From the Guidelines
The treatment for periodontal disease involves both professional dental care and improved home oral hygiene, with a focus on controlling infection, reducing inflammation, and preventing further damage, as supported by the most recent and highest quality study 1.
Key Components of Treatment
- Professional dental cleaning, including scaling and root planing, to remove plaque and tartar from above and below the gumline, smoothing rough spots on tooth roots where bacteria accumulate.
- For more advanced cases, dentists may prescribe antibiotics such as doxycycline or metronidazole, or topical antibiotics like minocycline microspheres placed directly into periodontal pockets.
- Chlorhexidine gluconate (0.12%) mouth rinse may be recommended twice daily to reduce bacteria.
Home Oral Hygiene
- Brushing twice daily with fluoride toothpaste using a soft-bristled brush.
- Flossing daily to remove plaque and food particles from between teeth and under the gumline.
- Using an antimicrobial mouth rinse to reduce bacteria and prevent infection.
Maintenance and Lifestyle Changes
- Regular dental check-ups every 3-4 months are essential for maintenance and to monitor the progression of the disease.
- Lifestyle changes, including smoking cessation and managing diabetes, can significantly improve treatment outcomes, as periodontal disease is associated with systemic diseases, including diabetes, cardiovascular disease, and Alzheimer's disease 1.
Additional Considerations
- The use of natural products, such as green tea, has been shown to have antibacterial and anti-inflammatory properties, and may be a useful adjunct to traditional treatment 1.
- However, the evidence for the use of natural products is not as strong as that for traditional treatment, and more research is needed to fully understand their potential benefits and risks.
From the Research
Treatment Options for Gum Disease
The treatment for periodontal (gum) disease typically involves a combination of non-surgical and surgical procedures. Some of the key treatment options include:
- Initial non-surgical periodontal therapy, which primarily consists of home care review and scaling and root planing 2
- Scaling and root planing (SRP) to remove subgingival calculus and biofilm deposits and create a biologically compatible root surface 3
- Systemic antimicrobial therapy in combination with SRP to improve clinical outcomes in certain cases 4
- Regenerative or traditional resective surgical therapy for residual sites with active periodontitis 2
- Periodontal maintenance therapy at regular intervals and long-term follow-ups to ensure the success of the treatment and long-term retention of teeth 2
Nonsurgical Treatment
Nonsurgical treatment of chronic periodontitis by means of scaling and root planing (SRP) with or without adjuncts is a common approach. The American Dental Association recommends SRP as the initial nonsurgical treatment for chronic periodontitis, with a moderate benefit and benefits outweighing potential adverse effects 5. Systemic subantimicrobial-dose doxycycline and systemic antimicrobials may be used as adjunctive therapies to SRP, but their use should be weighed against potential adverse effects 5, 4.
Surgical Treatment
Surgical intervention may be necessary for sites with persistent nonresponding probing depths and signs of inflammation following a definitive SRP 3. Regenerative or traditional resective surgical therapy can be utilized to treat these sites, and periodontal maintenance therapy is crucial to the success of the treatment and long-term retention of teeth 2.
Antibiotic Resistance
The use of antibiotics in periodontal therapy can contribute to the development of antibiotic resistance. A study found that periodontitis and SRP treatment resulted in an increase in the number of antibiotic-resistant genes (ARGs) and metal-resistant genes (MRGs) in dental plaque 6. This highlights the need for careful consideration of antibiotic use in periodontal therapy and the development of new antimicrobial strategies to control and treat periodontal disease.