Numerous periodontists have evaluated the adjunctive use of systemic antibiotics (by mouth) to halt the progression of Periodontal disease. Some benefit has been demonstrated when these medications are incorporated into the treatment protocol.

Given the potential side effects of these drugs, including the development of resistant bacterial strains or increased growth of opportunistic organisms (yeast infections), incorporation of systemic antibiotic therapy into the routine management for the majority of adult periodontitis cases cannot be justified at this time.

Systemic antibiotic therapy should be reserved for patients with continuing periodontal breakdown despite meticulous conventional treatment and oral hygiene care.  In addition, patients at high risk for periodontal breakdown, such as juvenile periodontitis (genetic-predisposed) and patients with other early-onset forms of periodontitis may be treated with antibiotics in conjunction with mechanical removal of pathogens.

Current data suggest that local delivery of antimicrobials into a periodontal pocket can improve periodontal health. However, these drug delivery systems do not provide a superior result when compared to scaling and root planing. Therefore, the benefits of utilizing local delivery systems as a monotherapy are questionable. In conjunction with scaling and root planing, the adjunctive use of local delivery may enhance the results in sites that do not respond to conventional therapy. A few, localized persistent lesions, in otherwise well controlled patients, may offer the greatest potential for success with this treatment modality.

It can be concluded that the adjunctive use of local drug delivery may provide a defined, but limited, beneficial response. However, the magnitude of the change anticipated by combined therapy must be interpreted in light of the severity of the defects being treated. Therefore, clinicians will need to make treatment decisions based on the desired outcomes of therapy. Furthermore, concerns with respect to the impact of widespread antibiotic use in dentistry suggest that local delivery devices should only be used in specific areas where conventional forms of therapy may fail to control the infection. Therefore, as with systemic antimicrobial therapy, local antimicrobial therapy should not be used routinely in situations when efficacious results can be accomplished with scaling and root planing.

Soft tissue grafts can be used to increase gum tissue thickness or possibly cover exposed roots where gum is absent due to excessive gingival recession. During this procedure your periodontist takes gum tissue from your palate or another donor source to augment tissue thickness or cover the exposed root if possible.

A soft tissue graft can help inhibit further recession. In some cases it can cover exposed roots. This may reduce tooth sensitivity and improve esthetics of your smile.

Since the bacteria that causes periodontal disease breed in the deepened pockets between the gum and the tooth, your dentists may attempt to eliminate the area in which this bacteria can grow with a gingivectomy.

In a gingivectomy, the periodontist will trim the unhealthy gum in order to reduce the pocket size. As a result, the bacteria will no longer have a suitable environment in which to grow, and healthy gum tissue can begin to grow back.

Your bone and gum tissue should fit snugly around your teeth like a turtleneck around your neck. When you have periodontal disease, this supporting tissue and bone is destroyed, forming "pockets" around the teeth.

Over time, these pockets become deeper, providing a larger space for bacteria to live. As bacteria develop around the teeth, they can accumulate and advance under the gum tissue. These deep pockets collect even more bacteria, resulting in further bone and tissue loss. Eventually, if too much bone is lost, the teeth will need to be extracted.

During this procedure, your periodontist folds back the gum tissue and removes the disease-causing bacteria before securing the tissue into place. In some cases, irregular surfaces of the damaged bone are smoothed to limit areas where disease-causing bacteria can hide. This allows the gum tissue to better reattach to healthy bone.

There are many benefits to this procedure. Reducing pocket depth and eliminating existing bacteria are important to prevent damage caused by the progression of periodontal disease and to maintain a healthy smile. Eliminating bacteria alone may not be sufficient to prevent disease recurrence. Deeper pockets are more difficult for you and your dental care professional to clean, so it's important for you to reduce them. Reduced pockets and a combination of daily oral hygiene and professional maintenance care increases your chances of keeping your natural teeth – and decreases the chance of serious health problems associated with periodontal disease.

Your bone and gum tissue should fit snugly around your teeth like a turtleneck around your neck. When you have periodontal disease, this supporting tissue and bone is destroyed and pockets develop. Eventually, if too much bone is lost, the teeth will need to be extracted.

Your periodontist may recommend a regenerative procedure when the bone supporting your teeth has been destroyed. These procedures can reverse some of the damage by regenerating lost bone and tissue.

During this procedure, your periodontist folds back the gum tissue and removes the disease-causing bacteria. Membranes (filters), bone grafts or tissue- stimulating proteins can be used to encourage your body's natural ability to regenerate bone and tissue.

There are many options to enhance support for your teeth and to restore your bone to a healthy level. Your periodontist will discuss your best options with you.

The benefits of this procedure are eliminating existing bacteria and regenerating bone and tissue helping to reduce pocket depth and repair damage caused by the progression of periodontal disease. With a combination of daily oral hygiene and professional maintenance care, you'll increase the chances of keeping your natural teeth – and decrease the chances of serious health problems associated with periodontal disease.

The ability to regenerate bone around teeth and on edentulous jaw ridges in association with implant reconstruction is called "Guided Bone Regeneration". This remarkable therapy has given patients who have already lost teeth a second chance to enjoy the benefits of permanent teeth with the help of dental implant reconstruction. 

It is known that bone heals more slowly than the gum tissues in the mouth. Without Guided Bone Regeneration techniques, the faster healing gum would prevent the bone from maximizing its full healing potential following surgical procedures. The concept of treatment is simple. A biocompatible membrane is placed between the gum and bone which acts as a barrier. This barrier prevents downgrowth of the gum into the underlying bone as it heals. Oftentimes, a bone graft is placed into the underlying bony irregularities, under the membrane, to help the body grow new bone. Membranes around teeth are typically designed to dissolve away after several weeks of healing have passed. Membranes used to restore bony ridges in association with implant therapy are typically non-resorbable, and must be removed at a later date.