Gum Disease Treatment: Antibiotics, Surgery & Other Options

Gum Disease Treatment: Antibiotics, Surgery & Other Options
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Gum Disease Treatment: Antibiotics, Surgery & Other OptionsClinical Content Reviewed by Dr. Jay Khorsandi, DDS
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Table of Contents

  1. Treating Gum Disease
  2. Preventing & Managing Gum Disease
  3. Professional Cleaning, Scaling & Root Planing
  4. Medications for Gum Disease
  5. Treating Gum Disease With Surgery
  6. Continuing Treatment for Gum Disease
  7. References

Gum disease is one of the biggest dental health concerns. Nearly 50 percent of American adults ages 30 and older have some form of it.

In the early stages, gum disease is called gingivitis and involves swelling and redness of the gums. In later stages, gum disease is called periodontal disease and is an infection in the tissues around the teeth, which can lead to pain, bleeding gums, tooth loss, and general health issues.

Gum disease needs to be diagnosed by a dental professional who can best determine the type of treatment needed. Early on, gum disease can be managed through good oral hygiene (regular brushing and flossing) after a professional teeth cleaning. Late-stage gum disease usually requires dental procedures, such as tooth planing and root scaling, surgical interventions, and antibiotic medications.

Treating Gum Disease

Red and swollen gums, sensitive or loose teeth, bad breath, gums pulling away from the teeth, pain while chewing, and sore or bleeding gums can all be signs of gum disease. If you suspect gum disease, the first step in treating it is to see your dentist. A dental professional can then examine your teeth and gums, and diagnose the progression of gum disease to determine proper treatment options.

Gum disease is caused by plaque-containing bacteria that build up on teeth, forming tartar and causing inflammation in the gum tissue. It is progressive and starts out mild, as gingivitis. It can continue to periodontal disease, which is more severe. The number one goal in treating gum disease is to manage the infection.

Treatments include:

  • Brushing, flossing, and practicing good oral hygiene.
  • Professional teeth cleaning.
  • Tooth scaling and root planing.
  • Medications, such as antibiotics.
  • Periodontal gum surgery.
  • Gum graft surgery.
  • Regenerative procedures.
  • Tooth extraction.

The stage and progression of gum disease will determine the treatment that is needed.

Oral Hygiene to Prevent & Manage Gum Disease

When you have gingivitis, the mild form of gum disease, you can often manage and reverse it with regular cleanings by a dental health professional and daily brushing and flossing.

The best treatment for gum disease is generally prevention. It can be managed and treated when caught early and by doing the following things:

  • Brush your teeth at least twice a day, ideally after eating.
  • Floss daily.
  • Use a water flosser to remove food between the teeth.
  • Rinse your mouth with an antiseptic mouthwash or hydrogen peroxide.
  • Eat a well-balanced and nutritious diet.
  • Stop smoking and using tobacco products, or do not start using them.
  • Have your teeth professionally cleaned by a dentist or dental hygienist at least once every six months.

Early on, gum disease can often be completely cured with a professional dental cleaning and then continuing to practice good oral hygiene.

Professional Cleaning, Tooth Scaling & Root Planing

After a dental professional examines your teeth and determines the stage and severity of your gum disease, they can use specialized methods to clean them. A deep clean often includes the use of a specialized tool that looks like a hook, or an ultrasonic scaling device, to scale your teeth. This will remove tartar that has built up under the gumline.

Root planing is an even deeper scaling procedure that helps to smooth out your root surfaces and keep the bacteria from sticking there again. This process helps to reduce the swelling in your gums and allows them to reattach better to your teeth.

The process of tooth scaling and root planing is often done under local anesthesia. Your dentist can prescribe pain medications, anti-inflammatory medications, and an oral rinse to minimize discomfort, aid in healing, and reduce the risk for infection.

After the procedure, your gums and teeth may be sensitive for a few days to a week. Your gums will initially be swollen and may even bleed.

You will need a follow-up visit to make sure that the pockets in your gum tissue are indeed smaller. Often, you will be able to manage periodontal disease with maintenance visits after that. If the pockets continue to get deeper, you will need additional treatment and possibly periodontal surgery.

In addition to medications, triclosan is often recommended because this type of toothpaste contains fluoride and an antibiotic, which help reduce plaque and gingivitis.

Medications for Gum Disease

Since gum disease involves infected tissues, antibiotic medications are often needed to help reverse the infection. Oral antibiotics can be taken to treat an acute periodontal infection in the short term, but this is not a long-term solution. Often, antibiotics are provided in conjunction with another treatment method.

Other medications for gum disease can include:

Prescription Mouth Rinse
Chlorhexidine is an antimicrobial mouthwash that is used to treat gum disease and also to minimize infection after dental surgery. It is used like a typical mouthwash to help control the bacteria in the mouth.
Antibiotic Gel
Containing doxycycline, this is a slow-release medication that is often placed in the pockets of the gums after a root planing and tooth scaling procedure to shrink them and control the bacteria.
Antiseptic Chip
This is a piece of gelatin filled with chlorhexidine. This is also a slow-release medication placed into gum pockets following root planing to control the bacteria and shrink the pocket size.
Antibiotic Microspheres
Containing the antibiotic minocycline, these small particles are placed into gum pockets following root planing to shrink them and control bacteria as a slow-release medication.
Enzyme Suppressants
These medications use a low dose of doxycycline to manage the body’s enzyme response, which can cause a breakdown of gum tissue. It is provided in pill form to be taken orally.
Medications are generally only part of the solution when it comes to treating gum disease. They can trigger some mild side effects. Be sure to talk to your dentist about any reactions you have to any medications.

