Gum Disease and Improved Treatments

Gum disease is rampant in our society.  More than half of all people over 18 have at least the early stage of gum disease called periodontal disease.  After age 35, three out of four adults are infected.   The major cause of tooth loss is gum disease.   Gum disease affects the entire body being correlated with heart disease, diabetes, strokes, ulcers, and pre-term births. Luckily, there are new advances in periodontal treatment. One of the best is the use of antibiotics put directly in the gums, a product called Arestin.

What is Periodontal Disease?

Periodontal disease is a chronic bacterial infection of the gums that causes damage to the gums, tissue, and bone around your teeth.  Periodontal disease is often painless, and usually develops slowly over many years, but may progress in rapid destructive stages.  The destruction of tissue and bone causes pockets around teeth that can lead to tooth loss.  Being warm and moist, gum pockets are an ideal environment for bacteria. The bacteria can feed on the sides of the pocket, increasing the pocket depth, which adds instability to the teeth. Bacteria form rough deposits, which are an irritation to the gums, causing gum bleeding and swelling.

Improved Treatments

Scaling and Root Planing

Often called a ‘Deep Cleaning’, scaling and root planing (SRP) is the first step in treating gum disease. Scaling removes plaque, tartar, and stains from the surface of the tooth and its root; planing smoothes the rough areas on the roots of teeth to promote healing.  Root Planing sounds like a rough carpenter term but actually is the fine smoothing of root surface using numerous light strokes.  The objective is to make the root surface super smooth by removing all the rough tartar and making it more difficult for the bacteria to adhere to the root surface.  Ultrasonic scalers comfortably speed up the process using ultrasonic vibration and warm water.  Depending on a person’s comfort needs, numbing with topical gel, anesthetic, headphones, nitrous oxide or conscious sedation can be used.

Arestin – Antibiotic Treatment

A recent advancement in periodontal treatment is the use of Arestin, an antibiotic treatment that is put into deep gum pockets during root planing.  Antibiotic treatment has been tried for many years but without an effective method of keeping the antibiotic in the gums until the advent of Arestin.

Arestin contains “Microspheres”, tiny, bead-like particles that are smaller than grains of sand and are not visible to the eye. The Microspheres are filled with the antibiotic minocycline, and they release the drug over time into the infected periodontal pocket, killing the bacteria that cause periodontal disease. Arestin Microspheres continue to fight the infection for up to 21 days.

Arestin is placed inside infected periodontal pockets just after the scaling and root planing (SRP) procedure is finished. Even though SRP removes a great deal of the bacteria that cause periodontal infection, the instruments used during this mechanical procedure can’t always reach the bacteria that hide in the bottom of pockets or in difficult to reach areas. Adding Arestin helps to kill the bacteria left behind, plus the slow release of Arestin allows the gum tissue to heal without the reinvasion of bacteria.

Amazing Results with Arestin

Since using Arestin for the past 3 years, I have seen amazing improvements in gum health. In the past teeth that were very loose with extremely deep gum pockets would be considered not savable and need an extraction. With the use of Arestin, many of these teeth have tightened up with major gum pocket reduction.  Two years ago, a 45-year-old woman had a loose first molar with a 12 mm pocket; extreme bone loss and I recommended extraction.  She wanted to try and save the tooth so I said we could try Arestin with scaling and root planning.  Amazingly the tooth tightened up.  She works hard on her dental hygiene and continues to have cleanings every three months. During those appoints, Arestin is added as needed. The tooth is still going strong today.

Avoiding Surgery

Arestin has helped avoid the need for gum surgery.  Surgery is very affective treatment, but is much more invasive and costly.  Plus with Arestin, the gum pocket can be retreated much easier. The most important aspect of periodontal treatment is the regular on-going maintenance visit, usually every 3 months.  It always bothers me when patients would have gum surgery, their gums would look great afterwards, and they would have regular cleaning appointments for awhile, doing great and then disappear for a few years, return and need surgery again.  Scaling and root planning with Arestin can often prevent that need. Often a periodontal pocket can be controlled with the retreatment of SRP and Arestin.

Periodontal Disease is often called ‘The Silent Killer’, because it can occur gradually and painlessly over time.  The good news is that gum disease can be stopped with professional treatment, such as SRP and Arestin.   So, please don’t wait until it hurts!  Have regular dental exams and cleanings.

Enjoy Life and Keep Smiling!

George Malkemus has had a Family and Cosmetic Dental Practice in Rohnert Park for over 22 years at 2 Padre Parkway, Suite 200. Call 585-8595, or email info@  Visit Dr. Malkemus’ Web site at

George A. Malkemus DDS
2 Padre Pkwy #200, Rohnert Park, CA 94928
Phone | (707) 585-8595

Gum Disease and Improved Treatments

4 Risk Factors of Gum Disease to Discuss with Your Dentist

Have you ever had something caught in your teeth for days? It’s likely because it was lodged deep between a tooth and your gums. That gum tissue is what keeps our chompers in place. There are three stages of gum disease and all are treatable.

The mild form of gum disease is Gingivitis. This is where plaque and other byproducts irritate the gums. It makes them swollen, tender, and more likely to bleed. Periodontitis is stage two. The gum tissue starts deteriorating as it detaches from the teeth forming pockets around the roots. This leaves teeth exposed and more susceptible to decay. Finally, Advanced Periodontitis can set in. Tooth pockets get deeper as the severe gum recession leads to bone loss causing loose teeth.

Common Risk Factors of Periodontal DiseaseGum Disease Sigh

  • Genetics – it’s hereditary and some of us are just unlucky! While you may be more susceptible to periodontitis, having a good oral hygiene routine with regular dental visits can help your smile stay healthy. Talk to us about finding the right balance for your needs.
  • Health – underlying medical conditions like diabetes and Crohn’s disease, as well as lowered immunity from illnesses and treatments often affect gum tissue. Medications, hormonal changes and obesity are also culprits and should be discussed.
  • Bad Habits – chewing on ice, not brushing or flossing daily and using tobacco are the most common behavior changes we encourage you to ditch. However, substance abuse and a diet lacking in vitamin C will also impact your smile.
  • Stress – it’s inevitable. But keep an eye on exactly how much it’s weighing you down. High levels or chronic stress can lead to poor hygiene habits. Anxiety can also lower your immune system from effectively fighting off bacteria that causes gingivitis (stage 1).

When to Seek HelpCapture

Common red flags of gum disease include:

  • Bleeding gums
  • Swollen or tender gums
  • Gums look bright red
  • Teeth wiggle

There’s no home remedy to cure gum disease. Only professional treatment can help, so call and schedule an exam today (707) 585-8595


2 Padre Pkwy #200, Rohnert Park, CA 94928

Phone | (707) 585-8595

4 Risk Factors of Gum Disease to Discuss with Your Dentist