We offer
the following Periodontal Procedures at our clinic:
Non-Surgical
Therapy Periodontal Procedures
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Gum
Disease (Periodontitis)
Gum disease is a progressive
inflammatory disease of the gums and the surrounding tissue around
the teeth. It is commonly known as gum disease and was referred
to as pyorrhea in the old days. It is estimated that up to 80% of
the population above the age of 40 may suffer from this disease
with the severity varying drastically from one person to another.
Periodontitis is the number one cause of tooth loss after the age
of 40.
If you notice any of
the following signs of gum disease, schedule an appointment immediately:
- gums that bleed
when you brush your teeth
- red, swollen or
tender gums
- gums that have
pulled away from the teeth
- bad breath that
doesn't go away
- pus between your
teeth and gums
- loose teeth
- a change in the
way your teeth fit together when you bite
- a change in the
fit of partial dentures
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Laser
Periodontal, or gum related care |
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Gum
related care has greatly benefited from
laser technology applications. Lasers are currently used for
re-contouring or reshaping gums, removing extra or diseased gum
tissue associated with the use of certain medications or periodontal
disease. Additionally, lasers are used for removing the bacteria
in periodontal pockets to promote patient recovery, and are credited
for greatly reducing both recovery time and post operative distress
and/or discomfort.
Gum and bone disease (periodontal
disease) is a common infection that causes bad breath, sore gums,
receding gums and bone and loose teeth. Sufferers may be putting their
hearts at risk because the bacteria can attach to heart valves. This
bacterial infection can also be transmitted to other people in your
family thr |
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Minor gums infections can be treated by ultrasonic and ozone cleaning
with a hygienist, but more serious stages of gum disease usually
need specialist care with a periodontist. Many times this involves
surgery that can be costly and traumatic. The good news is with
lasers we can offer more conservative and non-traumatic treatment
for moderate to serious gum disease. We work closely with a local
periodontist to ensure that if results are not achieved with the
laser that they are able to assist.
Laser gum disease treatment does not involve cutting and
sutures. It is much less invasive, usually painless and
without swelling. Healing and recovery are very fast and you don't
need to take extra days off work. This will save you time and money.
Treatment of gum
disease is aimed at cleaning the debris and toxins from beneath
the gum-line. This is accomplished virtuously painlessly and comfortably
using the latest and most conservative approach that suits your
particular stage of disease. All phases of treatment is provided
by certified dentist using Laser technology.
When lasers are used during periodontal therapy, there can be less
bleeding, swelling and discomfort to the patient. Scalpels and stiches
are often not necessary resulting in quick and comfortable healing.
Laser therapy can
be more effective in addressing the infectious nature of periodontal
disease than traditional methods. The laser can physically
interact with the bacteria and kill the organism by the absorption
of laser energy. Studies have shown the laser’s ability to reduce
99.4% of the bacteria in a periodontal lesion. In addition, the
laser can assist in forming a fibrin clot eliminating post-surgical
bleeding and providing a quick and comfortable healing. |
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Cosmetic
Periodontal Surgery
These procedures are a predictable
way to cover unsightly, sensitive or exposed root surfaces and to prevent
future gum recession. If you are unhappy with the appearance of short
unsightly teeth this can be greatly improved by a combination of periodontal
procedures and cosmetic dentistry.
Although your teeth appear
short, they may actually be the proper length. The teeth may be covered
with too much gum tissue. We can correct this by performing the periodontal
plastic surgery procedure, crown
lengthening.
During this procedure, excess
gum and bone tissue is reshaped to expose more of the natural tooth. This
can be done to more than one tooth, to even your gum line, and to create
a beautiful smile.
Another cosmetic procedure
is the soft tissue graft. It
is used to cover unattractive tooth roots, reduce gum recession and protect
the roots from decay and eventual loss.
Tooth loss causes the jawbone
to recede and can lead to an unnatural looking indentation in your gums
and jaw, an appearance of a general aging. The original look of your mouth
may not be recaptured because of spaces remaining under and between replacement
teeth. They may appear too long compared to nearby teeth.
Bone grafting following tooth
loss can preserve the socket/ridge and minimize gum and bone collapse.
