Procedures

Scaling & root planing

Treatment options

Laser debridement—may be useful as an adjunct to scaling & root planing; however, the position taken by the American Academy of Periodontics is that evidence is lacking in support of laser debridement as a superior treatment modality to scaling & root planing.

Nutritional supplements and herbal remedies—There is evidence to support the use of certain vitamin and nutritional supplements to help maintain the periodontal health of stable periodontal patients, and to promote healing after treatment has been done. Supplements which have been studied and may be useful in promoting periodontal wellness include vitamin A, vitamin C, vitamin E, Coenzyme Q10 (or "CoQ10), calcium and folic acid. Appropriate use of these supplements should be in compliance with the recommendations of your dentist / periodontist, who can also track their effectiveness.

Certain essential oils (including thyme oil, tea tree oil, eucalyptus oil, peppermint oil, and chamomile oil) are present in some toothpastes and mouthwashes, and in appropriate doses may promote gingival health. There are many books and web sites dedicated to naturopathic remedies such as essential oils and herbal supplements. If you are unfamiliar with these non-traditional medicinal products, avoid using them unless you have involved a naturopathic doctor or someone with equivalent credentials who understands their limitations and risks.

Certain "natural" supplements whose safe dose has not been established, or whose formulations are not regulated have been found, or suspected to alter hormone levels, encourage tumor growth, produce chemical burns, cause prolonged bleeding, cause allergic reactions and produce other adverse effects.

In general, essential oils should not be taken internally or used full strength on skin or mucous membranes. Their use should also be avoided by patients with asthma, epilepsy, or allergies, as well as by cancer patients and pregnant or nursing women. Prescribed by a qualified naturopathic doctor, aromatherapist, herbalist, or nutritionist, unregulated supplements can potentially be used safely. However, your dentist/periodontist should be involved so that the effectiveness of such supplements can be measured and any potential oral side effects can be evaluated.

Formulation of many "natural" supplements is unregulated by the Food and Drug Administration, and their potency may not be well controlled. This means that identical-appearing bottles of the same substance, packaged and sold by the same manufacturer may contain significantly different concentrations of the medication inside. For many, there is no established recommendation for appropriate or effective doses.

Tooth removal—Tooth extraction is an alternative to maintaining periodontal health, although one that comes with significant consequences. If teeth are lost, they can be replaced with dentures, with a significant compromise in chewing efficiency. Placing fixed bridgework or implants in a patient with active periodontal disease is contraindicated. If the patient's disease is brought under control, and their oral hygiene is good, those treatments become options for replacing missing teeth.
Learn more about the consequences of lost teeth: Diagnoses › Edentulism