Periodontal Therapy

Healthy gums for a healthy you!

Periodontal disease is a bacterial infection of the supporting tissues of the teeth, resulting in chronically inflamed, tender, bleeding gums and destruction of the bone surrounding the teeth.  If left untreated, these effects can result in tooth loss.  Furthermore, recent studies have shown that periodontal disease is associated with other chronic conditions including diabetes, heart disease, rheumatoid arthritis, and stroke. 

While more than half the US population has periodontal disease, most are not aware, and sadly, are not treated for this destructive disease.  Similar to high blood pressure, periodontal disease is often “silent”, without any discomfort or obvious symptoms in its early stages.  The good news is that periodontal disease is easy for your dentist to detect early, and if treated promptly generally has a good prognosis.  At River Oaks Dental, Dr. Monteiro screens all patients at least once a year for periodontal disease by gently measuring the gums around the teeth and evaluating bone health on dental x-rays. 

normal tooth vs periodontitis

Scaling and Root Planing

Often referred to as “SRP” or “deep cleaning”, scaling and root planing is a procedure performed by the dentist or hygienist to thoroughly clean the teeth and roots when a patient has active periodontal disease.  The goal of this treatment is to restore health to the gums by removing plaque and calculus (tartar) and eliminating the bacteria colonizing the gums, thus reducing inflammation, bleeding, and tenderness.  Scaling and root planing is typically the first step in treating periodontal disease, and for many patients is the only active treatment they will need.  Following the procedure, a periodontal maintenance schedule is established to ensure continued gum health.

perio progression

Antibiotic Therapy

In certain cases, antibiotic therapy may be prescribed to help treat periodontal disease and aid in restoring health to the gums.  Antibiotic treatment is an important part of periodontal therapy and  can improve treatment outcomes.  Adding additional therapeutic medicaments to your individualized periodontal therapy plan can help improve treatment outcomes, resulting in better and faster healing after treatment.  

At River Oaks Dental, Dr. Monteiro uses three types of antibiotic therapy in treating periodontal disease.

1. Chlorhexidine mouth rinse is used during the SRP (Scaling and Root Planing) procedure and for 7-14 days at home following treatment.  This rinse helps kill bacteria in the mouth and reduce the overall bacterial load, which assists in better healing of the tissues.

2.  Arestin is a locally applied minocycline microsphere that is placed into the gum pocket surrounding the tooth and slowly releases antibiotics into the gums for one month.  This continued fight against bacteria results in better healing than SRP alone. 

3. Cervitec is a chlorhexidine varnish that is applied to the teeth along the gumline and inhibits bacterial growth.  This assists the healing process following SRP, but also is useful in patients with a high risk of tooth decay and those with sensitivity along the gumline.  

Periodontal Maintenance

Perhaps the most important component of your periodontal therapy is periodontal maintenance.  It only takes 3 months for bacteria to re-colonize the gums to the point that the bone and gum destruction can begin again.  Even with perfect home care, patients with a history of periodontal disease will always be susceptible.  Our goal is to keep the disease in its inactive stage by regularly removing the toxic bacterial biofilm every 3 to 4 months, maintaining optimal home care complete with recommended brushing and flossing routines, and constantly monitoring the gums for changes by recording gum measurements and taking necessary x-rays as prescribed by Dr. Monteiro.

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