Treatment for gum disease depends on the degree of severity. The earliest stage, gingivitis, has infection in the gum tissue but the disease process has not spread down into the bone. More advanced stages, such as periodontitis, where bone damage has occurred, require different treatment. And gum recession, where gum tissue is lost, exposing tooth roots, also requires different treatment.
Gum disease, whether it is the early stage of gingivitis or a more advanced stage of periodontitis, cannot be cured in the same way a disease like pneumonia can be cured. Pneumonia, once successfully treated, eliminates the presence of the bacteria that caused the disease. It is very likely that a person who is successfully treated for pneumonia will never get it again. They don’t need to do anything special once the disease is gone, and the bacteria probably won’t come back.
Gum disease is very different. The bacteria that cause gum disease cannot be eliminated permanently. They are likely to remain in a person’s mouth forever, waiting for their next chance to penetrate the patient’s defense systems.
In any stage of gum disease, from earliest to most advanced, the first step is to control the bacteria in your mouth. Unfortunately, you cannot take an antibiotic to kill the germs permanently. Even when the dentist prescribes a course of antibiotics for an acute gum abscess, we know that the germs will start to return within a few weeks. Therefore, the starting point for all patients, and we know you hate it when we tell you, is brushing and flossing to remove the germs from in-between the teeth and along and under the gum line.
The bacteria that cause gum disease will always be in your mouth. But it is only when they form clumps between the teeth and under the gum line that gum disease occurs. The same bacteria that cause gum disease cannot cause a problem on your lips and tongue because they don’t build up undisturbed. Also, the tissue is thicker and stronger on the outside of your gums than the thin delicate tissue under the gum line.
Brushing and flossing is usually sufficient for patients whose gums are healthy or who have the earliest stages of gum disease, as long as they are effective in removing the plaque. However, some patients just aren’t as effective with brushing and flossing. Also, patients with more advanced gum disease or gum recession might need some extra help with controlling the germs in the plaque in their mouth. Also, some patients have orthodontic braces or fixed bridgework that make effective flossing harder to do. These patients can benefit from a Rotadent toothbrush, an end-tufted brush, a proxi brush, super floss, floss threaders, or a Hydrofloss dental irrigator.
Your job is to use the devices recommended by your dentist or hygienist to control the plaque on a daily basis at home. Second, you must come for dental cleanings and inspection visits every three months so the dentist and hygienist can remove any plaque you might miss and monitor your progress. Remember, gum disease cannot be cured. It can only be controlled.
As you have learned, some people have lower resistance to gum disease. Some people’s mouths provide a friendlier environment to the germs that cause gum disease.
Anyone who has had gum disease is never cured. We refer to them as a “healed perio patient”. That means that, although they do not have active gum disease in their mouths right now, we recognize their heightened susceptibility and their need for meticulous home care coupled with regular and consistent professional supervision.
We might add here that not all dentists have the training to provide these services and not all dental offices have the equipment and personnel to do this.
Now, let’s look at the procedure the dental office must provide in order to treat active gum disease.
In the case of earlier gum disease, such as gingivitis or early periodontitis, the first course of action by the dentist or hygienist is Scaling and Root Planing, abbreviated as SRP. The objective of SRP is to eliminate bacterial plaque and calculus (tartar) build-up deep under the gum line, where home care and even regular cleanings won’t reach. In addition, it is designed to eliminate the infection and gum pockets so the gums can heal.
If the gum disease is too advanced for SRP to completely heal the pockets, then a surgical procedure to remove infected gum tissue or to recontour the gum line may be needed.
In addition, more advanced procedures such as bone grafting may be needed to manage the bone loss of advanced gum disease.
And lastly, there are procedures to graft receded gum tissue as well. Sometimes they are done in conjunction with bone grafting and sometimes they are done separately.
Please note that we cannot guarantee that the solutions offered here are definitely applicable to your condition since we have not examined your mouth. However, if you know the solutions that are generally applied to dental problems, you will be much better informed and will likely make better decisions in your own dental health care.