Neal B. Suway, D.D.S. Nonsurgical Periodontal Therapies

Non-surgical Periodontal Therapy

Dr. Suway understands the body's ability to heal and regenerate, and therefore he emphasizes conservative therapies. Prevention is obviously the best and most effective non-surgical therapy. According to The National Institute of Health, the best things you can do for prevention are brush your teeth twice a day (with a fluoride toothpaste), floss every day, visit the dentist routinely for a check-up and professional cleaning, eat a well balanced diet, and don't use tobacco products.

The number and types of treatment will vary depending on the extent of the gum disease. Any type of treatment requires that the patient continue good daily care at home. Additionally, modifying certain behaviors, such as eliminating tobacco, also might be suggested to improve treatment outcome.

Scaling and Root Planing (deep cleaning)

Scaling and root planing is the procedure that removes the bacterial plaque and calculus through deep-cleaning. Instruments (similar to those used for a regular dental cleaning) that are specifically made for the root surfaces of the teeth are used. Scaling means scraping off the tartar from above and below the gum line. Root planing gets rid of rough spots on the tooth roots where the germs gather and removes bacterial toxins that contribute to the progression of disease. The goal of the deep cleaning procedure is to provide a clean healthy root surface which will allow the gum tissue to pull tight to the tooth and reduce pockets that harbor periodontal bacteria.

After scaling and root planing, many patients do not require any further active treatment, including surgical therapy. However, most patients will require ongoing maintenance therapy to sustain health.

Even in the most advanced cases, scaling and root planing is usually recommended to begin the healing processes. Non-surgical therapy does have its limitations, however, and when it does not achieve adequate periodontal health, surgery may be indicated to restore periodontal tissues and to facilitate oral hygiene practices.

Medications

Medications are playing an increasing role in non-surgical therapy. The following table lists available medications and how they are used. All of these treatments are used in addition to scaling and root planing.

Non-surgical Periodontal Therapy Dr. Suway understands the body's ability to heal and regenerate, and therefore he emphasizes conservative therapies. Prevention is obviously the best and most effective non-surgical therapy. According to The National Institute of Health, the best things you can do for prevention are brush your teeth twice a day (with a fluoride toothpaste), floss every day, visit the dentist routinely for a check-up and professional cleaning, eat a well balanced diet, and don't use tobacco products. The number and types of treatment will vary depending on the extent of the gum disease. Any type of treatment requires that the patient continue good daily care at home. Additionally, modifying certain behaviors, such as eliminating tobacco, also might be suggested to improve treatment outcome. Scaling and Root Planing (deep cleaning) Scaling and root planing is the procedure that removes the bacterial plaque and calculus through deep-cleaning. Instruments (similar to those used for a regular dental cleaning) that are specifically made for the root surfaces of the teeth are used. Scaling means scraping off the tartar from above and below the gum line. Root planing gets rid of rough spots on the tooth roots where the germs gather and removes bacterial toxins that contribute to the progression of disease. The goal of the deep cleaning procedure is to provide a clean healthy root surface which will allow the gum tissue to pull tight to the tooth and reduce pockets that harbor periodontal bacteria. After scaling and root planing, many patients do not require any further active treatment, including surgical therapy. However, most patients will require ongoing maintenance therapy to sustain health. Even in the most advanced cases, scaling and root planing is usually recommended to begin the healing processes. Non-surgical therapy does have its limitations, however, and when it does not achieve adequate periodontal health, surgery may be indicated to restore periodontal tissues and to facilitate oral hygiene practices. Medications Medications are playing an increasing role in non-surgical therapy. The following table lists available medications and how they are used. All of these treatments are used in addition to scaling and root planing.

	What is it?		Why is it used?	How is it used?
Antiseptic "chip"	A tiny piece of gelatin filled with the medicine chlorhexidine		To control bacteria and reduce the size of periodontal pockets	After root planing, it's placed in the pockets where the medicine is slowly released over time.

Antibiotic gel	A gel that contains the antibiotic doxycycline		To control bacteria and reduce the size of periodontal pockets	The periodontist puts it in the pockets after scaling and root planing. The antibiotic is released slowly over a period of about seven days.

Antibiotic micro-spheres		Tiny, round particles that contain the antibiotic minocycline	To control bacteria and reduce the size of periodontal pockets	The periodontist puts the micro-spheres into the pockets after scaling and root planing. The particles release minocycline slowly over time.

Enzyme suppressant	A low dose of the medication doxycycline that keeps destructive enzymes in check		To hold back the body's enzyme response -- If not controlled, certain enzymes can break down gum tissue	This medication is in pill form. It is used in combination with scaling and root planing

Information Disclaimer Dr. Suway is not providing specific medical/dental advice, but rather provides users with information to better understand their health. The information provided on this web site is intended to be general summary information for the public. While Dr. Suway will be happy to answer general questions, no specific medical/dental advice will be provided, and he urges you to consult with a qualified periodontist for diagnosis and for answers to your personal questions.