Antibiotic Treatment
Periodontal disease is a progressive condition which leads to severe inflammation and tooth loss if left untreated. Antibiotic treatments can be used in combination with scaling and root planing.
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Periodontics
Periodontics Waterloo
The term "periodontist" refers to the dental specialty that pertains to the prevention, diagnosis and treatment of periodontal disease that affects the gums and jawbone. The gum tissues serve to surround and support the teeth and the underlying jawbone anchors teeth firmly in place. Periodontists have completed several years of extra dental training and are concerned with maintaining the function, health and aesthetics of the jawbone and tissues.
Gum Health
Reasons for Periodontal Treatment
Periodontal disease is a progressive condition which begins with mild gum inflammation called gingivitis. It is the leading cause of tooth loss in adults living in the developed world, and should be taken very seriously. Periodontal disease (often called gum disease) is typically signified by red, swollen, painful, or bleeding gums, but in some cases has no noticeable symptoms.
Periodontal disease generally begins when the bacteria living in plaque cause an infection in the surrounding tissues of the teeth, causing them to become irritated and painful. Eventually, this infection will cause the jawbone to recede and the tooth to become loose.
There are several reasons why periodontal treatment may be necessary:
- Moderate/advanced gum disease – This occurs when the gums are bleeding, swollen or red around most teeth and the jawbone has begun to recede.
- Localized gum recession – The infection which propagates moderate or advanced gum disease often begins in one area. Gum recession may also be caused due to over brushing with a hard bristle brush, or due to a tooth that is not positioned properly. Immediate treatment is required to prevent further spreading.
- Before crown lengthening – The periodontist may lengthen the crown of the tooth by removing surrounding soft tissue to provide more tooth exposure.
- Ridge augmentation – This procedure, often called "recontouring" may be required to correct an uneven gum line. Before embarking on treatment, a periodontist needs to treat any bacterial infections and periodontitis.
In the case of mild/moderate periodontal problems, the focus of the periodontist will be on curing the underlying bacterial infection and then providing advice on the most appropriate home cleaning methods.
Sometimes a deep scaling is needed to remove the bacterial plaque and calculus (tartar) from the teeth and tissues. Where periodontal disease is advanced and the jawbone has regressed significantly, more intensive cleaning may be recommended and loose teeth that cannot be saved will be removed.
Gum Health
Because periodontal disease is progressive, it is essential to remove the bacteria and calculus build up to halt the spread of the infection. Your dentist will be happy to advise you on effective cleaning methods and treatment options.
Treatments
Our Periodontist Services
Bruxism Treatment
Bruxism refers to an oral parafunctional activity which occurs in most humans at some point in their lives.
Learn moreCrown Lengthening
Crown lengthening is generally performed in order to improve the health of the gum tissue, or to prepare the mouth for restorative or cosmetic procedures.
Learn moreGum & Jawbone Corrective Treatments
There are many reasons why the gums and jawbone may require corrective treatment, including periodontal disease, trauma and birth defects.
Learn moreGum Grafting
A gum graft (also known as a gingival graft or periodontal plastic surgery), is a collective name for surgical periodontal procedures that aim to cover an exposed tooth root surface with grafted oral tissue.
Learn moreReceding Gum Treatment
Gingival recession (receding gums) refers to the progressive loss of gum tissue, which can eventually result in tooth root exposure if left untreated.
Learn moreOral Cancer Exam
At Trillium Dental Centre, each and every one of our patients, regardless of their age, undergo a thorough oral cancer exam at their regular checkups and cleanings.
Learn moreRoot Planing
The objective of scaling & root planing is to remove etiologic agents which cause inflammation to the gingival (gum) tissue and surrounding bone. Common etiologic agents removed by this conventional periodontal therapy include dental plaque and tartar (calculus).
Learn morePocket Irrigation
Periodontal disease is a progressive condition which leads to gum inflammation, the recession of bone and gum tissue, and tooth loss if left untreated.
Learn morePocket Reduction Surgery
Pocket reduction surgery (also known as gingivectomy, osseous surgery and flap surgery) is a collective term for a series of several different surgeries aimed at gaining access to the roots of the teeth in order to remove bacteria and tartar (calculus).
Learn moreProphylaxis
A dental prophylaxis is a cleaning procedure performed to thoroughly clean the teeth. Prophylaxis is an important dental treatment for halting the progression of periodontal disease and gingivitis.
Learn moreRegenerative Procedures
Periodontal disease is an extremely serious progressive condition which can lead to tooth loss if left untreated. Periodontal disease occurs when a bacterial infection in the gum pockets causes the bone and gum tissue to recede away from the teeth.
Learn moreRidge Modification
Ridge modification is an effective procedure for treating deformities in the upper and lower jaws. These deformities can occur as a result of periodontal disease, trauma, injury, wearing dentures, or developmental problems.
Learn moreSinus Augmentation
A dental implant is essentially an artificial tooth root which is attached to the jaw bone. Eventually, a replacement tooth or bridge will be firmly fixed to this root, restoring complete function to the tooth.
Learn moreSoft Tissue Grafting
Soft tissue grafting is often necessary to combat gum recession. Periodontal disease, trauma, aging, over brushing, and poor tooth positioning are the leading causes of gum recession which can lead to tooth-root exposure in severe cases.
