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What is the treatment for mild periodontal disease?

Jonathan B. Levine, DMD
Prosthodontics
A treatment called Phase One Perio, also known as Soft Tissue Management can be effective in stopping bone destruction related to milder periodontal disease.

Phase One Perio or Soft Tissue Management involves a lot of scraping, digging and smoothing in the diseased gum area. Called scaling and root planning, it's a non-surgical treatment that involves removing the offending substance above and below the gum.
  • Scaling removes the deposits of tartar above and below the gum. A scaler looks like a pen with a curved end, making it easier for the dentist to get into the hard-to-reach spots, like the pockets.  Scaling also removes any diseased bacteria (called bacterial endotoxins) that may have gotten under the gum and stuck on to the root surfaces. After scaling, most hygienists go over the area over again with an ultrasonic vibrating tool, which acts like a mini sand blaster that literally blasts the more accessible hardened deposits off the teeth. 
  • Root planing goes after the bacterial endotoxins under the gum, and removes any diseased cementum (that cell layer covering the outside of the root that keeps the tooth attached) that might be there as well. Root planing smoothes the area the same way a carpenter buffs away roughness in a piece of wood.
If the gum tissue is also inflamed, the hygienist or dentist will also do something called curettage. Curettage removes the inner lining of the inflamed tissue, which then allows the new tissue to heal against the newly cleaned, "buffed" root surface.

Before he sends you home to care for your tender healing gums, your dentist may also insert a chemotherapeutic agent into the area, either in a chip that he'll stick under your gum flap or a gel, called Arrestin, which he'll insert with a syringe. They usually contain an antibiotic, like doxycycline or minocycline, which kills any remaining bacteria, speeds healing time and helps the pocket shrink faster. They're time-released and continue to work for about ten days. Many dentists also like to give patients an anti-bacterial rinse, called Peridex (lab name: chlorhexidine gluconate). Peridex stains teeth, so you need to over-compensate with an at-home stain removing, whitening product during the entire time that you use it.
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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.