There is less shrinkage and a more esthetic tooth replacement for either
an implant crown or fixed
bridge around the replacement teeth.
Flap
Surgery
Periodontal Flap Surgery,
which is also called pocket depth reduction, your periodontist folds the
gum back away from the tooth. Periodontal Flap surgery is recommended
in many cases where pocketing depths have reached a level that makes maintenance
or cleansing difficult. It is often associated with areas of bone loss
and inflammation of the gum tissue around the teeth when scaling and root
planing have been unsuccessful in eliminating the entire pocket of decay,
or when there has been bone loss that needs to be surgically corrected,
then a dentist may perform periodontal flap surgery.
In flap surgery, under local
anesthesia, small incisions are made in the gum, so that it can be lifted
back to expose the tooth and bone. The entire area is carefully cleaned
and all tarter and infected granulation tissue are removed and the bone
is examined. Because periodontal disease causes bone loss, often the bone
will need to be re-contoured in order for the gum to heal properly.
After scraping away the bacteria-laden
plaque and tartar, the dentist removes diseased tissue and smoothes the
surface of damaged bones. Then the dentist sews the tissue back into place.
Removing or smoothing damaged tissue allows the gum tissue to better reattach
to healthy bone.
Click
here for Post Op (Self-Care) instructions following Periodontal Flap
Surgery
Gingivectomy:
This procedure is performed when excess amounts of gum growth around the
teeth have occurred. This results in false pocket formation and the inability
to keep them clean.
Guided
Tissue Regeneration: This procedure is done in combination with
a surgical flap operation where gum growth into a defect is barriered
off to allow slower growing bone, cementum and ligament cells to populate
a bony defect.
Gingivoplasty:
Gingivoplasty is a procedure in which we surgically reshape and re-contour
the gum tissue for cosmetic, physiological, or functional purposes.
Gingivoplasty is the surgical
reshaping of the outer surface of the gums and it's usually done in combination
with gingivectomy. The term comes from gingiva meaning gums and the word
ending -plasty meaning to reshape. Many patients have a gummy smile which
is caused by excessive and overgrown gum tissue. Excess gum tissue can
usually be removed to reveal a beautiful smile underneath.
After a gingivectomy procedure,
the gingivoplasty procedure thins the remaining gums tissue so the tissue
looks natural and pleasing. It's done this using an electrosurgery unit
and a specially designed electrical cutting tip. The electrosurgery unit
uses electricity to cut the gum tissues and at the same time, causes the
gum tissues to clot and stop bleeding.
Gingivoplasty corrects the
remaining thick and unnaturally shaped gum tissue left after the gingivectomy
procedure exposes the hidden teeth. Natural gum tissue thins as it approaches
and surrounds teeth. It can get confusing because the two procedures are
almost always used at the same time. These procedures can also be used
to reshape irregularly shaped and unattractive gums.
Gingivoplasty procedures are
usually done with local anaesthetics. The electrosurgery equipment minimizes
bleeding and most patients experience very little post operative pain
after the procedure
Non-Surgical
Therapy Periodontal Procedures
Scaling
: Scaling is procedure that meticulously
removes contamination toxins, micro-organisms, plaque, tartar, cementum,
dentin that is rough and/or permeated by calculus from around, below and
under the gum line down to the bottom of the pocket. This is done to remove
biofilm, calculus, and toxin down to the bottom of each periodontal pocket
in order to obtain a healing response.
Root
Planing: Root planing involves smoothing the root surfaces of
your teeth with thin curettes so gum tissue can more firmly reattach to
roots that are clean and smooth to prevent tooth loss and sensitivity
problems. The procedure makes it more difficult for plaque to accumulate
along the root surfaces. Because this procedure goes deeper than a regular
cleaning, your mouth may be numbed. The cleaning may take two visits to
complete. Depending on the extent of the disease you may need one or more
sections (quadrants) of the mouth to be treated with scaling and root
planing. Treatment may require one or more visits.
