Gum treatment procedures, also referred to as periodontal therapy, are performed to manage gum disease (gingivitis or periodontitis), improve oral health, and prevent further damage to the periodontal structures. Here's a detailed guide tailored for dentists:
Step 1: Clinical Assessment
Gingival Examination:
Assess for signs of inflammation (redness, swelling, bleeding on probing). Evaluate gum recession and pocket depths using a periodontal probe.
Oral Hygiene Evaluation:
Check for plaque and calculus buildup. Assess the patient’s oral hygiene practices.
Step 2: Diagnostic Imaging
Use X-rays to evaluate bone levels and detect signs of bone loss. Identify contributing factors like overhanging restorations or subgingival calculus.
Step 3: Diagnosis and Classification
Classify the condition based on:
Gingivitis: Inflammation without bone loss.
Periodontitis:
Inflammation with attachment loss and bone destruction.
Step 1: Oral Hygiene Instruction
Educate the patient on proper brushing and flossing techniques. Recommend adjunctive tools such as interdental brushes or water flossers.
Step 2: Scaling and Root Planing (SRP)
Scaling:
Remove plaque and calculus above and below the gumline using ultrasonic or hand instruments.
Root Planing:
Smooth the root surfaces to discourage further plaque accumulation and promote healing.
Procedure:
Use local anesthesia for patient comfort in cases of moderate-to-severe periodontitis. Divide treatment into quadrants or sextants, depending on severity.
Step 3: Antibacterial Therapy
Use adjunctive therapies like:
Localized Antimicrobial Agents:
Chlorhexidine gel or doxycycline applied into periodontal pockets.
Systemic Antibiotics:
Prescribe for severe cases or those involving systemic conditions.
If non-surgical methods are insufficient, proceed to surgical interventions:
Step 1: Gingival Flap Surgery
Perform a flap surgery to access and clean deeper areas of periodontal pockets. Reshape bone if necessary (osseous surgery).
Step 2: Guided Tissue Regeneration (GTR)
Place membranes, graft materials, or biologic agents to regenerate lost periodontal structures.
Step 3: Soft Tissue Grafts
Address gum recession by grafting tissue from the palate or using allografts.
Provide detailed post-operative instructions, including:
Pain Management:
NSAIDs or analgesics for discomfort.
Antiseptic Rinse:
Chlorhexidine mouthwash to control bacteria.
Dietary Advice:
Soft diet for a few days post-treatment. Schedule follow-up visits to monitor healing.
Regular Cleanings:
Establish a periodontal maintenance schedule (e.g., every 3–4 months).
Ongoing Monitoring:
Reevaluate pocket depths, gum health, and bone levels. Address any recurrence of inflammation or disease progression promptly.
Laser Therapy:
Use lasers to remove diseased tissue and promote healing.
Host Modulation Therapy:
Prescribe medications like subantimicrobial dose doxycycline to modulate the inflammatory response.
