Periodontal Disease

Symptoms of Periodontal Disease 

Periodontal disease is often painless. You may not notice anything in the beginning. Symptoms you might start having are:

  • Inflammation - tender or swollen gums
  • Bleeding - on brushing or flossing
  • Sensitivity - of teeth or gums
  • Halitosis - bad breath
  • Pockets - deeper teeth pockets

If untreated, some consequences can be:

  • Teeth - become loose or are lost
  • Dental Work - needing bridges, implants
  • Problems - cavities, loose teeth, etc.
  • Bacteremia - bacteria gets in your blood and contributes to many medical problems.

Scaling & Root Planing

Scaling & Root Planing (also called Deep Cleaning or Phase 1 Periodontal Treatment) is a precision technique to remove harmful bacteria from the pockets around your teeth. It is usually the first treatment done for periodontal disease by Dr. Metz. 

Root Planning

Root Planing (also called “root smoothing) smooths and polishes the root surface after scaling so it is harder for future bacteria to attach onto the root. Having a smooth, disease-free root also helps your gums heal and grow back onto your teeth. This causes your pockets to shrink. There is less chance for reinfection.


Scaling is removing this bacterial calculus with dental instruments or ultrasonic scalers. This “deep cleans” the teeth and tooth roots below the gum line. Because calculus is often rock hard this is quite a task.


Antibiotics are used in many forms in the scope of our practice to control or prevent bacterial infections or to reduce the destructive effects of the body’s response to bacteria.

Systemic Antibiotics
Antibiotics are delivered systemically via pills, I.V., or intramuscular injection. They are primarily used to control acute infection or as an adjunct to control a severe, chronic infection. For some patients antibiotics are prescribed prior to dental treatment to reduce risks of bacterial infection to the heart or artificial joints.

Locally Delivered Antibiotics
There are several antibiotics that are available for use in the areas where infections occur around the teeth. They are provided in the form of a gel, fiber, or chip and can be placed under the gum by a hygienist or Dr. Metz for the treatment of periodontal disease. Full mouth treatment with locally-delivered antibiotics is not cost effective; however, when localized sites need treatment, antibiotics can be an important tool to help combat gum disease.

Host Modulated Antibiotics

PERIOSTAT is a very low dose antibiotic (Doxycycline), which is administered to reduce the destructive effects of the immune response against bacteria causing gum disease. The antibiotic is delivered in such a low dose that it does not kill the bacteria but reduces the inflammation associated with its presence. Periostat has been shown to be effective as an adjunct to other forms of periodontal treatment such as scaling and root planing.