Periodontal Treatment

Our practice provides a variety of surgical services. We pride ourselves on the fact that we are very conservative in our treatment recommendations and limit surgery to the areas where it is absolutely necessary.

Many times, the early stages of periodontal disease are best treated with non-surgical periodontal therapy. Even in severe cases, non-surgical periodontal therapy often precedes surgical therapy. This is done to improve the overall tissue quality prior to surgery and also to help limit the areas requiring surgery.

Scaling and Root Planing

The initial stage of treatment is usually a thorough cleaning that may include scaling to remove plaque and tartar deposits beneath the gum line.

The tooth roots may also be planed to smooth the root surface allowing the gum tissue to heal and reattach to the tooth. This deep cleaning is completed with the use of a local anesthetic in the affected areas.  In some cases, the occlusion (bite) may require adjustment.  Instructions Following Scaling and Root Planing are available online.

Antibiotics or irrigation with an anti-microbial rinse (chemical agents or mouth rinses) may be recommended to help control the growth of bacteria that create toxins and cause periodontitis.

When deep pockets between teeth and gums are present, it is difficult for our hygienist to thoroughly remove plaque and tartar. Patients can seldom, if ever, keep these pockets clean and free of plaque. Consequently, surgery may be needed to restore periodontal health.

Osseous Surgery

In a healthy mouth, the boney tooth sockets cup and support the teeth.  Patients with periodontitis develop defects (holes) in the bone around their teeth.  This is associated with the formation of periodontal pockets and loosening of the teeth.  Osseous defects can be treated either by reshaping the existing bone (osseous surgery) or regeneration the lost bone (regenerative surgery).  The decision to use one procedure or the other is based on the distribution of the bony defects.  Osseous surgery is commonly used to treat bone loss around multiple teeth while regenerative surgery is done when the defect(s) is localized to a single tooth.

Osseous surgery usually takes from thirty to sixty minutes depending upon the areas needing treatment. Following the application of a local anesthetic, we separate the gums from your teeth in the affected areas.  We will then thoroughly clean teeth roots and reshape the adjacent bone to help the gum tissue to reattach during healing.  The gums are then placed back over the remaining bone and sutured in place.  Over the counter pain medication following this care is usually sufficient for most patients.

Regenerative Surgery

The goal of regenerative surgery is to coax the body into rebuilding the structures that attach a tooth to the jaw, including bone.  Again, this procedure can take as little as thirty minutes and includes the use of a local anesthetic.  We surgically separate the gums from the affected tooth and thoroughly cleans the pocket out.  However, rather than taking bone away as in osseous surgery, the holes in the bone are filled in with a graft material and then covered with a physical barrier.  The gums are then repositioned over the treated site and sutured in place with sutures.  Over the course of six to nine months, your body fills in the periodontal defect with new hard and soft tissue, effective reattaching the tooth to your jaw.

Pre-Operative Information and Post-Operative Information Following Osseous Surgery information is available online.