Medications may be used with treatment that includes scaling and root planning, but they cannot always take the place of surgery. Depending on how far the disease has progressed, the dentist or periodontist may still suggest surgical treatment. Long-term studies are needed to find out if using medications reduces the need for surgery and whether they are effective over a long period of time. Listed on the next page are some medications that are currently used.
|Medications||What is it?||Why is it used?||How is it used?|
|Prescription antimicrobial mouthrinse||A prescription mouthrinse containing an antimicrobial called chlorhexidine||To control bacteria when treating gingivitis and after gum surgery||It’s used like a regular mouthwash.|
|Antiseptic chip||A tiny piece of gelatin filled with the medicine chlorhexidine||To control bacteria and reduce the size of periodontal pockets||After root planing, it’s placed in the pockets where the medicine is slowly released over time.|
|Antibiotic gel||A gel that contains the antibiotic doxycycline||To control bacteria and reduce the size of periodontal pockets||The periodontist puts it in the pockets after scaling and root planing. The antibiotic is released slowly over a period of about seven days.|
|Antibiotic microspheres||Tiny, round particles that contain the antibiotic minocycline||To control bacteria and reduce the size of periodontal pockets||The periodontist puts the microspheres into the pockets after scaling and root planing. The particles release minocycline slowly over time.|
|Enzyme suppressant||A low dose of the medication doxycycline that keeps destructive enzymes in check||To hold back the body’s enzyme response — If not controlled, certain enzymes can break down gum tissue||This medication is in tablet form. It is used in combination with scaling and root planing.|
|Oral antibiotics||Antibiotic tablets or capsules||For the short term treatment of an acute or locally persistent periodontal infection||These come as tablets or capsules and are taken by mouth.|
Flap Surgery- Surgery might be necessary if inflammation and deep pockets remain following treatment with deep cleaning and medications. A dentist or periodontist may perform flap surgery to remove tartar deposits in deep pockets or to reduce the periodontal pocket and make it easier for the patient, dentist, and hygienist to keep the area clean. This common surgery involves lifting back the gums and removing the tartar. The gums are then sutured back in place so that the tissue fits snugly around the tooth again. After surgery the gums will heal and fit more tightly around the tooth. This sometimes results in the teeth appearing longer.
Bone and Tissue Grafts- In addition to flap surgery, your periodontist or dentist may suggest procedures to help regenerate any bone or gum tissue lost to periodontitis. Bone grafting, in which natural or synthetic bone is placed in the area of bone loss, can help promote bone growth. A technique that can be used with bone grafting is called guided tissue regeneration. In this procedure, a small piece of mesh-like material is inserted between the bone and gum tissue. This keeps the gum tissue from growing into the area where the bone should be, allowing the bone and connective tissue to regrow. Growth factors – proteins that can help your body naturally regrow bone – may also be used. In cases where gum tissue has been lost, your dentist or periodontist may suggest a soft tissue graft, in which synthetic material or tissue taken from another area of your mouth is used to cover exposed tooth roots.
Since each case is different, it is not possible to predict with certainty which grafts will be successful over the long-term. Treatment results depend on many things, including how far the disease has progressed, how well the patient keeps up with oral care at home, and certain risk factors, such as smoking, which may lower the chances of success. Ask your periodontist what the level of success might be in your particular case.