Periodontal therapy treats the bone structures surrounding your teeth. To treat bone structures, we have to treat the gums that cover them. When gums are infected, nearby bone recedes, often permanently. Healthy gums mean healthy bones.

Most people don’t have healthy gums. To clean them up and preserve your underlying bone, there are both nonsurgical and surgical options.

Nonsurgical Options

• • Dental cleaning

Many problems in the guns start with a simple problem: calculus under the gums.

Calculus is petrified plaque. After it forms, it creates an inviting environment for more bacteria, causing constant irritation and common infections. Even worse, once it forms, it is too hard to be removed by a toothbrush.

The only way to get rid of it is to get a professional dental cleaning. Dental hygienists have special tools that use sonic vibration to clear calculus, leading to healthier gums.

• • Root planing

If gum disease progresses, gums may slightly detach from the teeth, creating a space for bacteria to grow. This can be fixed non-surgically by “planing” the roots of affected teeth.

Under a local anesthetic, the gum line is pulled back. Calculus is removed in a process called “scaling.” Then, bumps on the surface of the tooth root are smoothed and removed. This removes many places for bacteria to live. More importantly, it creates a smooth surface to which the gums can re-attach.

If the gums are too far gone, root planing will need to be combined with a surgical option.

Surgical Options

• • Gingivectomy

Gingivectomy is the removal of infected or loose gum tissue. After removing this tissue, gums stick closer to the teeth, thus preventing further infections. Gingivectomy is commonly performed with lasers to decrease scarring and the odds of complications.

• • Gum grafts

If gums are too far gone, removing additional gum tissue will expose the tooth roots. In severe cases, removed gum tissue will instead need to be replaced with healthy grafts. Graft tissue can be taken from the roof of the mouth.

• • Bone regeneration

If gum infections have compromised the bone structure, then the bone needs a break. With surgery, a mesh can be used to insulate the bone from the gum tissue. This allows the bone to regenerate by itself.

• • Bone grafts

If the bone is too far gone for regeneration, it can be replaced by grafts from donors, synthetic sources, or your own body. A bone graft is more invasive and complicated, and should be a last resort treatment.

Talk with your dentist about possible options for you. By acting early, you can often prevent periodontal problems without resorting to surgery.