How to Treat Gum Disease: Surgery, Antibiotics, Antimicrobials

17 January, 2020

Do you bleed a little when you brush your teeth, or is there any blood stuck to your gums during a floss? Gum bleeding might be a sign that you are currently suffering from gingivitis or gum disease.

In the early stage of gum disease, or sometimes called periodontal disease, bacteria in plaque can build up and inflame the gums. As a result, the gums are irritated, become more tender, and can easily bleed.

When left untreated, however, the bacterial infection can travel through your gum line and reach your jaw bone, causing a more serious form of periodontal disease called periodontitis or gum infections.

Both gingivitis and periodontitis are not only affecting your oral health, from tooth loss to bad breath, but also can raise risks to diseases like heart conditions, diabetes, pneumonia, and even cancer.

Treatment Options for Gum Disease

Above, we have discussed how early treatment for gum disease is very important.

During the early stage of gingivitis, the tooth is still firmly planted, and there is no permanent bone or tissue damages at this stage. In short, the condition is mostly reversible.

On the other hand, periodontitis can cause irreversible, permanent bone damages and tooth loss. Early treatment so that gingivitis doesn’t develop into periodontitis is very important.

There are plenty of treatment options for gum disease, both surgical and non-surgical. The treatment of choice might depend on the stage of the disease, your overall health, allergies, and how you responded to earlier treatments.

Non-Surgical Gum Disease Treatment Options

Here are possible treatments for gum disease that don’t involve a surgical procedure:

  1. Professional cleaning

One of the major causes of gum disease is plaque buildup. Regular brushing and flossing won’t cover all the areas inside your mouth, for example, areas between your teeth and behind your gum line. This is where professional dental cleaning is necessary.

During a regular visit to the dentist, the dental specialist will remove plaque and tartar (the hardened plaque that is accumulated on the tooth surface) from the surface of the teeth and below the gumline. Also, we can only remove tartar with a professional dental cleaning.

It is worth noting that dental cleaning alone won’t be effective to treat gum disease when it is already ‘active’, for example when the gum line has significantly receded. It is, however, an important procedure to prevent gum disease and also to slow down its progress.

  1. Deep cleaning: dental scaling and root planing

Deep cleaning is the most common non-surgical treatment to treat active gum disease and is mainly performed when your dentist determines that you have plaque and tartar under the gums, that need to be cleaned. Deep cleaning nowadays can be performed with two types of cleaning instruments:

  • Hand-held instruments: the dental specialist will use a thin tool called dental scaler and curette to manually ‘scale’ the plaque from the surface of your teeth, and also below the gum line and on your tooth’s root surface (root planing).
  • Ultrasonic instruments: these modern instruments clean plaque and tartar from the teeth’s surface and under the gums with a vibrating metal tip that ‘peels’ off the tartar, and can also spray water to rinse the plaque-tartar away while keeping the tip cool.

During the deep cleaning process, the dentist will apply local anesthetics to numb the gum and tooth’s root, so you will only feel slight pressure and discomfort during the scaling and root planing processes.

The deep cleaning process can effectively remove bacteria and provide a smooth, clean surface for the gums to reattach the teeth.

Drugs To Treat Gum Disease: Antibiotics and Antimicrobials

Antibiotic and antimicrobial treatment might be used as a non-surgical treatment for gum disease, either as a standalone treatment or in combination with professional cleaning procedure as discussed above.

Drug treatment might also be used in combination with surgery, as well as other therapies, and the main purpose of this treatment is to eliminate temporarily (and possibly, permanently) the bacteria that is associated with gum disease, while at the same time suppressing the destruction of the bone and gum-tooth attachment due to bacterial infections.

  • Doxycycline, minocycline (Aerestin), and tetracycline are common antibiotics used to treat gum disease
  • For antimicrobial, Chlorhexidine is the main choice and is commonly marketed as PerioChip, PerioGard, and other brands.

These medications can come in the form of a gelatin-filled chip that is placed in the gums’ pockets after scaling and root planing, often for as long as a week. They might also be able as a mouth rinse or usual oral medication (tablets).

Some kinds of toothpaste might also offer antibacterial features by including triclosan (an antibiotic) and fluoride.

Surgical Gum Disease Treatment Options

If the gum disease is determined as severe or has developed into periodontitis or other complications, surgical treatments might be applied, such as:

  • Bone Graft

This procedure is performed when gum infections have destroyed a significant portion of the jawbone, and so bone reconstruction is necessary.

Bone grafts involve using fragments of a healthy bone to replace the damaged bone and promoting healthy regeneration of the jawbone. The ‘graft’ can used a portion of your healthy bone, donated bone, and even manufactured, artificial/synthetic bone.

The bone graft mainly serves as a new foundation or platform to regrow the bone, mainly to maintain stability for the teeth and promote reattachment. Also, newer tissue engineering technologies can encourage bone and tissue regeneration at a much faster rate than ever before.

  • Tissue Graft

This procedure involves grafting thin tissue, that is stitched in place, in areas where gums have receded due to infections. The grafted tissue is usually taken from the roof of the mouth.

  • Guided Tissue Regeneration

A fairly new procedure involving new medical technology, applied when the jawbone supporting the tooth’s root has been completely destroyed by bacterial infections.

This procedure is mainly implemented to stimulate bone and gum tissue to regrow. Performed by performing a flap surgery to open the gums, and insert a mesh-like fabric between the gum tissue and bone. This material directs (or ‘guides’) the gum tissue to grow to the desired area. When the bone is severely destroyed, gum tissue tends to grow into the area where the bone should be, complicating the damage. This way, the bone, and surrounding tissue can regrow properly to support the tooth.

  • Pocket Reduction Surgery

In this surgical procedure, the gums are lifted back to expose the pocket. This is why the procedure is also often called ‘Flap surgery’. The opened, ‘flapped’ gums provide the dentist with more access to remove plaque and tartar from the periodontal pockets created by the gum disease.

Depending on the case, the damaged bone’s surface might be smoothed during the process. The gums are then placed so the gum tissue can fit perfectly to surround the tooth, reducing the pocket between the tooth and gum, and effectively decreasing the area where harmful bacteria can grow and limit areas where disease-causing bacteria can grow, effectively decreasing the risks of bacterial infections.

  • Bone Surgery

Performed in a combination with flap surgery. Flap surgery is performed to open the gums, and the bone around the tooth is reshaped and re-smoothed to eliminate the damaged areas and craters that are created due to bone loss. These damaged areas can be a place where bacterias collect and grow, further causing infections.

End Words

In most cases, your dental or periodontal specialist can perform most of the treatment procedures discussed above—including surgical ones— in their office. Different procedures might require different time required to perform it, and the time of recovery will also vary between different procedures and from patient to patient.

In general, however, local anesthesia will be implemented when required, so you won’t feel any pain during the treatment, just pressure and slight discomfort.

Contact dentists at Markham Smile Centre if you suspect yourself of suffering from gum diseases, our team of professional dentists will help determine the best course of actions to treat your disease according to your needs and financial comfort.