Treatment Options

While gum disease is one of the most prevalent diseases in the US, it is treatable. Treatment options vary depending upon the stage of the disease. The success of treatment is generally measured on its ability to reduce or eliminate inflammation; decrease pocket depth; and stop or slow attachment and bone loss. To better understand the treatment options, you should understand these three goals of treatment:

Reduce or eliminate inflammation: The bacteria, and the endotoxins produced by the bacteria, start the infection in your body. Your gums become redder, not pink, and may swell. Generally, reducing or eliminating inflammation means your body is winning the fight against the disease.

Decrease pocket depth: As gum disease progresses, the microscopic ligaments that bind your teeth to your gums become broken and ‘pockets’ form. The ‘pocket’ is the space between your tooth and gum. As you can imagine, loose particles of food may get stuck in these pockets and make the bacterial infection worse.

Stop/slow attachment and bone loss: The microscopic ligaments that bind the teeth to the gum tissue and bone is commonly referred to as ‘attachment’. The goal is to stop or slow the ligaments breaking. In severe cases of gum disease, the alveolar bone is also eaten away. Alveolar bone is the bone that holds your teeth; when it is eaten away your teeth will become loose and may fall out.

In the early stages of gum disease, you may be offered a Laser Pocket Disinfection or Scaling/root planing (SR/P). SR/P is also commonly called ‘deep cleaning.’

LASER POCKET DISINFECTION (LPD)
A dental laser is used to kill the bacteria in the pocket. Some states allow hygienists to use lasers, while other states only allow dentists to perform procedures using lasers.

Pros: Generally less painful, and may be more effective at killing bacteria.

What to watch for: Make sure your hygienist/dentist has taken proper education courses and is using the correct dental laser for the procedure. There are multiple types of lasers in dentistry with different uses.

SCALING AND ROOT PLANING
during SRP, the hygienist uses metal instruments to scrape away the tarter and calculus on the root surface. Depending upon your dentist, an antibacterial gel may be applied, or an antibacterial rinse prescribed.

Pros: One of the industry’s most commonly accepted ways to treat early gum disease.

What to watch for: Patients may experience discomfort, treatment may not remove bacteria.

If initial treatment is not successful, or if your gum disease is identified in a later stage, your dentist may recommend gum disease surgery.

OSSEOUS SURGERY
In traditional surgery, a periodontist uses a scalpel to cut your gums and fold them back. This allows the doctor to access to the tooth root to clean the target from the tooth and view the alveolar bone. If needed, the bone may be reshaped, and bone graft material is placed in the surgical site. The top of the gums may be cut back to make the pocket less deep and easier to keep clean. The gums are sewn back together. Dental laser is used to kill the bacteria in the pocket. Some states allow hygienists to use lasers, while other states only allow dentists to perform procedures using lasers.

Pros: The classic treatment for advanced gum disease, generally done by a specialist with additional years of dental school.

What to watch for: This surgery may cause your gums to recede, exposing more of your tooth root and leading to increased sensitivity. 

LANAP PROTOCOL
During this laser based surgery, your dentist inserts a fiber into the pocket between the gum and tooth. The laser energy kills the bacteria, targeting the source of the inflammation without hurting or removing healthy tissue. The biting surface of your teeth is adjusted to keep from hitting each other with too much force.

Pros: Patients report less pain and discomfort post surgery, with less recession of the gums. The LANAP protocol has been FDA cleared to regenerate new bone, new ligament and new cementum – replacing the oral tissues lost to advanced gum disease. 

What to watch for: LANAP treatment is a patented protocol, make sure your dentist has completed the required training to perform this procedure. Only one dental laser, the PerioLase MVP-7 has the proper operating parameters for this surgery, so not all dental lasers can be used. You should ask what laser your dentist will be using to perform this procedure.