Treating Gum Disease With Surgery

More advanced gum disease often requires periodontal surgery to repair bone and tissue damage, and control the infection. Here are some options:

Periodontal Gum Surgery

This procedure reduces the pocket size surrounding your gums by making a flap, pulling back the gums, and removing the tartar from underneath them through root scaling and tooth planing. The gums are then put back in place and should reattach to the teeth as they heal. The procedure typically takes around two hours to complete, and dentists regularly use local anesthesia.

About a week after surgery, the dentist will remove the stiches and check on your progress. Typically, it takes a week or two to start feeling your gums tighten up around your teeth.

During recovery, your teeth and gums can bleed. They may feel sensitive to temperatures and touch, and you may experience pain and some swelling. Your dentist will often prescribe pain medications and an antiseptic mouthwash.

Gum Graft Surgery

Advanced gum disease can cause your gums to recede, or pull back from your teeth, and this can cause your roots to become exposed. A gum graft involves taking tissue from somewhere else, typically from the roof of your mouth, and then reattaching it to cover the exposed root and replace the gums.

A local anesthetic is used during the procedure, which takes around two hours to complete. You will need a follow-up visit with your dentist a week or two after the procedure to check on progress.

Your dentist will often give you an antiseptic mouthwash to prevent infection and pain medications to control discomfort after the gum graft. During the first two days after the surgery, you are likely to experience pain, tenderness, some bleeding, swelling, and tooth sensitivity. You’ll need to rest and refrain from physical activities.

You will need to be careful when brushing or flossing around the area of the graft for the first two weeks. It’s best to consume only soft foods during this recovery time too. Your mouth will generally be completely healed in 10 to 14 days.

Regenerative Procedures

When gum disease has advanced enough to impact both the bone and surrounding tissue of your teeth, a regenerative procedure can often work to restore some of the damage.5 After the bacteria are thoroughly cleaned out, bone and tissue grafts can replace and fill in areas that have been destroyed.

A piece of mesh can be placed between the bone and gum tissue during guided tissue regeneration (GTR), which helps the bone and connective tissue to grow in the space they are meant to and keeps the gum line where it should be. Proteins that help to stimulate new growth can also be applied.

This is often done under local anesthesia; however, it can also be performed with general anesthesia as well. For the first week, you will need to use care when cleaning the area, and use the provided antiseptic mouthwash instead of brushing until the stitches are removed. Pain relievers and anti-inflammatory medications are also beneficial to control swelling and discomfort.

It can take a few weeks to months for the bones and connecting tissues to regrow and heal completely. Regular follow-up care is needed.

Tooth Extractions

When bone loss is significant and gum disease is advanced, the tooth will often need to be removed. Gum disease can cause the tooth to become loose. Sometimes, the only way to treat the infection is to remove the tooth completely. This is generally done through a surgical extraction that can also involve removing infected tissue and cleaning the area of bacteria.

Removing the tooth can help to stop the pain and cure the infection. After the extraction, you will need to stick to soft foods and liquids for a few days, and avoid smoking and using a straw.

Your dentist will usually prescribe an antiseptic mouthwash and pain relievers. You’ll have a follow-up visit in a week or two. This is about how long it will take to heal.

Continuing Treatment for Gum Disease

Gum disease is managed through continuing and ongoing care, even after a procedure to clean the infection. This may require lifestyle changes, such as changing your eating habits or stopping tobacco use. To keep gum disease from returning, you will need to follow your dentist’s instructions on how often to get your teeth cleaned and use their recommended methods for brushing and flossing.

Your dentist can recommend specific toothpastes and mouthwashes that can help you prevent gum disease from returning. Some people are more prone to tartar buildup and therefore gum disease. You will need to work with your dentist to manage this.

Gum disease can be reversed and often completely cured with prompt professional attention and the right treatment method. Once the infection is cleared, you must keep up with your dental health and work to keep the bacteria from damaging your gums and teeth.

Pay attention to your mouth. If you are noticing changes in your gums or tooth sensitivity, be sure to check in with your dentist.

References

What Is Gingivitis? Symptoms, Causes, and Treatments. (2021). Crest- Proctor & Gamble. Date Fetched: June 17, 2021.

What Dental Hygienists Do When Root Planing and Scaling Teeth. (2021). Colgate-Palmolive Company. Date Fetched: June 18, 2021.

What Is Periodontitis? (January 2018). Medical News Today. Date Fetched: June 18, 2021.

What Is Periodontal Surgery? (March 2018). Medical News Today. Date Fetched: June 18, 2021.

When Surgical Extraction of Teeth Is Necessary. (2021). Colgate-Palmolive Company. Date Fetched: June 18, 2021.

Periodontal Disease. (July 2013). Centers for Disease Control and Prevention (CDC). Date Fetched: July 17, 2021.

Periodontal (Gum) Disease. (July 2018). National Institute of Dental and Craniofacial Research (NIDCR). Date Fetched: June 17, 2021.

Gingivitis. (June 2021). U.S. National Library of Medicine (NLM). Date Fetched: June 18, 2021.

Periodontal Pocket Reduction Procedures. (2021). American Academy of Periodontology. Date Fetched: June 18, 2021.

Regenerative Procedures. (2021). American Academy of Periodontology. Date Fetched: June 18, 2021.

Disclaimer: This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to serve as dental or other professional health advice and is not intended to be used for diagnosis or treatment of any condition or symptom. You should consult a dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.

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