Non Surgical Treatment
Scaling & Root Planing in Manhattan and the Entire NYC Area
The initial stage of treatment for periodontal disease is usually a thorough cleaning that may include scaling or root planing. The objective of these non-surgical procedures is to remove etiologic agents such as dental plaque and tartar, or calculus, which cause gingival inflammation and disease. Scaling and root planing can be used as a stand-alone treatment, or a preventative measure. They are commonly preformed on cases of gingivitis and moderate to severe periodontal disease.
What do the procedures entail?
Dr. Scott H. Froum will only perform scaling and root planing after a thorough examination of the mouth, which may include taking x-rays and visually examining the mouth. Depending on the condition of the gums, the amount of tartar present, the depth of the pockets, and the progression of periodontitis, Dr. Scott H. Froum may recommend scaling and root planing. In some cases, a local anesthesia may be used during the procedure.
When scaling is performed, calculus and plaque that attaches to the tooth surfaces is removed. The process especially targets the area below the gum line, along the root. Scaling is performed with a special dental tool called an ultrasonic scaling tool. The scaling tool usually includes an irrigation process that can be used to deliver an antimicrobial agent below the gums to help reduce oral bacteria.
- Root Planing:
Root planing is performed in order to remove cementum and surface dentin that is embedded with unwanted microorganisms, toxins and tartar. The root of the tooth is literally smoothed, which promotes healing, and also helps prevent bacteria from easily colonizing in the future.
Antibiotics or irrigation with anti-microbial (chemical agents or mouth rinses) may be recommended to help control the growth of bacteria that create toxins and cause periodontitis. In some cases, Dr. Scott H. Froum may place antibiotic fibers in the periodontal pockets or prescribe Perio Trays® to deliver medication in the pockets after scaling and planing. This may be done to control infection and to encourage normal healing.
When deep pockets between teeth and gums are present, it is difficult for Dr. Scott H. Froum to thoroughly remove plaque and tartar. Patients can seldom, if ever, keep these pockets clean and free of plaque. Consequently, surgery may be needed to restore periodontal health.
Benefits of Treatment
If treatment is successful, scaling and planing may have many periodontal benefits. One is that it can help prevent disease. Research has proven that bacteria from periodontal infections can travel through the blood stream and affect other areas of the body, sometimes causing heart and respiratory diseases. Scaling and root planing remove bacteria that cause these conditions.
Another benefit of treatment is protecting teeth against tooth loss. When gum pockets exceed 3mm in depth, the risk for periodontal disease increases. As pockets deepen, more bacteria are able to colonize, eventually causing a chronic inflammatory response by the body to destroy gingival and bone tissue. This leads to tooth loss.
Finally, scaling and root planing may make the mouth more aesthetically pleasing, and should reduce bad breath caused from food particles and bacteria in the oral cavity. Superficial stains on the teeth will be removed during scaling and planing, adding an extra bonus to the procedures.
ARESTIN® is a new treatment that is effective against common bacteria that cause periodontitis. If you have periodontitis (gum disease), you may benefit from Arestin (minocycline hydrochloride microspheres, 1 gm.) in a local delivery system for controlled release in subgingival application that is being used by Dr. Scott H. Froum and his staff.
ARESTIN® is placed between your gum and the tooth in the pocket areas. It is used locally and provides a concentrated dose of antibiotic in the area of gum disease without the side effects associated with systemic (taking pills or injection) antibiotic use. The antibiotic is time released into your pocket over a 7-10 day period.
In clinical trials, ARESTIN® was generally well-tolerated. It was effective in reducing pocket depth and gingival (gum) bleeding and increasing gum attachment to the tooth. Side effects were: headache, common cold, gum discomfort, pain or soreness, toothache, and tooth sensitivity. ARESTIN® should not be used by patients who are hypersensitive to minocycline or any other drugs in the tetracycline class. The use of drugs in the tetracycline class during tooth development may cause permanent discoloration of the teeth. (This is in young children and pregnant women)
Tetracycline drugs, therefore, should not be used in pregnant women, unless other drugs are not likely to be effective or are contraindicated. However, tetracycline class antibiotic are very safe and have been used for years by dentists and physicians. Is has also been used for long term treatment of acne.
- No special preparation is necessary )except if you normally premedicate for your maintenance visits)
- Avoid aspirin, aspiring products, vitamin E for 7 days prior to your dental appointment.
- ARESTIN® is syringed into the gum space (pocket) in 1 visit. The site may or may not be covered with a dressing for 7 to 1- days. Dr. Scott H. Froum will determine the need for a dressing.
- Following your appointment, you can eat normally as soon as the numbness disappears. Avoid foods that are hard, hot, spicy, salty, popcorn, peanuts, seeds, rice, crusty bread, pretzels, and any food that will get caught between the treated teeth.
- Brush the rest of your teeth as usual. Do not brush the teeth treated with ARESTIN® for 12 hours. Do not floss or use toothpicks or other devices on the teeth treated with ARESTIN® for 10 days following treatment. To keep the area clean, rinse 4 to 5 times a day (1/2 teaspoon of Epsom salt in 8 ounces warm water).
- Return in 7 to 10 days to check the area and remove the dressing (if one is placed). If the dressing falls off, don’t be concerned, but still come back in 7 to 10 days for examination.
- It takes at least 4-6 weeks for maximum effect of the cleaning plus ARESTIN®. At that time, Dr. Scott H. Froum will re-evaluate the improvement.