Scaling and Root Planing

We remove the plaque through a deep-cleaning method called scaling and root planing. Scaling means scraping off the tartar from above and below the gum line. Root planing gets rid of rough spots on the tooth root where the germs gather, and helps remove bacteria that contribute to the disease.

Medications

Medications may be used with treatment that includes scaling and root planing, but they cannot always take the place of surgery. Depending on the severity of gum disease, we may still suggest surgical treatment. Long-term studies will be needed to determine whether using medications reduces the need for surgery and whether they are effective over a long period of time. Here are some medications that are currently used:

Medication	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	We place it in the pockets after scaling and root planing. The antibiotic is released slowly over a period of about seven days.
Antibiotic micro-spheres	Tiny, round particles that contain the antibiotic minocycline	To control bacteria and reduce the size of periodontal pockets	We place it in the micro-spheres 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 pill form. It is used in combination with scaling and root planing.