Periodontal Disease

dentist checking female patient

We can treat Periodontal Disease in one visit with sedation!

At many dental offices, treating periodontal disease completely may take up to four individual visits. Can you imagine having multiple fires in your yard and only putting out one or two? Dr. Davidian believes that by streamlining the overall process into one visit will increase your chances of success by removing unwanted bacteria. By doing so, this will discontinue the bacteria from reinfecting new or healing sites. Visiting our office is paramount to reaching optimal health in a timely manner.

The term “periodontal” literally means “around the tooth”, thus periodontal disease means disease around the tooth, specifically in the gums and supporting soft tissues. When periodontal disease affects only the gums it is known as gingivitis, however as it progresses, it can turn into periodontitis, which also affects the underlying soft tissues and eventually the jawbone.

Gum disease occurs when excess amounts of bacteria accumulate along the gum line and/or on the surface of the teeth, causing irritation. These bacteria ultimately cause the gum tissue to become inflamed. Without treating, the infection will continue to spread down below the gum line, where it can cause an inflammatory response in which the body starts to break down its own bone and soft tissue. When this happens, the teeth can shift or even fall out.

Did You Know?

As many as 4 out of 5 adults have some form of periodontal disease and many don’t even know it. This is because the early stages often don’t have noticeable symptoms. Unfortunately, however, periodontal disease is the leading cause of tooth loss in developed nations.

Frequently Asked Questions:

Do I have periodontal disease?

While an accurate diagnosis of periodontal disease can only be made after being thoroughly examined by your dentist, some possible signs of periodontal disease include:

  • Gums that bleed easily when brushing or flossing
  • Persistent bad breath
  • Tenderness in the gums
  • Red and/or swollen gums
  • Receding gums
  • Pus around the gums
  • Loose teeth
  • New spaces around the teeth

If you think you may have periodontal disease, schedule a consultation with Sedation Dental Care at Raleigh Smile Center in order to receive an accurate diagnosis and treatment plan.

How is periodontal disease treated?

There are a variety of treatments available for periodontal disease, however the exact treatment for you will depend on the severity of your case and what structures have been affected. Possible treatments for periodontal disease can include:

  • Scaling and root planing: this is one of the most common non-surgical treatments for periodontal disease. It resembles a traditional dental cleaning, however it also cleans below the gum line instead of just along the gum line. Once plaque and tartar has been removed from the gum pockets, antibiotics are usually placed in the pockets to eliminate the infection. Additionally, a prescription mouthwash can also be used.
  • Pocket elimination surgery: this surgical technique, also sometimes known as flap surgery, reduces the size of the gum pockets to decrease the amount of bacteria that can accumulate. In some cases, this procedure also works to eliminate bone indentations where bacteria have accumulated as well.
  • Tissue Regeneration: in cases where the bone and gum tissue has been destroyed, a bone graft may need to be placed in order to encourage new bone growth. Bone grafts are surgical procedures that are commonly associated with the placement of dental implants. Dental implants are artificial tooth roots that are sometimes used to replace missing teeth lost by periodontal disease.

Can dental sedation be used?

Yes! Dental sedation, also known as anxiety-free dentistry, is ideal for individuals who have dental anxiety, a sensitive gag reflex, or for those who simply want to relax during their dental procedure. Your dental sedation options include:


Valium is an anti-anxiety medication (diazepam) that is taken orally before a dental procedure. When under the effects of valium sedation, patients describe feeling “loopy” and uninterested with whatever procedure is being performed despite being aware of what is happening. Ativan is also an anti-anxiety medication (Lorazepam) that produces a calming effect and impairs memory formation. Since the effects of valium and Ativan can linger, a driver will be needed to drive you home.

Nitrous Oxide

Commonly known as “laughing gas” for its production of euphoric feelings, nitrous oxide is a form of inhaled sedation. When receiving nitrous oxide sedation, you can expect to have a small mask placed over your nose. As soon as you begin inhaling nitrous oxide gas, you will feel your body relax, but you will remain conscious. In some cases, you may fall into a light sleep. Once you stop inhaling the gas, you will quickly return to normal. Since nitrous oxide is only effective when being inhaled, you will be able to drive and return to your normal activities after undergoing nitrous oxide sedation.

Oral Sedation

Oral sedation medication is delivered by mouth involving a pill or liquid. Depending on the dosage, the level of sedation can range from minimal to moderate. When receiving oral sedation, you can expect to be drowsy and fall asleep.  We will be able to wake you, talk to you at times.  We wake you when we are using a lot of water or checking your bite. Oftentimes, patients that undergo oral sedation have little to no memory of their procedure. The effects of oral sedation will continue to linger after the procedure, so you will need a driver and someone to stay with you until the sedation has worn off.

IV Sedation

IV sedation is delivered through the vein, which makes it easy to control the amount of sedation you receive. IV sedation is used to achieve a mild to moderate level of sedation. Many times we start with oral sedation to alleviate the fear of the IV. Since the effects of IV sedation linger after the procedure, you will need a driver and someone to stay with you until the medication wears off.

General Anesthesia / Monitored Anesthesia

We employ the services of a Dental Anesthesiologist to deliver general anesthesia or monitor patients with specific health concerns that would prevent them from sedation in a typical office.  General anesthesia allows us to achieve greater levels of sedation and anesthesia. We can utilize an anesthesiologist to treat patients that have severe phobias, gag reflexes and patients with different medical conditions, and tolerances.  Having an anesthesiologist also allows us to treat most autistic patients and individuals that have intellectual challenges. The effects of general anesthesia will linger, meaning you will need a driver and someone to stay with you until the effects of the sedation have worn off.

Benefits of Dental Sedation

  • Reduces anxiety and promotes relaxation
  • Decreases discomfort from tension
  • Eliminates the gag reflex
  • Safe & minimal side effects
  • Combine treatments to save time & money

Dental sedation is ideal for individuals who experience feelings of anxiety or fear when visiting the dentist, as well as those who have an active gag reflex. Almost anyone can safely undergo dental sedation, however there are a few exceptions. For example, pregnant women, people with allergies to benzodiazepines, those with sleep apnea, or who are taking certain medications may not be an ideal candidate for sedation.

Because safety is our priority, our office offers consultations to determine if dental sedation is appropriate and what form would be best for your individual needs. During your consultation, you will be greeted and welcomed into our dental family. Our doctors will get to know you, listen, answer any questions you may have, and establish a good foundation for your oral health.


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