Topical gel will be applied to the gum with a q-tip to temporarily numb the gum tissue. The hygienist will use a combination of ultrasonic and hand scaling to remove the calcified tarter under the gums. Then she/he will use a little round ruler to measure the pocket. This is called periodontal charting. Measurements of 3 or less indicate no further treatment other than gingivitis therapy. Above 3 may indicate that the infection has moved into the bone and additional treatment may be required. Then the hygienist will comfortably use an antiseptic agent down in the pocket to kill all remaining bacteria, this is called antimicrobial irrigation. We will follow the antiseptic treatment with a home medication called Chlorhexidine to maintain control over the bacteria that causes infection. The Sonicare is a professional home care instrument that removes plaque, stimulates the gum, and encourages the gum tissue to grow tightly around the tooth to close the pocket. We recommend using Sonicare daily as your toothbrush.
Second Appointment (Prophylaxis) or (Re-evaluation)
A second visit will include the dental prophylaxis, which is an above the gum line cleaning and polishing of the teeth. We will re-evaluate the healing of the gum by measuring the pockets. Measurements are taken once again with the little round ruler called a periodontal probe. If the measurements are 3 mm or less with no bleeding or inflammation of the gums then health has been achieved. Measurements above 3-4 mm may indicate that the infection has moved into the bone and additional treatment may be required. The hygienist will re-evaluate your home care technique including the use of the Sonicare. Please bring it with you. More frequent cleanings may be recommended after this treatment to control bacteria that may continue to cause periodic gingivitis.
Root Planning and Scaling/STM 2
First Appointment/Gross Debridement - See Gingivitis Therapy Step 1
Second and Third Appointments – Root Planning
Pockets 4mm and above require SRP.
This procedure is essential in keeping your teeth for a lifetime if periodontal disease is diagnosed. Root planning and scaling removes calculus, which is embedded into the root structure of the teeth. These deposits have accumulated over a long period of time and are well below the gum line. This treatment requires local anesthetic and is done on a per quadrant basis. May require placement of an antibiotic in pockets 5 mm or greater.
WHY WE DO THIS…
Calculus (tartar) left to accumulate below the gum line will cause periodontal disease (pyorrhea) and the eventual loss of teeth. The inflamed gum tissue creates a "pocket" where more calculus accumulates. Root planning and scaling is the first and most important step in the treatment of periodontal disease. Many times this procedure, along with a regimen of improved Home Care, will control the progress of the disease. Professional cleanings and check-ups are necessary to monitor the condition of the gums.
THIS APPOINTMENT INCLUDES:
• LOCAL ANESTHETIC
• ROOT PLANNING AND SCALING PER QUADRANT
• MEDICINAL IRRIGATION OF THE QUADRANTS TREATED
• WITH PRESCRIPTION ANTISEPTIC
• PERIODONTAL POCKET DEPTHS ASSESSED
• HOME CARE/INSTRUCTIONS/PLAQUE CONTROL
WHAT HAPPENS IF THIS IS NOT DONE?
The periodontal pockets will continue to deepen and the accumulation of the calculus will increase. The bone supporting the teeth will recede from the calculus further deepening the pocket. This cycle will continue until the teeth become loose and are lost.
Fourth Appointment | Perio Maintenance
Keeping Your Gums Healthy
Now that you have completed the active phase of periodontal treatment, your periodontal disease is under control. The next step is maintenance therapy, a personalized program of care to keep your gums healthy.
The watchword of maintenance therapy is prevention. Its goal is to protect your periodontal health. Through proper home care and maintenance therapy visits, you have an excellent chance of keeping your teeth for a lifetime.
What is maintenance therapy?
Maintenance therapy is an ongoing program designed to prevent disease in the gum tissues and bone supporting the teeth. The building blocks of this program are simple: conscientious care of your mouth at home and regular maintenance visits with your hygienist.
Why is maintenance therapy important?
As you have learned, you are susceptible to gum disease. The main cause of gum disease is bacterial plaque, a sticky, colorless film that constantly forms on your teeth. Toxins (or poisons) produced by the bacteria in plaque constantly attack your gums and teeth. If the plaque is not removed, it hardens into a rough porous deposit called calculus, or tartar.
Daily oral hygiene including brushing and flossing will keep the formation of calculus to a minimum, but it won’t completely prevent it. No matter how careful you are in cleaning your teeth and gums, bacterial plaque can cause a recurrence of gum disease from 2-4 months after your last professional cleaning.
To keep your teeth and gums healthy, a dental professional must check for potential hidden problems and remove the hardened plaque at a time interval appropriate for you.
Who should perform maintenance care?
The answer depends upon the patient and the severity of the disease prior to treatment. Generally, the more severe your initial problem, the more the professional needs to oversee your care.
What is included in a maintenance visit?
Your maintenance visit may include:
• Discussing any changes in your health history
• Examining your mouth tissues for abnormal changes
• Measuring the depth of pockets around the teeth
• Assessing your oral hygiene habits and providing instruction
• Cleaning your teeth to remove bacterial plaque and calculus
• Taking necessary x-rays to evaluate the teeth and the bone supporting the teeth
• Examining your teeth for decay and other dental problems
• Checking the way your teeth fit together when you bite
• Applying or prescribing medications to reduce tooth sensitivity or other problems
How often should I have maintenance visits?
This decision is based upon your periodontal condition. The interval between maintenance visits varies between patients from every few weeks to every few months.
Everyone’s situation is different. The frequency of maintenance visits will be influenced by:
• Different types of periodontal disease
• Different types of periodontal treatment
• Different patient response to treatment
• Different rates of plaque growth
Last, but not least, the frequency of your maintenance appointments are not meant to take the place of regular dental check-ups. For example, the overall dental health, including such dental needs as new or recurrent cavities or changes in fillings, crowns or bridges and the early detection of periodontal disease.
Are maintenance visits worth the cost?
Without question! Maintenance visits help protect your periodontal health and prevent future dental problems. By treating disease in the early stages, you save dollars-and discomfort-in the long run. Simply put, a maintenance visit is a wise investment in your dental health.
If you have dental insurance, it may pay for just one dental examination every six months. Because you are susceptible to periodontal disease, you may need to be seen more often. So, you may need to cover the cost personally for some of your maintenance visits.
Periodontal disease is the major cause of tooth loss in adults, affecting three out of four people at some point in life. The best way to prevent periodontal disease and keep your teeth for a lifetime, is to carefully follow the guidelines of your therapy program.
Protecting your periodontal health brings many benefits. You can chew with more comfort. You can smile and speak with greater confidence. You can keep dental costs down by preventing future problems.
A commitment to maintenance therapy is a commitment to better health.