Several sessions of scaling and root planing are realized to decontaminate the root of the tooth. Radiographs and a detailed study of each tooth with an electronic probe (Florida Probe) are performed, which inform us of the degree of inflammation, recession, mobility and other important data to assess the response to treatment and, based on that, establish some guidelines for action and an individualized forecast.
It is essential to instruct the patient in brushing techniques and interdental hygiene.
After scraping, a microbiological analysis is done to determine if there are any more aggressive bacteria that have caused inflammation and bone loss. This will help us to know if we have to use antibiotics or not, and what specific antibiotic is necessary.
After completing this first phase, a new periodontal evaluation will have to be carried out in order to assess the response to the treatment and the need or not to perform surgery.
We can also carry out a genetic analysis to assess the predisposition to suffer the disease. This will serve to anticipate possible complications, and make certain decisions for the future.
Not all patients need it. If residual scraps are left after scraping, they must be removed so that they are not re-colonized by bacteria. Also, regeneration of lost tissues will be performed when it is possible through the use of membranes or matrix derived from the enamel, and recessions will be covered by gingiva grafts on the teeth that need it.
This phase is FUNDAMENTAL in the treatment of gums, if it is not fulfilled can not assure the success of the treatment. Maintenance is carried out by hygienists supervised by the periodontist. Supra and subgingival plaque and calculus are eliminated with the use of ultrasound and mini curettes to deepen the gingiva. Areas that retain plaque and areas of possible relapse are detected. How often maintenance should be performed depends on the type of periodontal disease, age, whether or not the patient is a smoker, and the patient’s ability to brush.