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Care for the Gums, Bone, and Foundation of Teeth
How a Periodontics Visit Works
Periodontics is the branch of dentistry concerned with the structures that surround and support the teeth — the gums, the bone of the jaw, and the ligaments that connect them. Periodontal care covers everything from routine preventive cleanings to advanced surgical procedures for severe gum disease. Most adult periodontal care at Trillium is provided directly by our team; for highly complex cases we coordinate with periodontists.
A typical periodontal-focused visit starts with a thorough evaluation. The hygienist or dentist measures pocket depths around every tooth, records bleeding patterns, examines the gum tissue, takes x-rays where needed, and compares findings to previous visits. Based on the evaluation, the visit may proceed as a routine preventive cleaning, a deeper therapeutic cleaning (scaling and root planing if needed), or planning for additional treatment if more involved care is indicated.
After the cleaning, the dentist reviews the findings and discusses any recommendations. Some visits result in just maintaining the current schedule; others identify changes that warrant treatment. Patients with active periodontal disease often shift from six-month to three- or four-month visits to keep the disease under control while it heals. Patients in stable maintenance after past treatment continue at whatever interval works for them.
What Periodontal Care Covers
Periodontics encompasses a broad range of services:
- Routine preventive cleanings every three to six months depending on individual need
- Periodontal evaluation with pocket measurements, bleeding assessment, and bone-level monitoring
- Scaling and root planing — deep cleaning under local anaesthetic for early to moderate periodontal disease
- Periodontal maintenance — ongoing cleaning visits every three to four months for patients with treated periodontal disease
- Pocket reduction surgery for areas of severe pocket depths not responding to non-surgical treatment
- Gum grafting to address recession or thin tissue around teeth
- Bone grafting and guided tissue regeneration for areas with bone loss
- Crown lengthening to expose more tooth structure for restorative work
- Treatment of gum abscesses
- Implant-related periodontal care, including treatment of peri-implantitis
- Cosmetic gum procedures for gummy smile or uneven gum line
- Coordination with general dental, orthodontic, and restorative care
- Patient education on home care techniques specific to your situation
Care plans are individualized based on what your gums actually need rather than a one-size approach. Some patients have very straightforward care; others have ongoing treatment plans spanning multiple visits.
Long-Term Periodontal Maintenance
Once active periodontal disease has been treated, maintenance becomes the long-term focus. Maintenance is not the same as a routine cleaning — it is a more thorough cleaning that includes pocket measurements, careful debridement of any areas that have started to accumulate plaque or tartar, and assessment of treatment stability. Most patients with treated periodontal disease attend maintenance visits every three to four months indefinitely.
Patients who maintain this schedule consistently have very good long-term outcomes, with most keeping their natural teeth for life despite previous periodontal disease. Patients who skip maintenance or extend visits too long tend to see disease activity return. The pattern is consistent enough that maintenance compliance is one of the strongest predictors of long-term success.
Home care between visits matters equally. Twice-daily brushing with fluoride toothpaste for two minutes, daily flossing or use of other interdental cleaning tools, and avoiding tobacco are the foundations. For some patients, prescription-strength fluoride toothpaste, antimicrobial rinses for periods of active disease, or specific tools (interdental brushes, water flossers) become part of the routine. Your dental team adjusts recommendations to your individual situation.
Cost and Insurance Coverage
Trillium provides comprehensive periodontal care including evaluation, non-surgical treatment, and many surgical procedures. For complex surgical cases we refer to periodontists we have worked with and trust. We follow the current Ontario Dental Association Suggested Fee Guide for all services. Most private dental insurance plans cover periodontal evaluation as part of routine exams and cover treatment when documented as medically necessary.
More frequent maintenance visits (every three to four months) are covered by most plans when documented as medically necessary for patients with periodontal disease. CDCP includes periodontal services within its annual benefits framework. We submit insurance claims directly where the plan allows and run pre-determinations for larger treatment plans so coverage is clear before treatment starts.
Frequently Asked Questions
How often should I have a periodontal cleaning?
Patients with healthy gums attend regular cleaning visits every six months. Patients with active or treated periodontal disease usually benefit from every three to four months. The right interval is set together with you based on your specific situation.
Is scaling and root planing painful?
The procedure is done under local anaesthetic so the area is numb during the cleaning. Mild gum tenderness for one to two days after is common, manageable with over-the-counter pain medication. Most patients describe it as more uncomfortable than a routine cleaning but not painful.
Will my gums recover after treatment?
Inflamed gum tissue heals significantly within weeks of treatment. Bone that has been lost does not grow back on its own (though grafting procedures can rebuild bone in some cases). The goal of treatment is to stop progression and stabilize what you have.
Do I need a periodontist?
Most patients with mild to moderate periodontal disease can be treated entirely within a general dental practice like Trillium. Severe cases, aggressive periodontitis, complex surgical needs, or certain implant complications benefit from periodontist involvement. We are honest about when referral is the right choice.
Can I keep my teeth if I have periodontal disease?
Most patients with treated periodontal disease keep their teeth long-term. Severely advanced cases may have some teeth that cannot be saved, but the majority of teeth in most patients can be stabilized with appropriate treatment and maintenance.
What about home care between visits?
Twice-daily brushing for two minutes with fluoride toothpaste plus daily flossing is the foundation. Patients with specific needs may add interdental brushes, water flossers, prescription-strength fluoride toothpaste, or antimicrobial mouthwashes. We adjust recommendations to your individual situation.