Scaling and Root Planing
We remove the plaque through a deep-cleaning method called scaling and root planing. Scaling means scraping off the tartar from above and below the gum line. Root planing gets rid of rough spots on the tooth root where the germs gather, and helps remove the bacteria that contribute to the disease.
Medications may be used with treatment that includes scaling and root planing, but they cannot always take the place of surgery. Depending upon the severity of gum disease, we may still suggest surgical treatment. Long-term studies will be needed to determine whether using medications will reduce the need for surgery and whether they will be effective over a long period of time. Here are some medications that are currently used:
|Medication||What is it?||Why is it used?||How is it used?|
|Prescription antimicrobial mouthrinse||A prescription mouthrinse containing an antimicrobial agent called chlorhexidine||To control bacteria when treating gingivitis and after gum surgery||Used like a regular mouthwash|
|Antiseptic “chip”||A tiny piece of gelatin filled with the medicine chlorhexidine||To control bacteria and reduce the size of periodontal pockets||After root planing, it’s placed in the pockets where the medicine is slowly released over time.|
|Antibiotic gel||A gel that contains the antibiotic doxycycline||To control bacteria and reduce the size of periodontal pockets||Placed in the pockets after scaling and root planing, the antibiotic is released slowly over a period of about seven days.|
|Antibiotic microspheres||Tiny, round particles that contain the antibiotic minocycline||To control bacteria and reduce the size of periodontal pockets||Micro-spheres placed into the
pockets after scaling and root planing, the particles release
minocycline slowly over time.
|Enzyme suppressant||A low dose of the medication doxycycline that keeps destructive enzymes in check||To hold back the body’s enzyme response — If not controlled, certain enzymes can break down gum tissue||This medication is in pill form. It is used in combination with scaling and root planing.|