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Like any successful treatment for a disease, the gum treatment is based on elimination of causes. As
previously discussed, the main cause for periodontal disease is bacteria.
You have to remember that the success of periodontal treatment depends not only on a doctor, but on you as well.
With out proper oral hygiene at home any professional treatment
of gum disease will be a failure.
So the first step in treatment of gum disease is your customized oral hygiene
instructions and their follow through.
No matter how thorough you are with
your brushing, there is still some plague and tartar that will build on you teeth. Our goal is to remove all the plague
and tartar, and to minimize the pockets(remember that they are the trap for food remnants
and bacteria). This is done with Scaling and Root Planing.
Scaling and Root Planing is
done to remove tartar and hard crusty calculus (Tartar) that is loaded with bacteria, around and BELOW
the gum line. (A professional polishing or prophylaxis removes only the soft sticky plaque that is above the gum line and
performed on a healthy dentition).
Scaling
Scaling is procedure that meticulously
removes contamination toxins, micro-organisms, plaque, and tartar that is rough and is below and under the gum line down
to the bottom of the pocket.
Root Planing
Root planing involves smoothing the root surfaces of your
teeth with thin curettes so gum tissue can more firmly reattach to roots that are clean and smooth to prevent tooth loss
and sensitivity problems.
Post scaling and root planing instructions
This procedure involves manipulation
deep under the gum, thus the patient may be numbed for comfort if necessary. Full mouth Scaling and Root Planing may take
few appointments, depending on the extent of disease.
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| Before Scaling and Roott Planning |
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| After the procedure was done |
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After this treatment is completed, a perio-maintenance appointment
will be necessary in a few weeks. At this visit the pocket depths are re-evaluated and additional cleaning may be performed.
Depending on the depth of the perio-pockets, you will be advised if any further treatment is necessary and frequency of you
maintenance appointments.
Depending on stage of gum disease and your personal response
to the treatment, Scaling and Root Planing, along with the good home oral hygiene, may be the only active treatment you will
require.
Evaluation of your perio status may reveal
areas of your mouth where Scaling and Root Planing alone is not sufficient. We
believe that a conservative approach is the best route, thus there are several medicaments available on the
market that can treat pocket depth locally (targeted to a specific site) in conjunction with Scaling and Root Planing and
in most cases avert future periodontal surgery.
With out proper oral hygeine at home any professional
treatment of gum disease will be a failure.
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Periodontal Medications
There are few medicaments available for localazed delivery of medicine
in the pockets. The principal is the local delivery of anti-microbal substanse directly into gum pocket, where it fights the
bacteria and inflammation. One thing: this drugs do not work alone, they will work good in conjuction with root planing
and scaling and good oral hygeine, but it is not the substituton for any of the above.
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Arestin (Minocycline HCI)
- uses microsphere technology to deliver the antiobiotic
directly to the infected araes in your gums
-the microspheres the gradully release the antibiotic over time,
allowing it to work over the course of 14 days
- throughout that time , Arestin helps Scalling and Root Planing
fight the infection, allowing your gums to heal
Illustrations and description of product is a courtesy of OraPharma,
INC
Atridox
Atridox (Doxicyline hyclate 10%) is an
antibiotic gel that is used to treat chronic adult periodontitis. ATRIDOX is applied with a syringe into the infected tooth
pocket by dental professional.It contains antibiotic which is mixed in a gel. After it applied into the infected pocket it
hardens upon contact with oral fluids to a wax-like substance. The antibiotic is slowly released from the
hardened gel into the surrounding infected pocket for 7 days.
This information provided by Collagenex Pharmaceuticals
Periostat
As we discussed before the high levels of bacteria initiate the
release of tissue-destroying enzymes. These enzymes start the destructive process which results in deeper
pockets and bone loss. Even after Scaling and root planing removed most of the bacteria, your body may still release
these tissue-destroying enzymes and continue the cycle of periodontitis. Periostat is the medication which will reduce the
production of these enzymes by your body.
Periodontal Surgery
Sometimes if periodontal disease reaches advanced stages, conservative
treatment may be not enough to stop it. Periodontal surgery may be considered in those cases. There are few
different surgical procedures, which may be performed in order to treat the periodontitis. They all simular in the techniques
and purpose served. The incision is done and gingival flap is opened, allowing doctor direct access to the
bone structure, supporting the tooth. Thorough cleaning of the area is then performed and all granulated(inflamed)
tissue is removed. Then depending on the particular situation bone reshaping may be done, in some
cases bone grafts are used to fill in bony deffects. Excess of the gum tissue is then removed, flap placed
back and sutured in place.
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