Periodontal disease is a low grade, chronic or long term bacterial infection that affects the gum and bone tissue that surround and support the teeth. It is a progressive disease which, if left untreated, will eventually lead to the loss of one's teeth. It is considered a ‘threshold’ disease, in that bacteria are always present in the mouth, and normally the patient’s immune system controls them. If the bacterial population reaches a certain threshold, the immune system may no longer handle it, and bone destruction around the teeth can occur.

Bacteria (plaque) and deposits (tartar) which form under the gum irritate and destroy the gum and supporting tissue. Bacteria deep in the pocket between gum and tooth release endotoxins which cause bone resorption. Plaque, if not removed within 24 hours, calcifies into hard deposits which can only be removed professionally.

Periodontal disease is a disease process which is not cured, but which can be controlled and arrested with proper treatment and home care. Scalings every two years and cleanings four times a year help keep the bacterial population in the pockets below the threshold level that causes further bone loss.

The goal of modern periodontal therapy is to remove or minimize the bacteria deep in the periodontal pockets, and to reduce the depth of these pockets so that the patient can keep them clean at home.

What is the Treatment for Periodontal Disease?

The goal of modern periodontal therapy is to remove or minimize the bacteria deep in the periodontal pockets, and to reduce the depth of these pockets so that the patient can keep them clean at home.

Treatment consists of:

1. Home Care Instruction: The patient’s home care is critical to the success of treatment. Successful treatment is directly related to the patient’s cooperation.
2. Clinical treatment, which consists of one or more of the following:
   1. A thorough deep scaling and root planing of the entire mouth, removing irritated gum tissue and deposits and bacteria from the root surface below the gum line;
   2. Irrigation of the pockets with an antibiotic solution;
   3. Antibiotic therapy to reduce the bacterial population and allow the patient's immune system to control the bacteria.
3. Re-evaluation and follow-up. At this time the necessity for further treatment such as local antibiotic delivery or periodontal surgery will be determined.
4. Follow up periodontal maintenance, normally at 3 month intervals.

Deep scaling and root planing does not involve surgery or cutting of the gums. It is conservative treatment which will hopefully prevent or minimize the need for surgery.