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It is very important the patient have a clear understanding
of the disease before they have any chance of treating it.
The disease is present because there are areas on the teeth
that the patient hasn’t been removing the bacteria.
It is necessary to have all of those areas cleaned, which
requires special instruments that reach into the periodontal
pockets and safely remove the bacteria.
There are two methods used to treat this disease.
NON-SURGICAL
The non-surgical treatment is called “deep scaling
and root planing,” or “dsrp.” Using specially
designed instruments and ultrasonic technology, the doctor
or hygienist carefully cleaned the teeth that are covered
by the periodontal pockets. Once the teeth are clean, it is
very important the patient keeps them as clean as possible,
particularly the area of the teeth that is covered by the
periodontal pockets. Once the bacterial numbers are decreased,
the gums start to shrink. The goal is to have the gums shrink
to the extent that all pockets are 3mm or less. Unfortunately,
the bone will not grow back. Consequently, when the gums shrink,
more tooth will be visible. This is normal, as the tooth is
no longer covered by the periodontal pocket. Incidentally,
some sensitivity can be experienced following the dsrp, as
the bacteria act like little sweaters on the root surfaces.
This can easily be treated.
The patient returns to the office, in most cases, one month
following the dsrp for another cleaning and exam. The doctor
measures the pocket depths and shows the patient the areas,
if any, that they are missing. Antibiotics can also be applied
if the pockets are greater than 5mm. The patient will return
every 3 months until the pockets are 3mm or less. The patient
will clean those areas 3mm or less and the doctor or hygienist
will clean the areas deeper than 3mm. If the pockets cannot
be reduced by this protocol, the patient may need surgery
to reduce the pocket depths. It is important to understand
that the pockets will only get worse, if they are not treated.
SURGICAL
If the non-surgical treatment is not successful in eliminating
the periodontal pockets, surgery is sometimes indicated. The
elimination of pockets around the teeth is accomplished surgically
and the practitioner also has better access for effectively
cleaning the root surfaces. Typically, the bone will be reshaped
and the surfaces below the gums cleaned.
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