Dental scaling is the most common nonsurgical way to treat gum disease, which is also known as periodontitis.
If your disease is moderate, but not severe, your dentist may recommend scaling to treat the disease and keep it from getting worse. But if you have severe periodontal disease and your condition may require gum surgery, your dentist and periodontist may recommend a scaling and root planing before the surgery, as well as a thorough teeth-cleaning prior to the procedure.

The sticky, bacteria-filled plaque that causes gum disease tends to accumulate in the area along and just below the gum line. If you have gums that are slightly receded from your teeth, you may be at increased risk for gum disease and your dentist may recommend scaling. Scaling is nonsurgical, but it is a different type of procedure from a standard dental cleaning because it involves cleaning the areas of the tooth below the gum line.

There are two types of scaling instruments and some dentists or dental hygienists may use both:

Scaling with hand-held instruments: Your dentist or periodontist will use a dental scaler and curette to manually remove (scale) the plaque from the teeth. Because the dentist or dental hygienist can't see the plaque, they rely on touch to identify areas of tartar buildup and rough spots.

Scaling with ultrasonic instruments: Ultrasonic scaling instruments clean plaque from the teeth with a vibrating metal tip that chips off the tartar and a water spray to wash it away and keep the tip cool.

Both crowns and most bridges are fixed prosthetic devices. Unlike removable devices such as dentures, which you can take out and clean daily, crowns and bridges are cemented onto existing teeth or implants, and can only be removed by a dentist.

How do Crowns Work?

A crown is used to entirely cover or "cap" a damaged tooth. Besides strengthening a damaged tooth, a crown can be used to improve its appearance, shape or alignment. A crown can also be placed on top of an implant to provide a tooth-like shape and structure for function. Porcelain or ceramic crowns can be matched to the color of your natural teeth. Other materials include gold and metal alloys, acrylic and ceramic. These alloys are generally stronger than porcelain and may be recommended for back teeth. Porcelain bonded to a metal shell is often used because it is both strong and attractive.

Your dentist may recommend a crown to:

Replace a large filling when there isn't enough tooth remaining

Protect a weak tooth from fracturing

Restore a fractured tooth

Attach a bridge

Cover a dental implant

Cover a discolored or poorly shaped tooth

Cover a tooth that has had root canal treatment

A root canal is a treatment used to repair and save a tooth that is badly decayed or becomes infected. During a root canal procedure, the nerve and pulp are removed and the inside of the tooth is cleaned and sealed. Without treatment, the tissue surrounding the tooth will become infected and abscesses may form.

"Root canal" is the term used to describe the natural cavity within the center of the tooth. The pulp or pulp chamber is the soft area within the root canal. The tooth's nerve lies within the root canal.

A tooth's nerve is not vitally important to a tooth's health and function after the tooth has emerged through the gums. Its only function is sensory -- to provide the sensation of hot or cold. The presence or absence of a nerve will not affect the day-to-day functioning of the tooth.

Why Does Tooth Pulp Need to Be Removed?

When a tooth's nerve tissue or pulp is damaged, it breaks down and bacteria begin to multiply within the pulp chamber. The bacteria and other decayed debris can cause an infection or abscessed tooth. An abscess is a pus-filled pocket that forms at the end of the roots of the tooth. An abscess occurs when the infection spreads all the way past the ends of the roots of the tooth.

In addition to an abscess, an infection in the root canal of a tooth can cause:

Swelling that may spread to other areas of the face, neck, or head,

Bone loss around the tip of the root,

Drainage problems extending outward from the root. A hole can occur through the side of the tooth with drainage into the gums or through the cheek with drainage into the skin..

A filling is a way to restore a tooth damaged by decay back to its normal function and shape. When a dentist gives you a filling, he or she first removes the decayed tooth material, cleans the affected area, and then fills the cleaned out cavity with a filling material.

By closing off spaces where bacteria can enter, a filling also helps prevent further decay. Materials used for fillings include gold, porcelain, a composite resin (tooth-colored fillings), and an amalgam (an alloy of mercury, silver, copper, tin and sometimes zinc).

