The objective of scaling and polishing, otherwise known as conventional periodontal therapy, is to remove the causative agents which cause inflammation such as dental plaque, its products, and calculus, to establish healthy gums and underlying bone.
Plaque is a soft and sticky mixture of bacteria its waste products and some food debris which irritates the gums and causes inflammation over time leading to gingivitis. The longer plaque remains on the teeth, the harder it gets. After some time, plaque hardens into calculus otherwise known as tartar. Once the plaque is mineralized and hardens, it will not come off with the brush and floss anymore. The bacteria in plaque and calculus cause an ongoing state of inflammation called gingivitis. If left untreated, gingivitis can progress to a more serious disease called periodontitis. The most common treatment for periodontitis is scaling and root planing.
B. Ultrasonic Scaling
An ultrasonic scaler is an instrument with a tip generating high-frequency vibrations, used to remove plaque and calculus from teeth and bits of debris from the walls of the gingival crevice.
The ultrasonic instrument tips are curved and rounded and are always kept in motion around the teeth. Their purpose is to remove tartar. It has no capacity to cut into the teeth. If the sensations are too strong settings can be adjusted to make it more comfortable. It’s always supplied by a water jet to cool and flush the debris.
C. Flap Surgery
You may need surgery for severe gum disease (periodontitis) if it cannot be cured with antibiotics or root planing and scaling. A flap procedure cleans the roots of a tooth and repairs bone damage caused by gum disease. A gum specialist (periodontist) or an oral surgeon often performs the procedure.
Before the procedure, you will be given a local anesthetic to numb the area where the doctor will work on your gums. The doctor will pull back a section of your gums to clean the roots of your teeth and repair damaged bone if needed. The gum flap will be sewn back into place and covered with gauze to stop the bleeding.
Periodontal splinting is a process by which loose teeth are stabilized by splinting them to adjoining teeth, to be held secure and heal properly. The periodontal splint is typically made of fibrous composite material and effective hold the teeth in place and save them from extraction. A periodontal splint can be affixed to your teeth and typically does not require anesthesia.
E. Occlusal Splints and Mouth Guards:
If para-functional habits like clenching or grinding are evident, then a removable occlusal splint or bite guard may further protect the teeth from the consequences of too much biting force such as teeth wear and tear and sensitivity. Since para-functional forces and habits are supposed to be stress related, these removable guards can be used during times of tension, stress or when these bad habits are evident. It can also be used for the patients suffering from night grinding. Mouth guards can also be used for dedicated swimmers to protect their teeth from harmful effects of chlorine on their teeth.