How Do Dentists Treat Gum Disease?

Gum disease, also known as periodontal disease, is one of the most common dental issues that Americans face, with 46% of adults over the age of 30 showing signs of the earliest form called gingivitis¹. Gum disease develops when plaque and tartar build up on teeth and irritate the gums, which causes inflammation, redness, and bleeding. Dentists look for these early signs during routine checkups, and if gum disease is present, dentists can treat the disease with non-surgical, surgical, or medicinal therapies.

Non-Surgical Treatments to Tackle Gum Disease

The first line of defense against gum disease is with non-surgical treatments. These are non-invasive options that target plaque and tartar buildup above and beneath the gum line. These treatments are recommended for patients who are actively trying to stave off gum disease, or are trying to prevent the early stages from progressing.

1. Professional Cleaning: during a professional cleaning, a dental hygienist will remove the thin film of bacteria that coats your teeth (plaque), and remove any yellow deposits of tartar (hardened plaque) that have accumulated on your teeth, both above and below the gum line. While dental cleanings are recommended twice a year to help stave off gum disease, those in the early stages of the condition may need to visit more frequently for cleanings.
2. Root Planing & Teeth Scaling: in cases where there is a lot of plaque and tartar (calculus) above and below the gum line, a deep cleaning treatment called teeth scaling and root planing may be recommended. It involves scraping the plaque and tartar from the teeth (scaling), and root planing, which is when the rough spots on the roots of your teeth are smoothed out for better gum reattachment. This treatment is performed under local anesthetic.

Surgical Treatments To Address Unhealthy Gum Tissue

In cases where gum disease has progressed too far for non-surgical treatments to be effective, surgical treatments are the next step.

1. Flap Surgery: with flap surgery, also known as pocket reduction surgery, our dentists lift back the gums to reveal the built-up tartar deposits underneath. These deposits are removed, and any damaged bone with irregular surfaces are smoothed out. Your gums are sewn back in place so that they are snug around the tooth, reducing the amount of space between the gums and the tooth. By shrinking the pocket of space, removing the tartar, and smoothing out the bone, the areas in which bacteria can grow and thrive is significantly diminished.
2. Soft Tissue Grafting: if you have lost gum tissue due to the progression of gum disease, we may recommend soft tissue grafting. This procedure involves taking tissue from the roof of your mouth and attaching it to the gums around your teeth that have lost tissue. This helps strengthen thin gums, and fills in areas where the gums have receded.
3. Guided Tissue Regeneration: in the later stages of gum disease, you can experience tissue loss and bone loss. To help combat this, guided tissue regeneration is often recommended in combination with flap surgery. With guided tissue regeneration, a mesh-like fabric is inserted between the exposed bone and your gum tissue, to help stimulate bone and tissue growth. The fabric prevents gum tissue from growing into the area where there is bone loss, leaving room for your bone and connective tissue to regrow.
4. Bone Grafting: in the case of extensive bone loss due to gum disease, a bone graft procedure may be recommended to help regenerate lost bone. This involves using fragments of your own bone, a donated bone, or synthetic material to either help bone regrow or to replace the bone entirely. In doing a bone graft surgery, this replenishes the secure attachment of your teeth. An alternative procedure may be used here called tissue engineering, which prompts your body to create new bone and tissue.
5. Bone Surgery: a side effect of moderate to severe bone loss in individuals with gum disease is the development of shallow craters across the bone. These small dips give bacteria a place to grow and hide in. Bone surgery removes these dips by smoothing out the shallow craters, decreasing them so that bacteria cannot grow and collect within them.

Medicinal Treatments for Gum Disease

In addition to non-surgical and surgical treatments, medication can also be used to treat gum disease. The two main types of medications used are antimicrobial mouthwashes and antibiotics.

1. Antimicrobial Mouthwash: antimicrobial mouthwashes are available over-the-counter, and can be used to help reduce plaque and tartar build up. These can also be prescribed to you by the dentist, and be picked up at your nearest pharmacy; if prescribed these will be quite a bit stronger than the over-the-counter versions. These mouthwashes work by killing bacteria in your mouth.
2. Antibiotics: in more severe cases of gum disease, antibiotics may be prescribed alone or in combination with other treatments as a way to temporarily eliminate bacteria. The idea here is to kill off bacteria, slow down the destruction of gum and bone tissues, and reduce inflammation in the mouth. Antibiotics can be taken orally, applied directly to the gums (paste), or can be inserted into the space between your teeth and gums (gel-filled packet), which slowly releases over the course of a week.

Common brand names of antibiotics include Peridex, PerioChip, PerioGard, which is the medication Chlorhexidine.

If you’ve been diagnosed with gum disease and need treatment, the majority of the above options can be performed in-office, with no special preparations needed on your end. You can request or have local anesthesia provided to you, or you can request sedation options for your own comfort.