PERIODONTOLOGY
Non‑surgical periodontal treatment
Non-surgical periodontal treatment aims to control inflammation, reduce periodontal pockets, and stabilize the supporting tissues of the teeth.
Schedule an initial consultation →Key points
Non-surgical periodontal treatment is generally the first step in managing periodontitis. It is based on an etiological approach: identifying and controlling the causes of inflammation, improving oral hygiene, removing bacterial deposits, and cleaning root surfaces located beneath the gumline.
At the 47VH clinic in Nice, we tailor this treatment to each patient according to the severity of the periodontal disease, pocket depth, and associated risk factors.
What is non-surgical periodontal treatment?
Non-surgical periodontal treatment aims to control the infection and inflammation responsible for the progressive destruction of the supporting tissues of the teeth.
It is most often the first phase in the treatment of periodontitis. This approach targets the main cause of the disease: the accumulation of bacterial plaque and calculus above and below the gumline.
Treatment generally includes:
- personalized reinforcement of oral hygiene techniques;
- deep scaling;
- root planing;
- periodontal re-evaluation after healing;
- and, if necessary, regular maintenance to stabilize the results.
When oral hygiene is well controlled and inflammation decreases, the gums reduce in swelling, bleeding diminishes, and periodontal pocket depth decreases.
Personalized plaque control reinforcement
The first step is to durably reduce the bacterial load responsible for periodontal inflammation.
Your periodontist explains the mechanisms of periodontitis and guides you in improving your oral hygiene techniques. The goal is not only to “brush better,” but to adapt brushing techniques and tools to your clinical situation.
Recommendations include in particular:
- adapted brushing techniques;
- the use of dental floss;
- the choice and use of interdental brushes;
- the frequency of home oral hygiene care;
- areas that are difficult to clean;
- aggravating factors such as smoking, certain overhanging restorations, or a history of periodontitis.
This step is essential: without effective plaque control, it is more difficult for patients to maintain the results of periodontal treatment over time.
Scaling and root planing
Scaling and root planing allow the removal of bacterial deposits, calculus, and toxins present on the teeth and root surfaces.
Using ultrasonic and hand instruments, the clinician cleans the tooth surfaces above and below the gumline. This deep cleaning decontaminates periodontal pockets and makes root surfaces more conducive to gingival healing.
When necessary, we also adjust overhanging restorations or prostheses to facilitate daily oral hygiene and reduce plaque re-accumulation.
We perform the treatment progressively and adapted to the patient’s sensitivity. We offer local anesthesia when pocket depth or inflammation justifies it.
Is antibiotic treatment necessary?
In certain situations, we prescribe antibiotic therapy as an adjunct to mechanical treatment.
We consider this in cases of severe periodontitis, active infection, rapidly progressing forms, or an insufficient response to initial treatment. A microbiological test may help guide this decision.
Antibiotics never replace mechanical periodontal treatment. They are used only as an adjunct to scaling, root planing, and plaque control.
Microbiological tests and additional analyses
Depending on the clinical situation, we may propose additional examinations to refine the diagnosis or better understand the response to treatment.
A microbiological test allows the identification of certain bacteria associated with severe or persistent forms of periodontitis. In some cases, we also investigate general factors, particularly in the presence of significant inflammation, chronic disease, smoking, or impaired healing.
These tests are not performed routinely. They are prescribed when their results are likely to influence the treatment strategy.
Periodontal re-evaluation after treatment
Periodontal re-evaluation is an essential step in treatment.
We perform it approximately two months after the initial phase. The periodontist re-measures pocket depths using a probe, checks for bleeding, assesses plaque control, and evaluates the response of the gingival tissues.
This re-evaluation allows us to determine whether the disease is stable or whether certain areas require additional treatment.
When deep pockets persist despite non-surgical treatment, we may recommend targeted periodontal surgery to gain more precise access to the lesions and achieve better control of the infection.
