Infection control is the main objective of periodontal treatment. Being of infective nature, gum diseases are treated by establishing and maintaining adequate cleaning at the border line between teeth and gums the so-called dentogingival area.
Reducing the bacterial load in this area is a teamwork between the patient and the periodontist. Professional debridement of the tooth/root combined with effective self-performed daily cleaning of the dentogingival area constitute the pillar of periodontal treatment.
For patients with superficial gum inflammation and no deepened pockets (so called gingivitis) the professional intervention focuses on tooth cleaning and oral hygiene instructions to the patient. For patients with deep pockets and loss of supporting bone (so called periodontits) the infection control remains a non-surgical therapy but it focuses on a more in depth root debridement usually performed under local anesthesia with minimum perceived discomfort.
As an effect of this cleaning effort the root are freed from microbial deposits and calculus, a condition that promotes resolution of the inflammation and healing of the pocket in many instances. Healing of the tissues after cause-related treatment in a patient with moderate periodontitis can be appreciated in the top row. Redness, swelling and bleeding disappeared.
More severe cases (i.e. when the pockets are deep and the bone presents with angular defects) may need additional surgical therapy. The rationale in doing so is that residual deep pockets are at more risk of further disease progression. Surgical intervention aims at pocket reduction or at periodontal regeneration if an angular bone defect is present.