Periodontal
scaling is a treatment procedure which involves the instrumentation
of the crown and root surfaces of the teeth. Plaque, calculus, and stains
will be removed from these surfaces. It is performed on patients with
periodontal disease and is therapeutic, as apposed to prophylactic and
may precede root planning. It is a definitive, meticulous treatment procedure
aimed at the removal of cementum and/or dentin that is rough and is possibly
permeated by calculus, or even contaminated with toxins or microorganisms.
When carried out thoroughly, some unavoidable soft tissue removal occurs.
This procedure can be used as a definitive treatment or as part of pre-surgical
therapy ("tissue preparation") depending on how far the periodontal
disease has advanced. Debriding the root surface is a critical element
in establishing periodontal health.
Antibiotics:
Because bacteria cause periodontitis antibiotics may be prescribed as
pills or as an Antibiotic fiber. The fibers are used in conjunction with
scaling and root planing. They are placed directly into the pockets and
are removed within 7-10 days later. Antibacterial mouth rinses may also
be recommended to help plaque control.
Bite correction:
An imbalanced bite may accelerate bone destruction. Your teeth may be adjusted
for proper and better function. A Bite-guard (removable retainer fitting
over teeth) may be required to protect teeth surfaces and relax tense muscles.
Splinting:
This technique attaches weak teeth together, combining them into a stronger
single unit, making them more sable and offering more comfortable chewing.
Please
contact us to setup a consulation.
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(FAQ
)Frequently Asked Questions about Preiodontal Disease
Who is a periodontist?
A periodontist is a dentist who specializes in the prevention,
diagnosis and treatment of periodontal disease and in the placement
of dental implants. Periodontists receive extensive training in these
areas, including three additional years of education beyond dental
school. Periodontists are familiar with the latest techniques for
diagnosing and treating periodontal disease. In addition, they can
perform cosmetic periodontal procedures to help you achieve the smile
you desire. Often, dentists refer their patients to a periodontist
when their periodontal disease is advanced. However, you don't need
a referral to see a periodontist. In fact, there are occasions when
you may choose to go directly to a periodontist or to refer a family
member or friend to your own periodontist.
Is there a relationship
between tobacco use and periodontal disease?
Studies have shown that tobacco use may be one of the most
significant risk factors in the development and progression of periodontaldisease.
Smokers are much more likely than non-smokers to have calculus form
on their teeth, have deeper pockets between the teeth and gums and
lose more of the bone and tissue that support the teeth.
What
are Causes of Periodontal Disease
The main cause of periodontal disease is bacterial plaque,
a sticky, colorless film that constantly forms on your teeth. However,
factors like the following also affect the health of your gums.
Smoking/Tobacco
Use
As you probably already know, tobacco use is linked with
many serious illnesses such as cancer, lung disease and heart disease,
as well as numerous other health problems. What you may not know is
that tobacco users also are at increased risk for periodontal disease.
In fact, recent studies have shown that tobacco use may be one of
the most significant risk factors in the development and progression
of periodontal disease.
Genetics
Research proves that up to 30% of the population may be
genetically susceptible to gum disease. Despite aggressive oral
care habits, these people may be six times more likely to develop
periodontal disease. Identifying these people with a genetic test
before they even show signs of the disease and getting them into
early interceptive treatment may help them keep their teeth for
a lifetime.
Pregnancy and
Puberty
As a woman, you know that your health needs are unique.
You know that brushing and flossing daily, a healthy diet, and regular
exercise are all important to help you stay in shape. You also know
that at specific times in your life, you need to take extra care
of yourself. Times when you mature and change, for example, puberty
or menopause, and times when you have special health needs, such
as menstruation or pregnancy. During these particular times, your
body experiences hormonal changes. These changes can affect many
of the tissues in your body, including your gums. Your gums can
become sensitive, and at times react strongly to the hormonal fluctuations.
This may make you more susceptible to gum disease. Additionally,
recent studies suggest that pregnant women with gum disease are
seven times more likely to deliver preterm, low birth weight babies.
Stress
As you probably already know, stress is linked to many
serious conditions such as hypertension, cancer, and numerous other
health problems. What you may not know is that stress also is a
risk factor for periodontal disease. Research demonstrates that
stress can make it more difficult for the body to fight off infection,
including periodontal diseases.