Which Type of Filling is Best?

No one type of filling is best for everyone: What's right for you will be determined by the extent of the repair, whether you have allergies to certain materials, where in your mouth the filling is needed, and the cost. Considerations for different materials include:

Gold fillings are made to order in a laboratory and then cemented into place. Gold inlays are well tolerated by gum tissues, and may last more than 20 years. For these reasons, many authorities consider gold the best filling material. However, it is often the most expensive choice and requires multiple visits.

Amalgam (silver) fillings are resistant to wear and relatively inexpensive. However, due to their dark color, they are more noticeable than porcelain or composite restorations and are not usually used in very visible areas, such as front teeth.

Composite (plastic) resins are matched to be the same color as your teeth and therefore used where a natural appearance is desired. The ingredients are mixed and placed directly into the cavity, where they harden. Composites may not be the ideal material for large fillings as they may chip or wear over time. They can also become stained from coffee, tea or tobacco, and do not last as long as other types of fillings generally from three to 10 years.

Porcelain fillings are called inlays or onlays and are produced to order in a lab and then bonded to the tooth. They can be matched to the color of the tooth and resist staining. A porcelain restoration generally covers most of the tooth. Their cost is similar to gold.

If decay or a fracture has damaged a large portion of the tooth, a crown, or cap, may be recommended. Decay that has reached the nerve may be treated in two ways: through root canal therapy (in which nerve damaged nerve is removed) or through a procedure called pulp capping (which attempts to keep the nerve alive).

A dental extraction is the procedure to remove a tooth from your mouth. A dental extraction is most commonly required if one of your teeth is damaged beyond practical repair.

The most common reasons for tooth extractions include:

Severe tooth decay or infection may make it impossible or too costly to repair a tooth

Advanced gum disease may required a tooth to be pulled so it doesn’t affect the supporting tissues and bone structures of your mouth,

A tooth may be extracted if it is blocking other teeth,

During orthodontic work, teeth may need to be extracted to create room for the teeth that are being moved into place Wisdom teeth are often extracted either before or after.

More than just a pretty smile: Orthodontics can help you keep your mouth healthy. Orthodontic treatments like braces help move teeth that are crooked or that do not fit together right. By fixing these problems, orthodontics can also help keep your mouth healthy. Crooked teeth can be harder to clean, putting you at risk for cavities and gum disease.

Using x-rays and other tools, your dental professional will decide if orthodontic treatments are right for you.

When should treatment begin?

The best age is between 10 and 14. This is when a child's head and mouth are still growing and teeth are easier to straighten, but patients can get braces at any age. In fact, more and more adults are getting braces.

How Do I Help My Children Care for Their Teeth and Prevent Cavities?

Teaching your child proper oral care at a young age is an investment in his or her health that will pay lifelong dividends. You can start by setting an example; taking good care of your own teeth sends a message that oral health is something to be valued. And anything that makes taking care of teeth fun, like brushing along with your child or letting them choose their own toothbrush, encourages proper oral care.

To help your children protect their teeth and gums and greatly reduce their risk of getting cavities, teach them to follow these simple steps:

Brush twice a day with an ADA — accepted fluoride toothpaste to remove plaque-the sticky film on teeth that's the main cause of tooth decay.

Floss daily to remove plaque from between your teeth and under the gumline, before it can harden into tartar. Once tartar has formed, it can only be removed by a professional cleaning.

Eat a well-balanced diet that limits starchy or sugary foods, which produce plaque acids that cause tooth decay. When you do eat these foods, try to eat them with your meal instead of as a snack-the extra saliva produced during a meal helps rinse food from the mouth.

Use dental products that contain fluoride, including toothpaste.

Make sure that your children's drinking water is fluoridated. If your water supply; municipal, well or bottled does not contain fluoride, your dentist or pediatrician may prescribe daily fluoride supplements.

Take your child to the dentist for regular checkups.