Non-surgical and Surgical Treatment of Periodontal Diseases

Periodontal disease, also known as gum disease, is a widespread oral health concern that affects the tissues surrounding and supporting the teeth. If left untreated, periodontal disease can lead to tooth loss and other severe complications. Fortunately, advancements in periodontal treatment have made it possible to address these issues effectively through both non-surgical and surgical methods. At San Antonio Periodontics & Implants, Dr. Steven C. Maller, DDS, MS, offers a range of treatments to restore gum health, prevent further damage, and ensure long-term oral wellness.

What is Periodontal Disease?

Periodontal disease is an infection that affects the tissues supporting your teeth, including the gums, bones, and ligaments. It begins as gingivitis, a mild form of gum disease characterized by inflammation of the gums, redness, swelling, and bleeding. If left untreated, gingivitis can progress to more severe forms of periodontal disease, such as periodontitis, where the infection spreads deeper into the gum tissue and bone, potentially leading to tooth loss.

Periodontal disease is commonly caused by the buildup of plaque and tartar on the teeth, which harbor bacteria that irritate the gums. Risk factors include poor oral hygiene, smoking, genetics, hormonal changes, certain medications, and conditions like diabetes.

Non-Surgical Treatments for Periodontal Disease in San Antonio, TX

Non-surgical treatments are the first line of defense against periodontal disease and are often used when the disease is in its early or moderate stages. These treatments aim to remove the bacterial infection, promote healing, and prevent further damage. Non-surgical treatments can be effective for patients with mild to moderate periodontitis and may help avoid the need for more invasive surgical procedures.

Scaling and Root Planing

Scaling and root planing (SRP) is the most common non-surgical treatment for periodontal disease. This deep cleaning procedure is performed to remove plaque, tartar, and bacteria from the surface of the teeth, both above and below the gumline.

• Scaling: Scaling involves the removal of plaque and tartar buildup from the surface of the teeth and below the gumline. A dental hygienist or periodontist uses special instruments, such as ultrasonic scalers or hand scalers, to clean the teeth thoroughly.
• Root Planing: After scaling, root planing is performed to smooth the surface of the tooth roots. This step helps remove bacterial toxins from the roots, which can cause gum inflammation and further damage if not removed. Smoothing the roots also allows the gums to reattach more effectively, reducing the pockets of infection between the teeth and gums.

Benefits of Scaling and Root Planing

• Reduces gum inflammation and bleeding.
• Removes plaque and tartar that cause infection.
• Prevents further gum recession and bone loss.
• Promotes gum reattachment to the teeth and improves oral health. Contact us to learn more.

Localized Antibiotics

In some cases, antibiotics may be applied directly to the affected area to help control bacterial infection after scaling and root planing. These antibiotics come in various forms, including gels, microspheres, or chips, and are placed in the gum pockets after cleaning.

Benefits of Localized Antibiotics

• Reduces bacterial infection and inflammation.
• Helps prevent the recurrence of infection in deeper gum pockets.
• Enhances the effectiveness of scaling and root planing.

Antimicrobial Mouth Rinses

Antimicrobial mouth rinses can be prescribed to help control bacteria and reduce plaque buildup. These rinses are used as a supplementary treatment to support good oral hygiene practices, such as brushing and flossing.

Benefits of Antimicrobial Mouth Rinses

• Helps reduce oral bacteria that contribute to periodontal disease.
• Reduces plaque and gingivitis.
• Aids in overall oral health management alongside other treatments.

Oral Hygiene Instructions and Education

In addition to professional treatments, proper at-home oral care is crucial in preventing periodontal disease and its recurrence. Dr. Maller and his team educate patients on effective brushing and flossing techniques, as well as the use of tools like interdental brushes, water flossers, and antimicrobial rinses.

Benefits of Oral Hygiene Education

• Reduces the risk of gum disease progression.
• Encourages long-term maintenance of oral health.
• Helps patients manage periodontal disease at home between visits.

When is Non-Surgical Treatment Enough?

Non-surgical treatments are typically sufficient for individuals in the early or moderate stages of periodontal disease. If the gum pockets are shallow (less than 5 millimeters) and the damage to the bone and gums is minimal, scaling and root planing, along with proper home care, can often restore gum health. In these cases, surgery may not be required, and the condition may be controlled with continued professional care and patient compliance.

However, when periodontal disease has advanced and caused significant damage to the bone and soft tissues, surgical intervention may be necessary to address the condition comprehensively. Dr. Maller will assess each patient's situation and recommend the most appropriate treatment plan based on their specific needs.

