Periodontal infection is typically a chronic infection that
works its way further into the gum and bone over a long period
of time. Because the bacteria are organized and different from
the normal bacteria in the mouth, and because the bacteria invade
the gum and affect the bone, many times conventional/routine
cleaning does not serve well to control the infection.
This infection
is typically without symptoms, such as pain. However, it can
give you signs of infection such as swollen gums, bleeding,
bad breath and looseness of teeth.
For mild
periodontal disease, Dr. Crump, utilizes a way to effectively
control periodontal infection and help patients heal in a
simple, less invasive and less expensive way. The technique
is simply called "Scaling and Root Planing". The
results of this technique have been shown to reduce "pockets"
and reduce bleeding.
The "Scaling" is typically done using local anesthesia,
with very small ultrasonically powered probes ("micro
ultrasonics"). This cleaning technique very thoroughly
cleans diseased roots and pockets with micro ultrasonic vibrations
of the instrument, as well as, with highly energized flushing
of water irrigation. (Patients who are anxious about treatment
can elect to be orally or intravenously sedated before the
local anesthesia and during the treatment.)
Because
there are specific bacteria that invade the gum tissue and
affect the bone, Dr. Crump has found that a course of a systemic
antibiotic helps to eliminate any bacteria residual to the
cleaning. The antibiotic used may vary based on patient tolerances
to different medications. When the infection is generalized
it is better to use systemic medications (oral pills). However,
when the infection is more localized, antibiotic gels may
be placed directly into the pocket to provide the disinfection.
These local antibiotics work in the gum for over a month as
they dissolve.
After
the initial procedure, patients typically have little or no
discomfort, and a reevaluation is performed after 6 weeks
to check the initial response to treatment. Subsequently,
patients are asked to have supportive periodontal treatments
at 3-4 month intervals for one year. These treatments are
micro ultrasonic cleanings (without anesthesia and without
antibiotics) and are performed to support healing by keeping
the teeth above and below the gumline as clean as possible.
Additionally, we help our patients with their effectiveness
in cleaning at home.
After
a year, selected x-rays are taken and a reevaluation of the
healing response is performed. At that point long term management
options are discussed. Sometimes, surgical treatment is recommended.
However, Dr. Crump estimates that, of the teeth that originally
have mild infection with pockets and bone loss, over 90% of
these teeth no longer require surgical treatment (this is
consistent with other published studies).
Periodontics
has made great strides in the surgical and non-surgical management
of periodontal problems. With this conservative technique,
Dr. Crump has been able to allow many patients to reach periodontal
health in a simple, effective, less invasive and more affordable
way.
If you
have any questions regarding this approach, please do not
hesitate to contact us.
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