What Periodontal Treatment Involves at the First Visit
Somebody told you that a regular cleaning is not going to cut it this time, and that you need periodontal treatment instead.
Most people leave that conversation with two thoughts. What is it, and how bad is this?
So here is the first visit written out, start to finish, so you can walk in knowing what is coming.
First, what the word means
Periodontal just means around the tooth. The gum, the bone under it, and the fibers that join the two together.
A standard cleaning handles what is on top of the gum line. Periodontal treatment handles what has gotten below it, into the pocket between the gum and the root, where a brush has never once reached.
That is the whole difference. Same idea, deeper, and it takes longer because of it.
The measuring comes first
Before anyone cleans anything, we measure. This is the part that surprises people, because it feels like a lot of counting out loud.
A small probe goes gently into the pocket around each tooth, and we read off how deep it goes in millimeters. Six spots per tooth. Somebody writes them all down.
Healthy is 1 to 3 millimeters. Four is worth watching.
Five and up means the pocket is deeper than you can clean at home, however good your brushing is. That is the number that decides the treatment.
It takes about ten minutes and it is mostly tapping and pressure. If a spot is tender, say so at the time.
We also take x-rays, because the probe reads the gum and the x-ray reads the bone underneath it. You need both to know what you are looking at.
Then we show you the chart
Every number goes on a screen you can see. This is the point where the whole thing stops feeling vague.
You get to look at which teeth are fine, which have one deep spot, and which are in trouble. Most mouths are a mix, and the mix changes the plan.
Four deep pockets in one corner is a different problem from deep pockets everywhere.
We go through it in plain language. Not tooth numbers and codes, just where and how deep and what it means.
The cleaning itself
The clinical name is scaling and root planing. It means two things happening in the same pass.
Scaling is removing the hardened deposit from the root surface below the gum. It has been there long enough to set hard, so it does not rinse or brush away.
Root planing is smoothing the root surface afterward. A rough root collects bacteria again quickly. A smooth one gives the gum something clean to reattach to, which is the entire point of doing this.
We numb the area first. You will feel pressure and you will hear the instruments, but the sharp part is handled.
Most people do this over two visits, one side of the mouth each time. That way your whole mouth is never numb at once. You can eat on one side while the other settles.
How long, and how you will feel after
Plan on about an hour to ninety minutes per side.
Afterward the gums are usually tender for two or three days. Cold can feel sharper for a couple of weeks, because the root surface is newly exposed to it. That fades.
Soft food the first day, nothing scalding hot, and go easy with the brush along the gum line for a few days without stopping altogether. Warm salt water rinses help more than people expect.
Take whatever your usual painkiller is, unless we have told you otherwise.
What happens after that
You come back in four to six weeks and we measure again, the same six spots per tooth.
That second set of numbers is what tells us whether it worked. A pocket that was 6 and is now 3 has healed. One that reads 6 again needs a different plan.
Better to find that out at six weeks than at your next yearly checkup.
After that, most people move to cleanings every three or four months instead of every six. For a while in most cases, and not in every case forever.
Gum tissue that has been through this rebuilds bacteria faster than tissue that has not. Three months is usually the right gap.
The part people wish they had heard sooner
Gum disease is painless early on. It does not hurt until it is far along, which is why so many people are surprised to be told they have it.
Bleeding when you brush is the early signal, and almost everybody decides bleeding is normal.
It is not. It is the first thing to mention, and it is the cheapest point to deal with any of this.
If it has been years since your last visit and you are bracing for a lecture, you will not get one here. We wrote out what a first visit looks like for that reason.
Our page on periodontal treatment in Chicago has more on the stages and what each one involves.
Coming to see us
We are at 1908 N Western Ave in Bucktown, steps from the Western Blue Line stop. Parking behind the building is limited, so call ahead if you need a spot.
We are open Monday to Thursday from 9 AM to 5 PM, Friday until 3 PM, and Saturday mornings until 2 PM.
If your gums bleed when you brush, that is the visit to book. Book a visit and we will start with the measuring.
