Dr. Robert L. Mandell

Four states of periodontal disease treatment

Stage one

The first stage of periodontal therapy begins with a thorough exam and consultation. Our oral surgeon gum specialist will explain the nature of gum disease and how it is normally treated. He takes a full-mouth series of dental X-rays to help in the diagnosis. He performs a detailed mapping of the gum pockets and a bite study to collect the necessary information for an accurate diagnosis. He presents a treatment plan and makes alternative recommendations so you understand your overall prognosis for your teeth and gums.

Stage two

Stage two is called initial periodontal therapy. During this time, you’ll learn various techniques for cleaning gum pockets and undergo a deep cleaning below the gum line. This scaling and curettage removes calculus, or tartar, from your teeth and gums as well as inflamed gum tissue or pocket lining. The healthy gums then shrink and reattach to your teeth within a very short time. Our periodontist re-evaluates or re-probes your gum pockets to evaluate the amount of healing achieved. He might perform a bite adjustment to eliminate excessive forces on your teeth and gums, which may have contributed to the bone loss. Essentially, a bite adjustment balances your biting forces. Your healing period helps our gum specialist evaluate how well you are cleaning your gums. He can help you refine your dental cleaning technique to clean most effectively. You cannot proceed to the next stage of treatment if you cannot perform effective home care.

Stage three

Patients who successfully finish stage two and have good healing and small pockets do not need further therapy. They can join a recall programs (explained in stage four). Those whose pockets are too deep and still infected often need some minor gum trimming. The extent of any procedure is usually determined by the amount of bone destruction. Our periodontist numbs the gums and trims away excess tissue and places sutures. The night of surgery, there is minor discomfort that is easily controlled with medication. Most people return to work the following day. A week later, we remove the sutures. Once your gums have healed, periodontal therapy is complete and you are placed on our recall program.

Stage four

The recall and maintenance program is essential. A daily home regimen of brushing and flossing or using other cleaning devices is essential for continued health. Plaque builds up daily and must be removed or disease will return. Your periodontal procedures were designed to facilitate cleaning. Gum surgery is not a cure but will enable you to clean the shallow residual pockets. We recommend a professional dental cleaning every three or four months to maintain continued gum health.

Protect your teeth and overall health by having your gums checked as soon as possible. If you are searching for a “Chelmsford oral surgeon” or “Westford oral surgery,” learn more by calling (978) 649-3058 or use our convenient Request an Appointment form. We welcome patients from Chelmsford, Dracut, Lowell, Westford, Tyngsborough and surrounding communities.

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