Surgical Treatments for Periodontal Disease in San Antonio, TX

Surgical treatments for periodontal disease are often necessary when non-surgical treatments alone cannot effectively address advanced periodontal conditions. These procedures are designed to access deeper areas of infection, restore lost bone structure, and regenerate tissues damaged by periodontal disease.

Pocket Reduction Surgery (Flap Surgery)

Pocket reduction surgery, also known as flap surgery, is performed when the gum pockets have become deep (greater than 5 millimeters) and scaling and root planing are no longer sufficient. During this procedure, the gums are lifted away from the teeth to expose the underlying bone and tooth roots. Our periodontist in San Antonio, TX can then thoroughly clean the area and remove any infected tissue. In some cases, the bone may need to be reshaped to eliminate pockets and reduce the risk of further infection.

After cleaning and shaping, the gums are repositioned and sutured back into place. This surgery helps reduce the depth of the gum pockets, which facilitates better oral hygiene and prevents future infections.

Benefits of Pocket Reduction Surgery

• Reduces deep gum pockets, making it easier to maintain oral hygiene.
• Removes infected tissue and bacterial buildup.
• Promotes better healing and gum reattachment.
• Prevents further bone loss and tooth instability.

Bone Grafting

Bone grafting is a surgical procedure used to restore lost bone in the jaw that may have been caused by periodontal disease. Bone grafts are typically made from natural or synthetic materials and are placed in areas where bone loss has occurred. Over time, the grafted bone integrates with the existing bone, stimulating natural bone growth and creating a solid foundation for dental implants or other restorative treatments.

Benefits of Bone Grafting

• Restores lost bone, making it possible to place dental implants.
• Promotes bone regeneration and prevents further bone loss.
• Improves the overall stability of the teeth and gums.

Soft Tissue Grafting

Soft tissue grafting is often performed when gum recession has occurred as a result of periodontal disease. During this procedure, a small piece of tissue is taken from the roof of the mouth (or another donor site) and grafted to the affected area. This helps cover exposed tooth roots, reducing sensitivity, and improving the appearance of the gums.

Benefits of Soft Tissue Grafting

• Restores lost gum tissue, improving the appearance of the smile.
• Protects tooth roots from further exposure and damage.
• Reduces tooth sensitivity and prevents gum recession from worsening.

Guided Tissue Regeneration (GTR)

Guided tissue regeneration (GTR) is a technique used to stimulate the regeneration of lost bone and tissue. During this procedure, a special membrane is placed between the gum tissue and the bone to encourage the growth of new bone and tissues. This technique is often used in conjunction with bone grafting to optimize healing and restore the natural structure of the jaw.

Benefits of Guided Tissue Regeneration

• Encourages the growth of new bone and tissue.
• Helps restore the natural structure of the gums and bone.
• Provides long-term support for teeth and dental implants.

Crown Lengthening Surgery

Crown lengthening surgery is performed when excessive gum tissue covers the teeth, making them appear short or causing functional issues. During this procedure, the gum tissue is carefully removed, and in some cases, the underlying bone is reshaped to expose more of the tooth structure. This can improve both the aesthetics of the smile and the function of the teeth.

Benefits of Crown Lengthening Surgery

• Improves the appearance of "gummy smiles."
• Allows for the proper placement of dental restorations like crowns.
• Helps treat teeth with insufficient length to support restorative work.

Recovery and Aftercare

After both non-surgical and surgical periodontal treatments, following Dr. Maller's post-treatment care instructions is essential for optimal healing. Recovery time varies depending on the type of treatment performed, but general recommendations include:

• Pain management: Over-the-counter pain relievers or prescribed medication can help alleviate discomfort.
• Dietary restrictions: A soft food diet is often recommended for several days following surgery.
• Good oral hygiene: Gently brushing and flossing, as well as using antimicrobial rinses, can help reduce the risk of infection and promote healing.
• Follow-up appointments: Regular check-ups are essential to monitor progress and ensure proper healing.

Conclusion

The treatment of periodontal disease, whether through non-surgical or surgical methods, is essential for maintaining optimal oral health and preventing tooth loss. Dr. Steven C. Maller, DDS, MS, and the team at San Antonio Periodontics & Implants are committed to providing effective, personalized care to address periodontal issues at every stage. By combining the right treatments with expert care, we can help restore gum health and ensure that your smile remains bright and healthy for years to come.

If you suspect you have periodontal disease or if you have concerns about your gum health, schedule a consultation with Dr. Maller today to discuss the best treatment options for your unique needs.

Take the first step toward optimal oral health and a confident smile. Contact Dr. Steven C. Maller, DDS, MS, at San Antonio Periodontics & Implants for expert care tailored to your needs. Call us at (210) 824-0111 or visit us at 4501 McCullough Suite 104, San Antonio, TX 78212. Your healthiest smile starts here!