Non Surgical Treatments

Non-surgical treatments scaling and root planing (deep cleaning)

Scaling and root planing is a non-surgical procedure, performed under local anesthetics, that removes the plaque and calculus from the pockets below the gum line. The root surfaces of the tooth are cleaned and smoothed with special instruments and ultrasonic scalers. By reducing the bacteria and irritants that cause inflammation, we can slow down or in some cases stop the progression of the periodontal infection. This procedure will usually take care of early periodontal infections that are limited to the gum tissues and not yet advanced into the bone. Along with this treatment, daily home care is essential to remove the daily build up of plaque around the teeth. We review and help our patients with the proper oral hygiene procedures, that will work for them. The best way to prevent further periodontal destruction is through brushing, flossing and regular dental maintenance visits. After four weeks, a re-evaluation appointment is necessary to assess how the gum tissues have responded to this treatment. Depending on the response, different treatment options will be necessary to further correct or maintain the gum tissues.

Re-evaluation appointment: following each course of treatment, it is necessary to evaluate the response to that treatment. At this appointment dr. Vravick will evaluate if we have met the final goals of treatment. Periodontal surgery is necessary when the tissue around your teeth is still unhealthy and cannot be repaired with non-surgical treatment. The following are the four types of surgical treatments most commonly prescribed:

• Pocket reduction procedures
• Regenerative procedures
• Crown lengthening
• Soft tissue grafts

Antibiotic treatment: the timing for using antibiotic or antimicrobial therapy is following removal of all calculus from the root surfaces. This is usually after surgical treatment, which allows access to the root surfaces for calculus removal. Use of antibiotics prior to this, will further mask unresolved disease and leaves the patient at risk of repeated destruction of attachment and bone loss until this residual calculus is removed. Dr. Vravick will assess your condition and use the best treatment for you to treat your periodontal infection.

Probe and bacterial culturing: plaque samples are used to allow dr. Vravick to detect specific bacteria in the periodontal pocket and if they will continue to destroy more bone and gum tissues. This procedure is used in more advanced cases where the periodontal destruction is difficult to get under control.

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