TREATMENT OF PERIODONTAL DISEASE

There are various modalities of treatment of gum disease depending upon the severity of the disease and other factors. If there is mild to moderate plaque or tartar accumulation then cleaning of the teeth i.e. removal of tartar deposits by a dental professional is done. This is known as scaling. This simple procedure of scaling is the most important treatment modality for gum disease. Sometimes scaling may require three or four sessions. It is also used for preparing the gums for surgery. There is a widespread misconception that scaling causes the teeth to become loose or that scaling causes gaps in the teeth. However that is not correct.

Professional scaling at regular intervals goes a long way in preventing dental disease. Even after regular brushing and flossing there are always a few places where plaque and tartar may be accumulating. It requires a dental professional to make the patient aware of this. Besides, the dental surgeon evaluates the oral hygiene habits of the patient and may suggest some improvement in oral hygiene habits or the use of some interdental cleansing aids.

Special care is required for partial dentures, bridges, crowns, implants and orthodontic appliances. More plaque tends to accumulate around any denture or appliance. The dental surgeon may suggest some special kinds of brushes or other cleansing aids to keep them clean.

Some times there are very heavy deposits of tartar. This results in gums pulling away from teeth. Such tartar cannot be removed by simple scaling. If there are heavy deposits of tartar then deep cleaning is performed by separating the gum from the teeth and then the tartar is removed.

If there has been a lot of bone loss than there is a new treatment modality available i.e. to put artificial bone. A new therapeutic procedure has been developed which is known as “Guided tissue regeneration”. However artificial bone placement and guided tissue regeneration can be done only in a minuscule number of cases. Furthermore, the high cost of the procedures is also a deterrent.

The gaps in the front teeth can be masked aesthetically by filling them with a special kind of restorative material, or by placing ceramic laminates

If the teeth are very mobile than they can be splinted together. However, when this is done, diligent oral hygiene must be practiced by the patient. If there are teeth missing than they should be replaced so that there is no shifting of the other teeth. If teeth are not replaced than the other teeth tend to move causing interdental gaps. The tooth in the opposing arch may grow too long.

Bad habits like smoking, tobacco chewing, gutkha, pan parag etc contribute in a big way to gum destruction. They must be stopped immediately.

In case there are excessive stains on the teeth, they can be removed by bleaching. Bleaching also restores the natural color of the teeth and provides a much needed psychological boost for the patient to quit his bad habits. Patients must not hesitate to take psychiatric help in case the habits obstinate.

The general systemic condition of the patient also affects the initiation and progress of gum disease. Any systemic disease that is present must also be treated simultaneously for satisfactory and early resolution of gum disease.