Periodontal Treatment

Periodontal treatment addresses gum disease, the inflammation that follows when plaque and tartar are left against the gum. It starts as gingivitis: the gum is red and swollen and bleeds when brushed, but its attachment to the tooth is intact. Where it continues it becomes periodontitis, in which that attachment and the bone beneath it are lost, and the tooth gradually loses its support.

When periodontal treatment is needed

Gums that bleed on brushing are the first sign, and the one most often passed over. Later come persistent bad breath, gums that pull back so the teeth look longer, tenderness or discharge at the gum margin, and teeth that feel loose or begin to drift. Routine scaling keeps deposits off gums that are still healthy; once attachment has been lost and pockets have formed around the teeth, cleaning the surface is no longer enough on its own.

How the treatment works

The dentist measures the depth of the pockets around each tooth first, which establishes how far the disease has gone and gives a baseline to compare against later. Treatment then works below the gum: deposits are removed from the root surface and the root is smoothed, so that the gum can settle back against it instead of against a rough, contaminated surface. Medication is used where the infection calls for it. The mouth is reassessed afterward, and treatment continues at the sites that have not responded.

Keeping the result

Periodontal disease is managed rather than cured, and what holds the result is daily cleaning and regular review.

• Brush at least twice a day, with a fluoride toothpaste.
• Clean between the teeth the way your dentist shows you, with floss or interdental brushes.
• Replace a toothbrush every three to four months, or sooner once the bristles splay.
• Keep to the review interval you are given, which is shorter after periodontal treatment than for a mouth that has never had it.