How is chronic adult periodontal disease treated?

When a diagnosis is made based on the patient anamnesis and a complete periodontal study (involving X-rays, probes, gum retractions, mobility, etc.), a series of conclusions can be reached regarding the prognosis and treatment.

Obviously, if the disease is at an advanced stage and a large amount of bone has been lost around the roots and the teeth are very loose, little can be done to save them. However, if the bone loss is at an early or moderate stage, it is usually possible to obtain excellent results in saving these teeth in the long term, providing the patient understands the problem and strictly controls their plaque at home.

Every mouth is different, although the full treatment basically consists of three stages:

  1. Hygienic stage: eliminating the thick tartar and teaching the patient correct brushing techniquesand other additional measures (using interdental brushes, dental floss, oral irrigator, etc.)
  2. Anti-inflammatory stage: which involves scraping and smoothing the roots using instruments called curettes to remove the tartar and plaque beneath the gum. This is usually done under anaesthetic and by quarters (dividing the mouth into four parts). If the disease is at a moderate stage this treatment is usually enough, together with regular maintenance (regular professional cleaning).
  3. Surgical stage: once the inflammation has been removed from the gum, the periodontal pockets must be removed that contain the germs. This stage is carried out when the pockets are too deep to remove all of the inflamed tissue, and correctly smooth the bone surrounding the roots. The gum is then stitched around a healthy bone base, without leaving any space between it and the bone. As a result the patient can easily access the gaps in order to clean them. When this treatment is carried out, the gums are more retracted and the roots are more sensitive in the first few days.

The main purpose of this treatment is to stop the bonen loss, not to recover what has been lost. This can be done in specific cases using regenerative techniqueswith grafts and/or membranes.