Which is the best treatment approach for a diabetic 58yr old man with degenerative gum disease?

Treat the bacteria: Diabetics have a harder time fighting off infections. Find a doctor who uses the perio protect method as it delivers a hydrogen peroxide gel into the infected region and kills the harmful bacteria within days. Used regularly you can keep the disease from coming back and you can control the problem. Preventing the problem by controlling the cause is your best answer.

Comprehensive trx: May be you have chronic periodontitis. You need to work on controlling your diabetes and gum infection at the same time. These two conditions/diseases are closely related. It is harder to control your gum infection if the blood sugar is not controlled and vise versa. Controlling one condition will help controlling the other condition. Go to see a periodontist is my advise.

See your dentist: And your physician. Both conditions make the other worse. You may need a deep cleaning and then surgical treatment for the gums; but treating the inflammation in the mouth will sure help the control of your blood sugar too.