Scaling and root planing is the most common and non-surgical form of treatment for periodontal disease. This procedure is more intensive than a routine general dental cleaning, which traditionally occurs every six months.
It is a careful cleaning of the root surfaces to remove plaque and calculus [tartar] from deep periodontal pockets and to smooth the tooth root to remove bacterial toxins. Commonly, a local anaesthetic is required for this procedure.
Sometimes, scaling and root planing can be completed in one visit. This usually is possible if you have gingivitis, the earliest stage of gum disease. However, if you have periodontitis, multiple visits are usually needed.
However, it is important to remember that some patients may not respond optimally to scaling and root planing. Non-surgical treatment may be less effective in deeper pockets where there is limited access for cleaning instruments to reach. Periodontal surgery is often required to clean pockets that are too deep to be cleaned with non-surgical treatment.
Periodontal flap surgery is a simple procedure under local anaesthetic. It is usually done in an outpatient setting. After anaesthetic has taken effect, a small cut is made in the gum line near the tooth root. During this procedure, your periodontist will fold back the gum tissue and remove the disease-causing bacteria before securing the tissue back into place. If the underlying bone has been damaged, the irregular surface will be smoothed out to limit areas where disease-causing bacteria can hide. This will also allow your gum tissue to reattach to healthy bone more effectively.
When a tooth is broken or decay extends below the gum line, this area must be uncovered before it can be restored. Crown lengthening surgery is a surgical procedure performed on a healthy periodontium that requires exposure of adequate tooth structure for restorative purposes, so the amount of tooth exposed supra-gingivally is increased.
Crown lengthening may also be a procedure used for smile line correction. In this case, crown lengthening is performed to reshape the gum line to improve the aesthetics of your smile by exposing more of your natural tooth surface.
Crown lengthening is normally performed under local anaesthetic. The amount of time this procedure takes will largely depend in how many teeth are involved and whether a small amount of bone needs to be removed, in addition to the soft tissue. During this procedure excess gum and bone tissue are reshaped to expose more of your natural teeth. The surgical site will be completely healed in approximately six to eight weeks time.
Today, periodontists are often able to restore or regenerate lost bone and attachment around teeth as a result of long-standing periodontal disease. Not all bone lost with periodontal disease can be restored with bone regeneration, but there may be isolated defects around individual teeth where this treatment can provide additional support to the tooth and improve health, function, and appearance of the area. Periodontal regeneration surgery refers to minimally invasive surgical procedures that aim to regenerate lost periodontal structures (bone, periodontal ligament, and connective tissue attachment) that support our teeth.
Under normal circumstance, most patient will not require any further active treatment after non surgical and/or surgical periodontal treatment. However, the majority of patients will require ongoing periodontal maintenance therapy to maintain their optimal periodontal health.
Periodontal maintenance is an detailed dental cleaning procedure that specifically targets plaque, bacteria and tartar build-up along the surfaces of teeth ensure periodontal health. Maintenance is an important dental treatment for halting the progression of periodontal disease and it should be scheduled at a regular interval in order to successfully managing and treating periodontal disease.
Normally periodontal maintenance is recommended every 3 to 4 months, as research indicates that bacterial formation on teeth and gum occurs almost immediately after the cleaning, and bad bacteria forming after 3 months. Frequent removal of the bacteria from under the gum line can control the inflammation and can often prevent the further breakdown of the bone and gum supporting your teeth. The interval varies according to the severity of a patient’s periodontal condition, and their ability to perform appropriate oral hygiene to manage disease.
Please click here for the pdf of Post-op Instruction for Periodontal Flap Surgery.