Gum disease is common and often minor, but in its advanced stages it can cause serious damage to the gums and bones that support the teeth, according to the National Institute of Dental and Craniofacial Research, or NIDCR. Sometimes it causes the loss of teeth. Common bacteria that live in the mouth can infect the gums if the teeth and gums are not properly cared for. In advanced disease this infection causes the gums to pull away from the teeth and form pockets that become infected. There are several treatment options depending on the severity of the disease.
Scaling and Root Planing
This is a deep cleaning that removes plaque, a buildup of the bacteria that causes gum disease, according to the NIDCR. In scaling, a dentist scrapes the plaque buildup off the teeth both above and below the gum line. In root planing, the rough spots on the root of the tooth where bacteria can build up are filed smooth. Root planing also removes any collected bacteria in those rough spots. Side effects include bleeding, swelling and pain. Sometimes a laser is used to accomplish this and early research suggests that laser procedures are more effective than conventional methods and cause fewer side effects, according to the American Academy of Periodontology.
Drugs
Medications can be used in combination with scaling and root planing in hopes of preventing the need for surgery, according to the NIDCR. However, as of 2010 there is no strong research proof that this works. These drugs include an antibacterial mouthwash containing the drug chlorhexidine that is used like a conventional mouthwash. Chlorhexidine or other antibiotics can also be inserted into the gums during root planing so the medicine is slowly released over time. Sometimes doctors prescribe oral antibiotics or a drug called doxycycline that suppresses certain naturally occurring enzymes that can break down gum tissue.
Surgery
If less invasive treatments don't work, surgery may be needed, according to the NIDCR. In flap surgery, the gums are lifted off the teeth so that the buildup of bacteria can be thoroughly cleaned. Then the gums are stitched back in place so that they fit tightly over the teeth. The gums will shrink as they heal, snugly covering the teeth. But sometimes the teeth appear longer after this procedure. Sometimes bone and tissue grafts are needed to replace bone or gum that has been destroyed by advanced gum disease.
