Gum Disease Treatment

1. A periodontal exam measures the pocket around each tooth with a thin probe, checks for bleeding, recession, and loose teeth, and reviews your medical history, medications, and tobacco use
2. X-rays show the level of bone around the teeth
3. The findings are used to stage the disease and plan treatment, and you are shown how to clean along the gumline and between your teeth at home
4. For scaling and root planing, local anesthetic numbs the area being treated, often one or two quarters of the mouth per visit
5. Plaque and tartar are removed from the tooth and root surfaces down to the base of each pocket with ultrasonic and hand instruments, and the roots are smoothed
6. A medicine placed under the gums or a prescription rinse may be added for some sites
7. After the gums have healed, a re-evaluation visit measures the pockets again to see how they responded
8. Where deep pockets remain, osseous surgery may be planned for those areas – after numbing, the gum is folded back, the roots are cleaned, the bone is reshaped, and the gum is stitched in place
9. Periodontal maintenance visits follow active treatment at an interval set by your risk and response, often every 3 months at first

Periodontitis is driven by a bacterial biofilm (plaque) and the hardened deposits (tartar, or calculus) that form on root surfaces inside the gum pocket. Brushing and flossing cannot reach deep into a pocket, so those deposits keep feeding the inflammation that breaks down gum attachment and bone.

• Scaling and root planing disrupts and removes the biofilm and calculus with ultrasonic and hand instruments, cleaning to the base of each pocket. Smoothing the root surface removes the rough deposits that plaque clings to and gives the gum a clean surface to heal against. As inflammation settles, the gum tissue tightens and shrinks back, and pockets measured at re-evaluation are typically shallower.
• Osseous surgery gives direct access to roots and bone that instruments cannot reach through the pocket. With the gum folded back, deposits are removed under direct view, and the bone around the tooth is reshaped to remove craters and ledges that trap plaque. The gum is then secured at a lower position, which reduces or eliminates the pocket so the area can be kept clean at home and at maintenance visits.
• Periodontal maintenance works by disrupting the biofilm below the gumline again before it rebuilds, and by re-measuring the pockets so that a site becoming active again is found and treated early.
• Those steps describe periodontal care in general; here it is the work of Dr. Sung Min Lee. She is board-certified by the American Board of Periodontology (2023), and she completed a periodontics specialty residency at Columbia University College of Dental Medicine after a general practice residency at Hackensack University Medical Center and her DDS at NYU. Our gum disease care covers both scaling and root planing and osseous surgery, and osseous surgery is one of the procedures she performs, which means a pocket that stays deep after the deep cleaning can also be treated surgically in Carlstadt.
• Maintenance after active treatment follows the recall schedule our office sets for each patient: every six, four or three months. Your risk profile and how your gums responded to treatment both bear on how often these visits are needed.

• After scaling and root planing, the gums may be sore for a day or two and teeth may be sensitive for up to about a week
• Most people return to their normal routine the same day as a deep cleaning
• Gum bleeding and tenderness typically resolve within 3 to 4 weeks of treatment
• Recovery from osseous surgery commonly takes two to four weeks; aftercare usually includes soft foods, an antibacterial mouth rinse, and avoiding drinking through straws for about a week
• Keeping up daily brushing, cleaning between the teeth, and maintenance visits helps keep the gums stable after treatment
• Contact the dental office promptly if you notice swelling, pus, fever, or pain that worsens instead of easing after the first few days

• Professional cleaning and improved home care for gingivitis (gum inflammation without bone loss)
• Regenerative periodontal surgery with bone grafts, membranes, or biologic agents for certain deep bony defects
• Gum grafting where gum recession is the main concern
• Continued scaling and root planing with closer maintenance visits when surgery is declined or not advisable
• Extraction of teeth with a hopeless prognosis, with replacement by dental implants, bridges, or dentures

• About 4 in 10 U.S. adults aged 30 or older had mild, moderate, or severe periodontitis in 2009–2014, according to CDC national survey data[2]
• Periodontitis cannot be reversed, but it can be slowed down and managed with professional treatment[2]
• The European Federation of Periodontology S3 guideline gives a Grade A recommendation to subgingival instrumentation for reducing pocket depths, gum inflammation, and the number of diseased sites[4]
• An American Dental Association guideline panel favored scaling and root planing as the initial non-surgical treatment for chronic periodontitis, judging its benefits to outweigh its potential adverse effects[5]
• Smoking is the most significant risk factor for gum disease, and tobacco use can slow healing and make treatment less successful[1]

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  Sung Min Lee

  DDS

  Treats gum disease in our office, including surgery for gum pockets that stay deep after a deep cleaning.

  Board-certified periodontist specializing in gum disease treatment and dental implant surgery

  Full profile