Periodontal (gum) therapy for gum disease can be classified into three basic categories. These categories consist of dental cleaning, known as prophylaxis or prophy, root planing and scaling (RP&S), and periodontal (gum) surgery. A Periodontist is the dental specialist who typically treats gum disease. General dentists are legally allowed to perform all types of gum treatment. We prefer that our Periodontist treat the majority of gum disease and bad breath problems in our Gum Disease Treatment office.
A thorough dental cleaning is generally recommended every six months. This is appropriate for those who have great home oral hygiene and only small gum pocket depths around their teeth. A ‘check-up’ does not necessarily include a cleaning. It could mean a patient wants only x-rays and a general examination. Therefore when a patient calls to make an appointment they should be as specific as possible.
Root planing & scaling is a deep cleaning under the gum line and is suggested to patients who may need more work than a regular cleaning. This need could be caused by a high sugar diet, lack of good home oral hygiene, gum pocket depths that are deeper than normal around the teeth, or due to extensive dental work that might hinder access for a normal cleaning. Usually RP&S is split up into multiple (2-4) office visits. The procedure involves cleaning all the way to the depth of the gum pockets, therefore anesthesia is often used. There is little pain after a root planing & scaling and you should be able to continue all activities, social and professional, later that night and definitely the following day. The benefits are often immediate and profound. Most people notice a remarkable difference in the freshness of their breath and the cleanliness of their mouth.
Three to six months after the completion of the procedure, the patient needs to see the periodontist for a reevaluation examination. At that time the specialist will usually advise the patient one of the following:
1) Return to regular cleanings every three months, rather than every six months.
2) Undergo another root planing & scaling procedure.
3) Periodontal surgery is suggested for either the entire mouth or just sections.
The difference between periodontal surgery and root planing & scaling is that surgery involves cutting and moving of the gum. This enables the periodontist to directly view the issue and permits direct access for cleaning and repair of the unhealthy tissue.
Microbiologic analysis will often provide important information about the types of pathogens that cause infections in the gum. To ensure accuracy, this test should occur before RP&S or surgery. In these cases local or systemic chemotherapy (usually antibiotics) are very beneficial.
–Dr. Jeffrey Dorfman, Director
The Center for Special Dentistry