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Periodontal Disease Treatment

  • Nonsurgical Periodontal Therapy
    Some people think periodontal therapy in a periodontist's office always means surgical treatment. The fact is, in its earlier stages, periodontal disease responds quite favorably to nonsurgical periodontal therapy. Only in its more advanced stages of destruction is surgical intervention necessary. In fact, surgery is usually reserved for those situations when nonsurgical therapies have failed to achieve the desired clinical outcome of periodontal health, and to repair damage to gum tissue and bone as a result of periodontal disease. As a result of his additional training in the diagnosis and management of periodontal disease, Dr. Stanton has specialized capabilities to perform an accurate periodontal health assessment and develop an appropriate plan for the long-term management of your periodontal condition. Dr. Stanton follows the American Academy of Periodontology treatment guidelines which stress that periodontal health should be achieved in the least invasive and most cost effective manner. The primary cause of periodontal disease is the body's inflammatory response to bacterial plaque. The purpose of nonsurgical periodontal therapy is to remove or eliminate the etiologic agents which cause inflammation: dental plaque and its toxins, and calculus or tartar, which is hardened dental plaque.
  • Oral Hygiene Instruction
    Proper oral hygiene is the first step in achieving periodontal health. If you've been diagnosed with a periodontal disease, you may be more susceptible to a reoccurrence of periodontal disease. For this reason, you may need to keep your teeth cleaner than most people in order to maintain periodontal health. We take our role as coaches for your daily oral hygiene efforts seriously, and we will work with you to develop proper oral hygiene practices. There are many products on the market, and it can become confusing when deciding which items to utilize in your home oral hygiene efforts. Dr. Stanton is a strong believer in the value of oral hygiene aides such as electric toothbrushes, interproximal brushes for the areas between your teeth, and dental floss. We see excellent results with electric toothbrushes, when used along with flossing. Oral irrigators (water spraying devices) will rinse your mouth thoroughly, but will not always remove plaque in key areas. You will need to brush and floss in conjunction with the irrigator. If used in conjunction with brushing and flossing, fluoride toothpaste and mouth rinses can help reduce tooth decay by as much as 40%. Tartar control toothpaste will help reduce tartar above the gum line and help prevent gingivitis. However, periodontal disease occurs below the gum line, so these products will not be as effective in the prevention of periodontal disease. Sensitivity toothpaste can assist with controlling the sensitivity brought on by exposure of the roots due to periodontal diseases. Anti-plaque rinses contain agents that may help bring early gum disease under control. They should be used in conjunction with brushing and flossing. Your periodontist or hygienist is the best person to select the products that are best for you. Dr. Stanton encourages his patients to bring their oral hygiene aides with them to scaling and root planing, and routine maintenance visits so that oral hygiene instruction can be reinforced.
  • Prophylaxis
    A prophylaxis is a routine dental cleaning performed on patients with healthy stable mouths in order to maintain health and prevent the initiation of dental diseases. Traditionally, it has also been utilized for the management of gingivitis patients who do not have significant calculus (tartar) built up below the gum line.
  • Scaling and Root Planing (Deep Cleaning)
    Scaling and root planing (also referred to as a deep cleaning) is a careful cleaning of the root surfaces to remove plaque and calculus (tartar) from deep periodontal pockets and to smooth the tooth roots to remove bacterial toxins and make it more difficult for plaque to accumulate on the root surfaces. When performed properly, scaling and root planing can reduce gingival inflammation and probing depths, and can shift the bacterial composition living in the pockets from one associated with disease towards one associated with health. It is considered an active treatment for periodontitis and the results of the therapy should be assessed for success at some point after adequate time for healing has been allowed. For those patients who achieve periodontal health following scaling and root planing, regularly scheduled maintenance therapy are necessary to sustain health. After scaling and root planing, many patients do not require any further treatment. However, nonsurgical therapy does have its limitations. Areas that have not responded favorably to scaling and root planing (continued to show signs of periodontal disease) may require further treatment. Multiple studies in the periodontal literature have shown the limitations of effectively scaling and root planing in a pocket that is 5 millimeters or deeper. Because of the complex shapes of the root surfaces below the gum line and limited visual access, scaling and root planing is a much more demanding procedure than a prophylaxis. It is often necessary to perform the scaling and root planing treatment over the course of more than one appointment and with the use of local anesthesia so that the procedure can be performed in a comfortable manner.
  • Locally Delivered Antimicrobials
    Locally delivered antimicrobials are antibiotic medications that are delivered directly into periodontal pockets to reduce or eradicate periodontal bacteria. The most common locally delivered antimicrobial in the dental market today is Arrestin. When used properly, these medications have definite indications in the treatment of patients with periodontitis. Locally delivered antimicrobials are utilized in conjunction with thorough scaling and root planing of the pocket. With inadequate scaling and root planing the medications will have little benefit. Because studies have not shown a clinically significant difference in pocket depth reduction utilizing locally delivered antimicrobials versus scaling and root planing without these medications, Dr. Stanton does not recommend their usage in most cases during the initial scaling and root planing process. Because of their cost and need for multiple continued applications over time, he does not recommend treating multiple sites using locally delivered antimicrobials. Dr. Stanton recommends the usage of locally delivered antimicrobial medications in those patients with a few sites in their mouth that have not responded favorably to scaling and root planing therapy. He also recommends these medications for patients who have had definitive periodontal therapy and have localized areas that show persistent signs of periodontal disease or recurrence after treatment. As with scaling and root planing, if localized antimicrobials are utilized as a method for active periodontal disease treatment, the success of this treatment should be evaluated at a reevaluation appointment. Areas that continue to show signs of periodontal disease may require further treatment.
  • Reevaluation
    A reevaluation should be performed following adequate time to respond to your active treatment of periodontal disease. For areas that continue to exhibit signs of periodontal disease, further active therapy may be indicated. Treatment options available to Dr. Stanton include continued nonsurgical therapy, periodontal surgical therapy, dental implant therapy, or a combination of each. Dr. Stanton's periodontal training and years of management of patients utilizing different modalities of treatment provide him a unique perspective to anticipate your expected response to various treatments available for management of your periodontal condition. We are proud of our abilities to be a patient advocate and provide guidance for what we feel is most appropriate treatment while respecting your right to know about alternative treatments their risks and their benefits.
  • Periodontal Maintenance
    Periodontal maintenance is a specialized program developed for each patient once periodontal health has improved and is stable. These appointments tend to be more thorough than traditional six-month cleanings. They are designed to prevent periodontal disease from occurring in patients who have undergone treatment for periodontitis or dental implant therapy. This ongoing phase of treatment will allow Dr. Stanton and his hygienist to assess your periodontal health and make sure infection stays under control. Periodontal diseases are chronic diseases, just like diabetes. Without careful, ongoing treatment, periodontal diseases can and often do recur.
  • Pocket Reduction Surgical Procedures

