Treatment of Gum Diseases

Our Clinic offers surgical and non-surgical treatment of gum diseases. Depending on the nature and extent of the periodontal disease Doctors at braces n gum care clinic will recommend the proper course of therapy that would produce the optimum results.

Scaling and Root Planning

Scaling refers to the professional removal of soft plaque and hard calculus (tartar) deposits from the teeth and around the gum line. It is undertaken using hand instruments (scalers or curettes) and/or sonic/ultrasonic instruments which use high frequency vibrations to help remove these deposits from the tooth surface.

Root planing is really an extension of scaling which involves getting down further under the gum line to remove plaque and calculus from the tooth root surface. This is usually undertaken while the gum tissues are numb with dental anesthetic so that the treatment can be performed painlessly. Scaling and root planing aim to provide a clean smooth tooth and root surface in order that the gum tissue/ attachment has a chance to heal around the tooth. Both scaling and root planing are non-surgical treatments. Scaling and root planing may sometimes be combined with antibiotic treatment to assist in the management of the gum infection.

Flap surgery

When periodontitis cannot be cured with the use of antibiotics and other procedures such as root planing and scaling, then periodontal flap surgery is the only technique left to deal with the problem. By periodontal flap surgery, the periodontist effectively cleans the roots of a tooth, and the damage caused to the bone due to periodontitis can also be treated at this time.

Local anesthesia is required for periodontal flap surgery. With this surgery, the periodontist will incise the gum, where required, and pull it back. The roots of the tooth can then be easily cleaned and if the bone is damaged, it can be repaired as well. After the cleaning and repairing is done, the gum is sutured back into place. Appropriate gauze and dressing is applied to stop the bleeding and to let the healing start. Picture 1 shows the upper front teeth with a gum “flap” raised. The flap is pink and recognizable on the upper right part of the picture. The dark material on the middle tooth root is bacterial plaque and calculus which is the primary cause of periodontal disease. Bone can be seen surrounding most of the adjacent tooth roots with obvious bone loss around the middle tooth because of the plaque and calculus. Picture 2 is taken after removal of Plaque & calculus . Picture 3 is taken after sutures (stitches) placement.

Besides cleaning the roots of the tooth, a damaged bone can also be repaired with the periodontal flap surgery. This repairing includes:

• Reshaping and smoothing of the bone. This is done to prevent the development of plaque
• Bone grafting: the bone can be repaired or regenerated through the placement of bone filler materials, or bone grafts.
• GTR: Sometimes, the defects can be repaired and the bone regenerated through a process referred to “guided tissue regeneration” which involves the placement of a sheet of material, referred to as a “membrane” around the bony defect allowing the defect to naturally fill in with bone and tooth ligament instead of gum tissue collapsing into the defect and filling in the defect with soft tissue. Some of these membranes are bio-absorbable and dissolve on their own and some require removal.

The healing process takes a few days. Even after the surgery, good care and maintenance is required for the teeth and gums so that the treatment is successful and the effects of periodontitis fade away. Periodontal flap surgery effectively prevents the further growth of periodontitis. With the surgery, the gums of the patient become healthier and pink as they should be.

Only a qualified periodontist has the specialist surgical skills to recommend and provide the periodontal surgery required for your specific circumstances.

Bone Grafting

This surgical procedure replaces bone that has been lost around the teeth as a result of advancing gum disease. Various types of bone grafting materials are used including synthetically derived bone, the patient’s own bone, or non-human freeze-dried bone.

Guided Tissue Regeneration

Often a “membrane” or “barrier” is used to help contain the graft within the prepared bone site and help the graft to heal properly.