This initial phase of treatment consist of 2-3 appointments of 1 to 1.5 hours each. The initial stage of treatment is usually a thorough cleaning that includes scaling and root planing (root detox) to remove plaque and tartar deposits on the root surface beneath the gumline. It may also involve analysis of the occlusion of teeth as well as slight bite adjustment.
The purpose of this initial phase of therapy is to decrease the numbers of bacteria and the amount of toxin present in the pockets around the teeth. In other words, this phase is designed to remove the infection. The clinical goals of this conservative therapy are improved tissue color, contour and consistency.
Failure to complete this phase of treatment will result in eventual tooth loss as well as the possibility of systemic infections. Slight gum recession as well as slight reduction in pocket depth can be expected as the tissue heals. This shrinkage may cause temporary root sensitivity, which can be alleviated with post treatment rinses and/or toothpastes.
Treatment consists of the use of local anesthetic to numb the teeth and gums and debridement of the root surfaces with ultrasonic as well as hand instruments. Irrigation of the pockets with antimicrobials (chemical agents) may be performed. With the area numb, there is no discomfort during the procedure. There is minimum, if any post–treatment discomfort. Generally, patients do well just taking over-the-counter ibuprofen or acetaminophen afterwards. On the day of the appointment, only light meals should be eaten and all prescribed medications should be taken. The patient should expect a numbness to last for about 2 hours after therapy. Work and exercise can resume on a normal schedule.
After 6-8 weeks of healing, the patient will return for a follow up appointment called a Periodontal Maintenance/Re-evaluation. This appointment will last about one hour. The patient’s periodontal health will be evaluated and the teeth will be professionally cleaned. If the patient still exhibits active disease or deep pockets, they will be instructed on proper home care techniques and evaluate for further treatment needs such as the Repair Phase.
The term scaling refers to the removal of plaque, calculus and stain from teeth.
The term root planing refers to the removal of root cementum and dentin that is rough, and /or permeated by calculus or contaminated with toxins or microorganisms. The root surface is smoothed during this process, thus allowing the gum tissue to heal and repair.
This is the term given to the appointment 6-8 weeks after the scaling and root planing segment of the Anti-infective Phase. This appointment will last approximately one hour and the periodontal health will be evaluated, proper home care techniques will be reviewed and the teeth will be professionally cleaned. Should the patient still exhibit active disease or deep pockets, we will evaluate for further treatment needs such as the Repair Phase.
Antibiotics and/or irrigation with anti-microbials (chemical agents) may be recommended to help control the growth of bacteria that create toxins and cause periodontitis.
When deep pockets between teeth and gums are present, it is difficult to thoroughly remove the plaque and tartar. Patients can seldom, if ever, keep these pockets clean and free of plaque on a daily basis.
Anti-infective treatments may need to be repeated from time to time on one or multiple teeth. However, chronic inflammation and infection must be resolved for the overall health of the patient. Consequently, the ‘advanced periodontal therapy’ of the Repair Phase may be needed to restore periodontal health in certain situations.