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Alan L. Stott, DDS

Gum Treatment

Female dentist with male patient

What is gum treatment?

Gum treatment is the term used for treating problems with the gum tissues in the mouth and the supporting bone around the teeth. Gum treatment can include: a regular dental cleaning, deep cleaning (root planing and scaling), tissue grafting and surgeries, and periodontal surgery with bone grafting.

Why is gum treatment so important?

 If you want to keep your teeth, you will need to do some type of gum treatment. Even with good oral hygiene at home, most people will accumulate plaque, bacteria, and tartar around the teeth. Everyone needs the minimal amount of gum treatment, which is a regular dental cleaning at the dental office. Those that do not have ideal homecare will need at least a deep cleaning to remove the plaque, bacteria and tartar deeper in the gum pockets around the teeth. Patients who have not taken good care of their teeth and want to save their teeth, may need more advanced treatment like periodontal surgery. It is a lot easier to spend time daily brushing and flossing well than to have to go through the cost and discomfort of the more advanced gum treatments.  

When does a patient need just a regular dental cleaning?

 If a patient has beginning to moderate gum disease or gingivitis and the gum pockets around the teeth are not too deep or infected, a regular dental cleaning will work fine.

What is a deep cleaning or root planing?

A deep cleaning or root planing is used when the plaque, bacteria and tartar have caused the gum pockets to deepen around the teeth. The plaque, bacteria and tartar will stick to the root surfaces of the teeth causing further infection and eventually leading to bone loss. In order to adequately remove the buildup of plaque and tartar, we need to numb the teeth and gums and use special instruments to clean the root surfaces and gum tissue.

 When does a patient need deep cleaning?

If a patient has moderate to severe gum disease or gingivitis and the gum pockets around the teeth are getting deeper and more infected, then deep cleaning may be indicated. These patients may brush their teeth adequately but never floss. Some of these patients do not brush or floss at all, and most have not had a professional dental cleaning for years.

 How can I avoid needing a deep cleaning?

You can avoid the need for deep cleaning by brushing and flossing daily and having your teeth cleaned in the dental office at least every six months. You need to also take care of any decayed teeth with fillings or crowns. Decayed areas trap more plaque and bacteria, causing more gum disease.

 Is deep cleaning painful?

Unlike a regular cleaning, we usually numb the teeth and gums so we can clean deeper into the gum pockets. With the numbing, the procedure is comfortable. After the treatment, you may have some slight discomfort that can be taken care of with over-the-counter pain medication.

 If I need deep cleaning and I don’t do it, what will happen?

 Gum disease progresses at a different speed in each person. Without a deep cleaning that will remove a lot of the deeper plaque and tartar, the gum pockets will get deeper, the tissues will get more infected, and the bone supporting the teeth will dissolve. For some, this worsening of the gum disease takes a few years. For others, it can take several years. 

What is a periodontal maintenance cleaning?

We recommend a periodontal maintenance cleaning for those patients who have trouble keeping their teeth and gums healthy. This treatment is a little more thorough than a regular cleaning. It is often recommended after root planing treatment. Patients may have this type of cleaning every 3-4 months instead of the 6 months for a regular cleaning.

What is gum tissue surgery?

This is where we make some corrections in the gum tissue surrounding the teeth in order to make the gums healthier. It may involve removing excess tissue, moving tissue around, or placing tissue grafts.

 When does a patient need gum tissue surgery?

Gum tissue surgery is indicated when: we want to prevent gum recession, we want to cover exposed tooth roots that are sensitive or unsightly, we need to uncover teeth that have not erupted fully, or we need to create a better and healthier band of gum tissue around the teeth.

How can I avoid needing gum tissue surgery?

It can be avoided with brushing and flossing well and having regular dental cleanings and exams.

Is gum tissue surgery painful?

There can be slight to moderate pain after the treatment. OTC pain medications should work adequately.

If I need gum tissue surgery and I don’t do it, what will happen?

Without gum tissue surgery, the teeth may be harder to clean or more gum recession may occur.

 Does all gum recession need to be covered with gum tissue surgery?

No. Exposed roots and gum recession can occur when the teeth are positioned a little too far to the cheek and lip sides of the arch of teeth. Having some exposed roots and gum recession can actually occur in a healthy mouth. The exposed roots may need to be covered if they are very sensitive or if the area does not look attractive.

 What is periodontal surgery?

This surgery involves numbing the gums and teeth well and flapping or moving the gum tissue back, so we can see the infected root surfaces and bone and treat them. With this access, the dental surgeon will clean the root surfaces well, remove infected tissue, recontour the supporting bone so it is healthier, and place bone grafts to fill in defects in the bone caused by the gum disease.

 When does a patient need periodontal surgery?

Periodontal surgery is used when the gum disease is severe and we are starting to see deep infected gum pockets and bone loss. It is used when the patient wants to save teeth that have too much tissue and bone loss around them. If a patient is unwilling to go through the procedure and cover the cost, or is not motivated to keep the teeth and gums clean after the treatment, periodontal surgery is not recommended.

How can I avoid needing periodontal surgery?

 It can be avoided with brushing and flossing well and having regular dental cleanings and exams. Good home care needs to be started early in one’s life to avoid severe problems caused by gum disease.

 Is periodontal surgery painful?

The gums and teeth are numbed will before starting the procedure. Afterwards, there may be some moderate to heavy pain. This treatment may require a pain prescription.

 If I need periodontal surgery and I don’t do it, what will happen?

Without needed periodontal surgery, the gum disease will get worse and teeth will become loose and fall out.

Are there times a patient needs periodontal surgery but does not “qualify” for the surgery?

Periodontal surgery is not recommended if a patient is unwilling to spend the time and money to do it, or if he/she is unwilling to do the necessary homecare and dental cleanings. A patient must be committed to making this treatment work or it will be a waste of time and money.

What can I do to prevent needing periodontal surgery?

Start with brushing and flossing early in your life. Have regular dental checkups and cleanings. If deep cleanings are recommended, have those done.

What is a periodontist?

A periodontist is a dental specialist who treats the gums and supporting structures around the teeth. He may be involved in your treatment if you need gum tissue surgery, periodontal surgery, or bone grafting.

I do not want to lose my teeth. What can I do to save my teeth?

Develop a good habit of daily brushing and flossing. Have yearly checkups by the dentist to see if there is tooth decay or gum disease. Don’t wait to treat these problems. We see everyday patients who say they want to keep their teeth but don’t brush and floss well or don’t take care of decayed teeth before they are beyond repair.

What are the options if I lose a tooth or multiple teeth?

If you lose a tooth, you have four options with the space created:

1. You can leave the space with no replacement.

2. You can place a dental bridge which is attached to the teeth on the sides of the space.

3. You can have a dental implant placed.

4. You can have a partial denture made to fill in the space with plastic teeth. See our comments in other areas of this website on dental crowns and bridges, dental implants, and dentures.

Where can I get my gums evaluated to see if I need gum treatment?

Give us a call for a full dental evaluation. We will look closely at the gums and teeth to see if treatment is needed. Our goal is to help you get your mouth healthy and maintain it healthy for life. It is never too late to get started.

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