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non-surgical periodontal treatment
Many cases of gum disease can be managed successfully by a procedure called subgingival debridement, a process where the roots of the teeth are cleaned as thoroughly as possible to allow the gums to heal.

Subgingival debridement is usually undertaken with local analgesia (injections to numb the area being treated) and can therefore be completed with minimal discomfort. In mild cases the treatment may be completed without injections, or you may chose to not be numbed if that suits you best.

It is normal to experience some discomfort for a day or two following your treatment. Pain relief such as paracetamol, or ibuprofen, or similar medication is usually adequate to control the discomfort.

The aims of treatment are to eliminate the infection, resolve the gum inflammation and to reduce the depth of pockets between the gum and tooth surface. As the tissues heal following treatment, there will be a degree of gum recession. This gum recession is determined to an extent by how much bone loss you have suffered. Gum recession leads to teeth that will look longer, there will be larger spaces developing between the teeth, and teeth may become more sensitive to hot/cold/sweet stimuli. The recession is a result of the damage caused by the gum disease and unfortunately it cannot be reversed easily. The sensitivity will usually settle on its own, but may require the application of desensitizing varnishes or the use of a desensitizing toothpaste.

It is more difficult to treat deeper pockets, so the result of treatment at these sites is less predictable. If healing is incomplete, the treatment can be repeated at that site or other options may be considered such as periodontal surgery.

periodontal surgery
When periodontal disease is advanced, where there are factors that complicate the disease or where the disease has not responded well to non-surgical debridement, it may be necessary to consider surgery to achieve good healing. Periodontal surgery is undertaken to allow the affected root surfaces to be viewed directly and to provide good access for removal of the accumulated plaque and calculus, allowing the gums to heal.

Surgery is undertaken with local analgesia (injections to numb the area being treated) and can therefore be completed with minimal discomfort. After surgery there will usually be stitches in place to hold the tissues together for good healing, and periodontal dressings may be used to protect the area. It is important that the area of surgery is not disturbed during healing – some changes in diet may be necessary and use of a mouthwash rather than normal tooth-brushing routines is essential during the immediate period following surgery. Any dressing and sutures are usually removed one week after surgery at a postoperative visit.

There will be some discomfort for a few days following surgery and advice on appropriate pain relief will be given. Most patients find that they are able to return to their normal routine with minimal disruption after surgery. Further information will be provided prior to, and at the time of surgery.

Gum recession and sensitivity will follow surgical treatment – please note the information in the section above.
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