgical procedure must be performed to pull back the gums and remove the lower levels of infection. Your periodontist pulls back the gum tissue and removes the disease-causing bacteria before securing the tissue into place.
In some cases, irregular surfaces of the damaged tooth root are smoothed to limit areas where disease-causing bacteria can grow. This allows the gum tissue to better reattach to healthy tooth roots, and it can help reduce the depth of the pockets around your teeth.
With today's newer techniques (e.g. bone regeneration ) it may be possible to "grow" some bone back in certain instances where it has been lost due to periodontal disease. Dr. Nicholson has special training in these techniques and will be happy to explain all your options for treatment.

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