The initial stage of treatment is usually a thorough cleaning that may include scaling to remove plaque and tartar deposits beneath the gum line. The tooth roots may also be planed to smooth the root surface allowing the gum tissue to heal and re-attach to the tooth. Scaling consists of carefully placing a fine delicate instrument in between the tooth and gum tissue to remove plaque and calculus that is below the gum line and to smooth the root. Additionally, a fine ultrasonic tip may be used. Scaling and Root Planing is performed comfortably using topical anesthetics and local anesthesia to numb the gum tissue.
Antibiotics or irrigation with antimicrobials (chemical agents or mouth rinses) may be recommended to help control the growth of bacteria that create toxins and cause Periodontitis. In some cases, antibiotic micro pellets may be placed in the periodontal pockets after scaling and root planning. This may be done to control infection and to encourage normal healing.
When deep pockets between teeth and gums are present, it is difficult for us to thoroughly remove plaque and tartar. Patients can seldom, if ever, keep these pockets clean and free of plaque. Consequently, surgery may be needed to restore periodontal health.