Medications
Some drugs, such as oral contraceptives, anti-depressants,
and certain heart medicines, can affect your oral health. Just as
you otify your pharmacist and other health care providers of all
medicines you are taking and any changes in your overall health,
you should also inform your dental care provider.
Clenching or
Grinding Your Teeth
Has anyone ever told you that you grind your teeth at
night? Is your jaw sore from clenching your teeth when you're taking
a test or solving a problem at work? Clenching or grinding your
teeth can put excess force on the supporting tissues of the teeth
and could speed up the rate at which these periodontal tissues are
destroyed.
Diabetes
Diabetes is a disease that causes altered levels of sugar
in the blood. Diabetes develops from either a deficiency in insulin
production (a hormone that is the key component in the body's ability
to use blood sugars) or the body's inability to use insulin correctly.
According to the American Diabetes Association, approximately 16
million Americans have diabetes; however, more than alf have not
been diagnosed with this disease. If you are diabetic, you are at
higher risk for developing infections, including periodontal diseases.
These infections can impair the ability to process and/or utilize
insulin, which may cause your diabetes to be more difficult to control
and your infection to be more severe than a non-diabetic.
Poor
Nutrition
As you may already know, a diet low in important nutrients
can compromise the body's immune system and make it harder for the
body to fight off infection. Because periodontal disease is a serious
infection, poor nutrition can worsen the condition of your gums.
Other Systemic
Diseases
Diseases that interfere with the body's immune system
may worsen the condition of the gums.
Is it normal
for my gums to bleed when I brush my teeth?
Bleeding gums are one
of the signs of gum disease. Think of gum tissue as the skin on your
hand. If your hands bled every time you washed them, you would know
something was wrong. There are a number of other warning signs of
gum disease.
What are pockets?
Your bone and gum tissue should fit snugly around your teeth
like a turtleneck around your neck. When you have periodontal disease,
this supporting tissue and bone is destroyed, forming "pockets"
around the teeth. Over time, these pockets become deeper, providing
a larger space in which bacteria can live. As bacteria develop around
the teeth, they can accumulate and advance under the gum tissue. These
deep pockets collect even more bacteria, resulting in further bone
and tissue loss. Eventually, if too much bone is lost, the teeth will
need to be extracted.
Could my periodontal
disease be genetic?
Research proves that up to 30% of the population may be
genetically susceptible to gum disease. Despite aggressive oral care
habits, thesepeople may be six times more likely to develop periodontal
disease. Identifying these people with a genetic test before they
even show signs of the disease and getting them into early interventive
treatment may help them keep their teeth for a lifetime.
Can I pass my
periodontal disease to others?
Periodontal disease may be passed from parents to children
and between couples, according to an article in the September 1997
issue of the Journal of the American Dental Association. Researchers
suggest that bacteria causing periodontal disease are passed though
saliva. This means that when a family or couple come into contact
with each other's saliva, they're at risk for contracting the periodontal
disease of another family member. Based on this research, the American
Academy of Periodontology recognizes that treatment of gum disease
may involve entire families. If one family member has periodontal
disease, the AAP recommends that all family members see a dental professional
for a periodontal disease screening.
Prevention
What can I do to
avoid periodontal disease?
To keep your teeth for
a lifetime, you must remove the plaque from your teeth and gums every
day with proper brushing and flossing. Regular dental visits are also
important. Daily cleaning will help keep calculus formation to a minimum,
but it won't completely prevent it. A professional cleaning at least
twice a year is necessary to remove calculus from places your toothbrush
and floss may have missed.
Other factors can affect the health of your gums.
I'm over 55. Does
this mean I'm more likely to get periodontal disease?
Your chances of developing
periodontal disease increase considerably as you get older. More than
half of people aged 55 and older have periodontitis. The good news
is that research suggests that these higher rates may be related to
risk factors other than age. So, periodontal disease is not an inevitable
part of aging. Risk factors that may make older people more susceptible
include general health status, diminished immune status, medications,
depression, worsening memory, diminished salivary flow, functional
impairments and change in financial status.
When should I
see a periodontist?
If you value your oral as well as overall health, anytime
is a good time to see a periodontist for a periodontal evaluation.
