Periodontal Treatment and Maintenance

Scaling and Root Planning (deep cleanings)

Periodontal disease is bone loss and attachment loss around teeth. It progresses as the bacteria, plaque, and tartar build up and cause bone to recede. If these irritants are not removed they can cause damage to the gums and eventually the bone that supports the teeth. In the early stages (gingivitis), no permanent damage is done and one or two cleanings will be recommended to control it. However, if you have bone loss, scaling and root planning will be recommended, which is a deeper cleaning of the teeth and roots. One or two quadrants (upper right and lower right side) of the mouth are treated at a time. The tartar, plaque, and toxins are removed from above and below the gum line (scaling) and rough spots on root surfaces are made smooth (planning). Special medicated mouth rinses, special toothpaste, and an electric tooth brush may be recommended to help control infection and healing. Periodontal surgery may be recommended if your bone loss is sever or does not respond to conventional therapy. We will refer you to a periodontist (specialist).


Once your periodontal treatment has been completed, we recommend that you have regular maintenance cleanings, usually 3-4 times a year. During these appointments, your bone loss will be checked to ensure that your periodontal disease is not worsening. Plaque and calculus will be removed, and your teeth will be polished. A thorough exam will be done to check existing fillings and crowns to make sure new decay is not present, oral hygiene recommendations will be made, and x-rays will be taken, if needed. Our goal is to help you keep the periodontal disease under control by encouraging good oral hygiene practices and having you come in for your periodontal maintenance cleanings. The success of your maintenance treatment depends on you. Brushing and flossing daily as well as using any other cleaning brushes that have been given to you by our office, is very important.

Arestin placement (subgingival antibiotic therapy)

There are times when scaling and root planning will not be enough to treat your periodontal disease. Arestin, an antibiotic in powder form, will be recommended in some cases to help in fighting this disease. It is placed directly into the infected areas by your dentist. It is made up of 100,000 tiny microspheres containing the drug minocycline, which release slowly over time into the infected area. Arestin keeps working long after you have left the dental office. After this antibiotic has been placed, you will be asked to refrain from brushing the area for 24 hours and flossing for a few days. This time period could change depending on the doctor’s recommendation.