Nonsurgical vs. surgical treatments for gum disease: What are my options?
Whether you need surgical or nonsurgical gum disease treatment depends on several factors, including:
- The stage of gum disease.
- Your existing oral health.
- Your existing overall health.
- Your ability to follow post-treatment oral hygiene instructions.
There are a number of nonsurgical and surgical gum disease treatment options available. In addition, many periodontists offer sedation dentistry to keep you comfortable during your treatment. To learn more, talk to a healthcare provider.
Nonsurgical gum disease treatments
People with early-stage gum disease — such as gingivitis or mild periodontitis — can benefit from nonsurgical therapies. Nonsurgical treatments for gum disease include:
Dental prophylaxis
Dental prophylaxis is a routine dental cleaning — like the one that many people have with their hygienist twice a year. During this procedure, a provider removes plaque and tartar from your teeth surfaces.
People who have gingivitis (the first stage of gum disease) can often reverse it with professional dental cleanings and improved oral hygiene at home. Depending on your specific situation, you might need more frequent cleanings with your dentist or hygienist to keep harmful bacteria at bay.
Scaling and root planing
Scaling and root planing — a deep dental cleaning — reaches deep beneath your gum line to remove plaque and tartar on your root surfaces. In addition to thoroughly cleaning your teeth, your periodontist or dental hygienist will smooth away any rough spots on your teeth roots. This helps prevent bacteria and plaque from reattaching. Your periodontist will give you local anesthesia to numb your gums and keep you comfortable during this procedure.
Antibiotic therapy
Your periodontist may use antibiotics — either as a stand-alone treatment or in combination with other procedures. Common antibiotics used in the treatment of gum disease include products like minocycline HCl (Arestin®) or chlorhexidine (PerioChip®). Your periodontist can place these medications in the space between your gums and teeth (the periodontal pocket).
Laser periodontal therapy
During this procedure, your periodontist uses a tiny laser to remove diseased tissue and kill bacteria under your gums. In some cases, providers recommend laser therapy as an alternative to traditional gum surgery. Unlike traditional gum surgery, laser therapy doesn’t require incisions or sutures.
Surgical gum disease treatments
People with moderate to advanced periodontal disease usually require surgical intervention. Surgical treatments for gum disease include:
Pocket reduction surgery (flap surgery)
During this procedure, your periodontist will create incisions along your gum line, then temporarily move your gums away from your teeth. This allows them to see the roots underneath. Next, they’ll remove the tartar buildup and clean your root surfaces. In some instances, they may smooth and reshape areas of damaged bone, making it harder for bacteria to hide and grow. Finally, they’ll reposition your gums and suture them into place.
Bone grafting
A dental bone graft uses your own bone, donated bone or synthetic bone to rebuild areas that have been damaged by gum disease. The graft serves as a type of scaffolding that holds space until your body can regenerate new bone. Periodontists often perform bone grafting in combination with pocket reduction surgery.
Gum grafting
A gum graft uses your own tissue, donated tissue or synthetic tissue to treat gum recession (when your gums pull away from your teeth). Gum recession is a common symptom of periodontal disease.
During gum grafting surgery, your periodontist places the tissue graft in areas where your gums have receded and sutures (stitches) it into place. If they use your own tissue, they’ll take the graft from the roof of your mouth.
Guided tissue regeneration
Periodontal disease can cause gaps that form between your tooth root and bone. During guided tissue regeneration, your periodontist places a membrane in the damaged area to keep your gum tissue from growing where bone should be. This gives your body time to regenerate bone around your tooth. In many cases, periodontists place a bone graft during the same procedure to help this process.