Sometimes the only way
to detect periodontal disease is through a periodontal evaluation.
A periodontal evaluation may be especially important in the following
situations:
- If you notice any symptoms
of periodontal disease, including:
- gums that bleed
easily, such as during brushing or flossing
- red, swollen or
tender gums
- gums that have pulled
away from the teeth
- persistent bad breath
- pus between the
teeth and gums
- loose or separating
teeth
- a change in the
way your teeth fit together when you bite
- If you are thinking
of becoming pregnant. Pregnant women who have periodontal disease
may be seven times more likely to have a baby born too early and
too small. In addition, about half of women experience "pregnancy
gingivitis." However, women who have good oral hygiene and
have no gingivitis before pregnancy are very unlikely to experience
this condition.
- If you have a family
member with periodontal disease. Research suggests that the bacteria
that cause periodontal disease can pass through saliva. This means
the common contact of saliva in families puts children and couples
at risk for contracting the periodontal disease of another family
member.
- If you have heart disease,
diabetes, respiratory disease or osteoporosis. Ongoing research
is showing that periodontal disease may be linked to these conditions.
The bacteria associated with periodontal disease can travel into
the blood stream and pose a threat to other parts of the body. Healthy
gums may lead to a healthier body.
- If you feel that your
teeth are too short or that your smile is too "gummy."
Or, if you are missing one or more of your teeth and are interested
in a long-lasting replacement option.
- If you are not satisfied
with your current tooth replacement option, such as a bridge or
dentures, and may be interested in dental implants.
- have a sore or irritation
in your mouth that does not get better within two weeks.
What can I expect
the first time I visit a periodontist?
During your first visit, your periodontist will review your
complete medical and dental history with you. It's extremely important
for your periodontist to know if you are taking any medications or
being treated for any condition that can affect your periodontal care.
You will be given a complete oral and periodontal exam. Your periodontist
will examine your gums, check to see if there is any gum line recession,
assess how your teeth fit together when you bite and check your teeth
to see if any are loose. Your periodontist will also take a small
measuring instrument and place it between your teeth and gums to determine
the depth of those spaces, known as periodontal pockets. This helps
your periodontist assess the health of your gums. Radiographs (x-rays)
may be used to show the bone levels between your teeth to check for
possible bone loss.
What is Flap and
Bone Surgery
When gum is inflamed severely
(periodontitis), alveolar bone will be absorbed, and defected. Periodontal
ligaments which connect between the alveolar bone and the teeth will
disappear. Sever bone lose will cause tooth moving and missing. Flap
and bone surgery is order to contour the bone, deeply clean the tooth
to reduce the inflammation, and promote bone re-growing and connections
firm.
Gingivectomy
and Gingivoplasty (Gum Removal) FAQ
My gums have become loose and larger than normal. What's wrong?
Healthy gums, tight against
the necks of the teeth, are an important part of a beautiful smile.
But sometimes, a problem like this can develop. As the gums extend
onto the front surface of the teeth, the natural balance between the
length of the teeth and the height of the gums was lost. Your dentist
will probably recommend a gingivectomy procedure to reduce your gums.
What is a gingivectomy
and what does it entail?
The first step in a gingivectomy,
or gum-removal procedure, is making sure that all of the involved
areas are completely numb with a local anesthetic. Your dentist then
carefully makes a small incision and removes the excess gum tissue.
After removing the gum tissue, the doctor will put a temporary putty-like
substance over your gum line. This will protect your gums while they
heal. You can eat soft foods and drink cool or slightly warm liquids
while the putty is in place and your gums are healing.
What is a gingivoplasty?
Gingivoplasty is a procedure
in which we surgically reshape and re-contour the gum tissue for cosmetic,
physiological, or functional purposes. Gingivoplasty is the surgical
reshaping of the outer surface of the gums and it's usually done in
combination with gingivectomy. Many patients have a gummy smile which
is caused by excessive and overgrown gum tissue. Excess gum tissue
can usually be removed to reveal a beautiful smile underneath.
How is a gingivoplasty done?
