Perio consult
Your dentist and hygienist may refer you to our periodontist for a variety of reasons. In this first consultation appointment, the periodontist will do the following:
- Complete periodontal examination – this includes measuring the pocket depth
- Evaluation of the risk factors
- Prescribe the relevant radiographs
- Establish a treatment plan and cost estimate
Radiographs (x-rays) show the bone condition around the roots and the shape/length of the root. These radiographs are almost always necessary in order for the periodontist to finalize a diagnosis. These x-rays are also required to evaluate the health of your jawbone prior to considering the placement of implants.
A precise diagnosis is necessary in order to formulate a treatment plan with predictable and long-term results. After the perio exam, a detailed written report and a copy of the radiographs will be shared with your general dentist.
Deep cleaning (root planing)
This is the usual first step taken to reduce the gingival inflammation and thus allow the supporting bone to partially recover. For an optimal result, the oral hygiene must be excellent. Deep cleaning is done by a dental hygienist and involves the following:
- Personalized oral hygiene instructions using techniques and tools adapted to your needs.
- Scaling and root planing (deep cleaning) to remove the plaque and tartar buildup which adheres to the root surface below the gum line. This procedure is not a surgery, but rather a very thorough cleaning (compared to the habitual more superficial cleanings). It is done mainly under local anesthesia (freezing) and usually requires 2 to 4 appointments. Special instruments are used below the gum line to remove soft and hard deposits from the tooth surface. Deep cleaning removes the irritants from the root surface but it does not eliminate deep pockets, so it maybe have to be done more than once.
Once the freezing has worn off, there is usually no pain. However some patients may experience the following side effects:
- Tooth sensitivity (especially to cold, although temporary, it may last up to 2 months)
- Contraction of the healing gums (as the inflammation decreases). This may create some spaces between certain teeth.
The benefits of this treatment significantly outweigh the potential side effects, especially considering that without the treatment, the teeth would be eventually lost.
Maintenance
In order to maintain the high level of periodontal health obtained with the deep cleaning, it is important to meticulously follow the recommended home care instructions.
A maintenance recall frequency will be recommended, depending on your specific needs. The preventative maintenance appointments allow us to determine the stability of your periodontal health and to intercept any minor problems before they become major ones.
When treated and maintained properly, long lasting and predictable results can be expected.
Re-evaluation
Between 6 and 12 weeks after the deep cleaning appointment(s) are completed, the periodontist will re-examine your gums in order to evaluate the healing that has occurred, determine if additional treatment is recommended, and then create a treatment plan to meet your specific needs. This important phase of periodontal care confirms short-term improvement and can help us to establish the potential improvement that might be achieved with further treatment.
Further treatment may consist of more non-surgical procedures and preventative maintenance visits; however, in some cases, corrective periodontal surgery may be recommended.