Gum disease is an infection of specific bacteria living in dental plaque or biofilm that migrates below the gumline, and infects and destroys the supporting tooth structures. This infection can cause inflammation, redness, irritation, bleeding, bad breath, bone loss and eventually, tooth loss. Unfortunately, these issues can be painless and lead people to not realize they need treatment until it’s too late.
Factors that can cause gum disease are:
- Oral care
Appropriate treatment for gum disease may include a full mouth debridement (FMD), scaling and root planing (SRP), localized antibiotic therapy and more frequent cleanings known as periodontal maintenance (PMR).
An FMD removes heavy calculus/tarter deposits. We use this appointment to evaluate the need for further treatment or as a precursor to scaling and root planing. Sensitivity may occur after this procedure, as tooth surfaces that were covered by debris or buildup are now exposed. Insurance usually covers 50 to 80% of this procedure.
SRP is deep instrumentation that removes bacteria on root surfaces, calculus or tarter deposits, and contamination below the gumline in the periodontal pockets. This procedure is usually done by quadrant—in other words, a quarter of the mouth at a time—under local anesthetic, which may require multiple visits. However, sometimes it can be done in one long appointment, if desired. Sensitivity may occur after this procedure, as tooth surfaces that were covered by debris or buildup are now exposed. Ibuprofen should take care of this discomfort. If you need a stronger pain reliever, contact us to determine if another issue is causing your discomfort. For a rinse, we usually recommend warm salt water vs. alcohol rinses. To further reduce post-operative discomfort, be careful when brushing and flossing for two to three days after your treatment. Insurance typically covers 50 to 80% of this procedure.
PMR is maintenance cleaning for patients who have gum disease and always follows scaling and root planing. We usually perform PMR every three to four months after root planing. Why three months? The bacteria that cause inflammation and periodontal disease must be removed at this frequency to control the disease process, as it continually re-establishes itself. PMR involves a re-evaluation of periodontal pocketing, bleeding, mobility, furcation and recession, and includes deep instrumentation to remove any newly formed calculus and debris. Based on your comfort level, we may use local anesthetic. If your periodontal condition stabilizes, we may only perform PMR every four months. Insurance typically covers 80 to 100% of this procedure, twice a year.
An adult prophy is a regular cleaning for gums that are usually healthy and a preventative procedure that includes scaling and teeth polishing to remove plaque and stain above the gumline. It’s usually performed every six months. This procedure isn’t done when periodontal disease is present. Insurance typically covers 100% of this procedure, under preventative care.