Periodontal (tissue and bone around the tooth) Therapy is also known as Gum Therapy

During your exam in our office, we probe your tissue between the gum and tooth - this "pocket" of tissue is measured (depth) and its characteristics are noted (bleeding, recession, firm, swollen, pus/exudate).  These findings can objectively tell us the Tissue Type that you present.

• Type 0 - perfect healthy tissue/bone
• Type 1 - gingivitis; bleeding on probing; no involvement with bone; reversible
• Type 2 - early periodontitis; same as Type1 but more advanced due to some bone loss (1-2mm bone loss)
• Type 3 - moderate periodontitis - same as Type 2 but more bone loss (3-5mm bone loss)
• Type 4 - same as Type 3 but advanced bone loss showing some mobility of teeth (5+mm bone loss)

 Tissue type 1,2,3,4 requires specific treatment for each type

• Type 1 - better home care (flossing/brushing) and perhaps deep scale if home care alone does not remove gum infection
• Type 2 - better home care plus deep scaling perhaps in limited areas; deep scaling sometimes requires local anesthesia
• Type 3 - better home care and deep scaling for entire mouth; also local anesthesia can be used; may need specialty care (periodontist) if deep scaling does not eradicate infection
• Type 4 - usually this disease has been present for a long time, so a specialist is the best care but the patient can opt for deep scaling in our office on a more frequent basis to slow the progression of the infection.

Our STM (soft tissue management) is the procedure name for deep scaling root planing - usually with local anesthesia (novocaine).  This allows the hygienist to get deep under the gum tissue to remove calculus (tartar) and bacteria that is causing the gum infection and bone loss. Type 1,2,3, and 4 are indications of the need for STM.  We develop a treatment plan to help you understand the treatment and where the sites of infection are most advanced.

We also use an antibiotic paste under the gum tissue - Arestin.  We use Arestin in deep pockets that have infection and hope after 3 treatments, once every 3 months, that the bone will be replaced and the gum tissue healthy. There is no guarantee this antibiotic will "cure" the area but it is a non-surgical approach that might work.  This is the protocal for this paste to be effective:

• deep scaling with root planing in area where paste is indicated 
• placement of paste in pocket
• no brushing in site for 24hrs; no flossing for 10 days
• only soft foods to be eaten in this area for 7 days

We can also use an anti-bacterial rinse (Peridex) that can help decrease the bacterial numbers - used after a surgical treatment or used in Type 1 gingivitis