Periodontal maintenance
Once the disease is stabilized, periodontal maintenance helps preserve the achieved results.
These regular maintenance visits aim to control inflammation, prevent recurrence of periodontal pockets, remove hard-to-reach deposits, and adjust oral hygiene techniques when necessary.
The frequency of visits depends on each patient’s level of risk. They are generally scheduled every three to four months, particularly for patients with a history of severe periodontitis or associated risk factors.
Maintenance is an integral part of treatment: periodontitis is a chronic disease that can recur if follow-up is interrupted.
Can periodontitis be treated without surgery?
In many cases, non-surgical periodontal treatment controls inflammation and stabilizes the disease.
However, the outcome depends on several factors: the initial severity of periodontitis, pocket depth, the quality of oral hygiene, smoking, the patient’s general health, and the regularity of maintenance care.
When certain pockets persist after the initial phase, we propose targeted surgical treatment. The objective remains the same: control inflammation, preserve the teeth, and stabilize the supporting tissues.
Bibliographic References
- Sanz M. et al. — Treatment of stage I–III periodontitis: the EFP S3 level clinical practice guideline. J Clin Periodontol, 2020. PubMed PMID 32383274
- Tonetti M.S. et al. — Staging and grading of periodontitis: framework and proposal of a new classification and case definition. J Periodontol, 2018. PubMed PMID 29926952
- Suvan J.E. et al. — Subgingival instrumentation for treatment of periodontitis. A systematic review. J Clin Periodontol, 2020. PubMed PMID 31889320
- Teughels W. et al. — Adjunctive effect of systemic antimicrobials in periodontitis therapy: a systematic review and meta-analysis. J Clin Periodontol, 2020. PubMed PMID 31994207
- Lang N.P., Tonetti M.S. — Periodontal risk assessment (PRA) for patients in supportive periodontal therapy (SPT). Oral Health Prev Dent, 2003. PubMed PMID 15643744
FAQ
Is non-surgical periodontal treatment painful?
The treatment is performed under local anesthesia — you do not feel any pain during the procedure.
In the days following treatment, mild tooth sensitivity may occur, particularly to cold, but it gradually subsides.
How many sessions are needed?
Le nombre de séances dépend de l’étendue de la parodontite et du nombre de dents concernées.
En général, le traitement se déroule en deux à quatre séances, suivies d’une réévaluation parodontale environ deux mois après la fin du traitement.
Is this treatment reimbursed?
Le détartrage sous-gingival et le surfaçage radiculaire peuvent être partiellement remboursés par l’Assurance maladie dans certaines situations spécifiques.
Cette prise en charge concerne uniquement les patients diabétiques présentant une parodontite. Un devis détaillé vous est remis avant tout traitement.
Can periodontitis be permanently cured?
Periodontitis is a chronic disease that can be stabilized but not permanently cured.
Le traitement non chirurgical permet de contrôler l’infection et de stopper la progression de la maladie. Une maintenance parodontale régulière est indispensable pour éviter les récidives.
Should you stop smoking before treatment?
Le tabac est l’un des principaux facteurs de risque de la parodontite — l’arrêt du tabac améliore significativement les résultats du traitement.
It reduces the visible inflammatory response, masks clinical signs, and impairs healing. Stopping smoking is strongly recommended before and during treatment.
When is periodontal surgery necessary?
When deep periodontal pockets persist after non-surgical treatment, surgery may be indicated.
Elle permet d’accéder plus précisément aux lésions et d’améliorer le contrôle de l’infection. Cette décision est prise lors de la réévaluation parodontale, environ deux mois après la fin du traitement initial.
Can I consult directly without being referred by my dentist?
Oui — vous pouvez nous contacter directement, sans ordonnance ni lettre d’adressage.
À l’issue de la consultation, un compte-rendu est systématiquement adressé à votre praticien correspondant pour assurer la continuité de votre suivi dentaire global.