Periodontal disease, or bone loss, can be treated several ways but are broadly categorized into non-surgical therapy and surgical therapy. The recommendation of your periodontist treatment options will depend on a number of factors.

Non-Surgical Therapy

Most of the time non-surgical therapy is used as a first-line of treatment in order to potentially reduce the necessity for surgical treatment. The primary goal of either of these treatments is to remove the calcified bacteria from underneath the gums, as they act like a “splinter under your fingernail” and are a constant source of irritation.

Types of non-surgical therapy:

• Scaling & Root Planning (deep cleaning) – This is a necessity, even if patients will eventually need surgical therapy. It is absolutely necessary to remove the bacterial deposits (calculus or tartar) so that the irritation to your gums and bone loss does not persist. This will also allow the tissue to be as healthy as possible prior to completing any further surgical procedures.
• Local Antibiotics – Localized antibiotics, usually in the form of a chip or powder that is inserted into a periodontal pocket, are a form of “adjunctive” therapy. The antibiotics are used after deep cleanings to improve the results obtained or attempt to further treat pockets that did not respond to deep cleaning. These are NOT meant to be used without removing bacterial deposits (calculus or tartar). In fact, using them by themselves may “trap” the calculus on the root surface and result in an abscess, which is a highly active and painful type of infection that must be treated surgically.

Surgical Therapy

• Pocket Reduction – This procedure is meant to remove deposits from the roots of the teeth that cannot be reached through deep cleanings, remove unhealthy tissue, and recontour the bone to mimic “healthy” bone structure.
• Guided Tissue Regeneration – This procedure actually allows your body to build back support on teeth where it has been lost next to teeth in the past. It replaces bone and the supporting structures for teeth and can be helpful to gain lost support in isolated areas. Bone grafts and growth factors are commonly used to enhance the overall result.
• Biologic Root Reshaping – Root reshaping accomplishes several goals with one thing in mind: keeping your teeth. This procedure was developed to remove many of the physical causes of periodontitis – the little nooks and crannies in and around the roots of teeth. The result is a perfectly smooth tooth that you are able to keep clean at home.