    Pocket reduction surgery (also known as Gingivectomy, Osseous surgery and Flap surgery) is a term that is used several different surgeries, all aimed at gaining access to the roots of the teeth in order to remove bacteria and tartar (calculus).

    The human mouth contains hundreds of different types of bacteria at any given time. There are specific bacteria found in plaque under the gum line that cause the body to react with an inflammatory response that can ultimately lead to periodontal disease.

    Periodontal infections cause a chronic inflammatory response in the body that destroys bone and gum tissues once they invade the area below the gum line. Gum pockets form and deepen between the gums and teeth as the tissue continues to be destroyed. Periodontal disease is a progressive condition which, if left untreated, causes increased bacterial growth in gum pockets and can eventually lead to teeth falling out. Pocket reduction surgery is an attempt to alleviate this destructive cycle and reduce the depth of the bacteria-harboring pockets.

  • Reasons for the pocket reduction surgery
    Pocket reduction surgery is a common periodontal procedure which has been proven effective at eliminating bacteria, reducing inflammation and saving teeth. The goals of pocket reduction surgery are:
    • Reducing bacterial spread- Oral bacteria has been connected to many other serious conditions such as diabetes, heart disease and stroke. Oral bacteria can travel to various parts of the body from inside the bloodstream and begin to colonize. It is important to decrease bacteria in the mouth in order to reduce the risk of secondary infection.
    • Halting bone loss- The chronic inflammatory response induced by oral bacteria leads the body to destroy bone tissue. As the jawbone becomes affected by periodontal disease, the teeth lose their rigid anchor. When the teeth become too loose, they may require extraction.
    • Facilitate home care- As the gum pockets become progressively deeper, they become incredibly difficult to clean by the patient. The toothbrush and dental floss cannot reach the bottom of the pockets, increasing the risk of further periodontal infections.
    • Enhancing the smile- An oral cavity that is affected by periodontal disease is not attractive to the eye. In fact, smiles may be marred by brown gums, rotting teeth and ridge indentations. Pocket reduction surgery halts the progression of gum disease and improves the aesthetics of the smile.

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