Scaling and Root Planing
Scaling and root planing, often referred to as a deep cleaning, is a common periodontal procedure performed by our specialist periodontists to treat gum disease. This process includes the following steps:
Step 1: Assessment: Our periodontist begin by assessing the extent of gum disease through a comprehensive examination, which may involve probing depths and X-rays.
Step 2: Scaling: Using specialized instruments, our periodontists remove plaque and calculus (tartar) deposits from tooth surfaces and below the gumline.
Step 3: Root Planing: The tooth roots are meticulously smoothed (planed) to eliminate rough areas where bacteria can accumulate. This promotes gum reattachment to the tooth’s surface.
Step 4: Antibacterial Agents: In certain cases, our surgeons may apply antimicrobial agents or antibiotics to treated areas to further combat infection.
Step 5: Follow-Up: Periodic follow-up appointments are scheduled to monitor healing progress and address any residual pockets or concerns.
When gum disease reaches an advanced stage or if more complex treatment is needed, our specialist periodontists may recommend periodontal surgery. Common procedures include:
Gingival Flap Surgery
Indications: Gingival flap surgery, also known as pocket reduction surgery or osseous surgery, is typically recommended for individuals with moderate to advanced periodontitis, where gum pockets have formed, and bone loss has occurred.
- Anesthesia: Before commencing the surgery, local anesthesia is administered to ensure the patient’s comfort during the procedure.
- Incisions: The surgeon makes precise incisions in the gum tissue to create a flap, which is gently lifted away from the teeth and underlying bone. This provides access to the root surfaces and allows for thorough cleaning.
- Root Debridement: Once the tooth roots are exposed, our surgeon meticulously removes plaque, calculus (tartar), and any infected tissue from the tooth surfaces. Special instruments are used for this purpose.
- Smoothing of Bone: In cases where there is irregular or damaged bone due to periodontal disease, the surgeon may perform bone reshaping or recontouring. This process helps eliminate areas where bacteria can hide and supports the reattachment of healthy gum tissue.
- Flap Repositioning: After the cleaning and bone reshaping, the gum flap is repositioned and sutured back into place. The sutures used are often dissolvable and will naturally dissolve as the gums heal.
- Postoperative Care: Patients receive detailed postoperative care instructions, including guidelines on oral hygiene, diet, and the use of prescribed medications.
Benefits: Gingival flap surgery aims to reduce pocket depths, promote gum reattachment to the tooth surfaces, and halt the progression of periodontal disease. It can help preserve teeth that might otherwise be lost to advanced gum disease.
Bone Grafting: When bone loss occurs due to advanced gum disease, our surgeons may perform bone grafting to regenerate lost bone tissue. This restores tooth stability and improves overall oral health.
Soft Tissue Grafting: Soft tissue grafts are used to augment and thicken gum tissue in areas where it has receded. This procedure protects tooth roots and enhances smile aesthetics.
Indications: Crown lengthening is recommended when there is excessive gum tissue covering the tooth crowns, affecting the appearance of the smile or the ability to place restorations like dental crowns.
- Anesthesia: Local anesthesia is administered to ensure patient comfort.
- Gum Tissue Removal: The surgeon carefully removes excess gum tissue to expose more of the tooth crowns. In some cases, bone may also be reshaped to achieve the desired gumline.
- Suture Placement: The gum tissue is sutured into its new position to facilitate healing.
- Postoperative Care: Patients receive postoperative instructions and may need to follow a soft-food diet while the gums heal.
Benefits: Crown lengthening improves the balance between gum and tooth exposure, enhancing the aesthetics of the smile and allowing for the placement of dental restorations.
Guided Tissue Regeneration
Indications: Guided tissue regeneration is employed to stimulate the growth of new bone and tissue in areas affected by periodontal disease.
- Anesthesia: Local anesthesia is administered for patient comfort.
- Barrier Membrane Placement: A biocompatible barrier membrane is placed over the affected area. This membrane prevents unwanted tissue (such as gum tissue) from invading the healing area, allowing bone and other tissues to regenerate.
- Suture Placement: The barrier membrane is secured in place with sutures.
- Healing and Regeneration: Over time, the barrier membrane guides the growth of new bone and soft tissue, promoting proper healing.
- Postoperative Care: Patients receive postoperative instructions and may need to follow specific guidelines for oral hygiene and diet during the healing process.
Benefits: Guided tissue regeneration helps regenerate bone and soft tissue in areas affected by periodontal disease, ultimately improving the health of the supporting structures of the teeth.