After a gingivectomy procedure,
the gingivoplasty procedure thins the remaining gums tissue so the
tissue looks natural and pleasing. It's done this using an electrosurgery
unit or a soft tissue laser. The electrosurgery unit uses electricity
to cut the gum tissues and at the same time, causes the gum tissues
to clot and stop bleeding.
It sounds like
one and the same. What is the difference between a gingivoplasty and
a typical gingivectomy procedure?
Gingivoplasty corrects
the remaining thick and unnaturally shaped gum tissue left after the
gingivectomy procedure exposes the hidden teeth. Natural gum tissue
thins as it approaches and surrounds teeth. The two procedures are
almost always used at the same time. These procedures can also be
used to reshape irregularly shaped and unattractive gums.
How long do the
effects of a gingivectomy take to heal?
A couple of weeks after
the gum removal procedure, the area will be completely healed.
Will I be able
to see the results of my gingivectomy right away?
Once your gum removal surgery
has healed, you should notice how much more natural this area looks.
I have periodontitis
(severe gum disease). Why has my dentist recommended a gingivectomy?
You may need surgery for
severe gum disease (periodontitis) if it cannot be cured with antibiotics
or root planing and scaling. A gingivectomy removes and reshapes loose,
diseased gum tissue to get rid of pockets between the teeth and gums.
It sounds painful.
Is it safe?
Gingivectomy and gingivoplasty
procedures are usually done with local anesthetics. The electrosurgery
equipment minimizes bleeding and most patients experience very little
post operative pain after the procedure. A gingivectomy is a safe
and predictable way to remove excess gum tissue and improve the natural
appearance of your smile.
Oral Care Products
What kinds of oral
care products should I use?
Here are some guidelines
for choosing dental care products – what works for most patients
most of the time. To find out what is best for your particular needs,
talk to your periodontist.
- Begin with the right
equipment – a soft bristled toothbrush that allows you to
reach every surface of each tooth. If the bristles on your toothbrush
are bent or frayed, buy a new one. A worn-out brush will not clean
your teeth properly.
- In addition to manual
toothbrushes, your choices include automatic toothbrushes and "high
tech" electronic toothbrushes. These are safe and effective
for the majority of patients.
- Oral irrigators (water
spraying devices) will not remove plaque from your teeth unless
used in conjunction with brushing and flossing.
- Another aid is the rubber
tip, often found on the handle end of a toothbrush used to massage
the gums after brushing and flossing.
- Other options include
interproximal toothbrushes (tiny brushes that clean plaque between
teeth) and interdental cleaners (small sticks or picks that remove
plaque between teeth). If used improperly, these dental aids can
injure the gums, so it is important to discuss proper use with your
periodontist.
How should I choose
oral care products?
Choose products that carry the American Dental Association
Seal of Acceptance – an important symbol of a dental product's
safety and effectiveness.
What is gum disease?
Gum disease refers to inflammation of the soft tissue (gingiva)
and abnormal loss of bone that surrounds the teeth and holds them
in place. Gum disease is the second most common cause of toothache.
What causes gum
disease?
Gum disease is caused by toxins secreted by bacteria in "plaque"
that accumulate over time along the gum line. This plaque is a mixture
of food, saliva, and bacteria.
What are symptoms
of gum disease?
Early symptoms of gum disease include gum bleeding without
pain. Pain is a symptom of more advanced gum disease as the loss of
bone around the teeth leads to the formation of gum pockets. Bacteria
in these pockets cause gum infection, swelling, pain, and further
bone destruction. Advanced gum disease can cause loss of otherwise
healthy teeth.
How is gum disease
treated?
Treatment of early gum disease involves oral hygiene and
removal of bacterial plaque. Moderate to advanced gum disease usually
requires a thorough cleaning of the teeth and teeth roots called "root
planing" and "subgingival curettage." Root planing
is the removal of plaque and tartar (hardened plaque) from exposed
teeth roots while subgingival curettage refers to the removal of the
surface of the inflamed layer of gum tissue. Both of these procedures
are usually performed under local anesthesia and may be accompanied
by the use of oral antibiotics to overcome gum infection or abscess.
Follow-up treatment may include various types of gum surgeries. In
advanced gum disease with significant bone destruction and loosening
of teeth, teeth splinting or teeth extractions may be necessary
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