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Periodontics
We offer the following Periodontal Procedures at our clinic:
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Laser Dentistry - Laser periodontal or gum care -the latest technology to treating gum disease.
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Cosmetic Periodontal Surgery
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Flap Surgery
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Gingivectomy
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Guided Tissue Regeneration
Non-Surgical Therapy Periodontal Procedures
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:
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Gums that bleed when you brush your teeth
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Red, swollen or tender gums
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Gums that have pulled away from the teeth
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Bad breath that doesn't go away
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Pus between your teeth and gums
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Loose teeth
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A change in the way your teeth fit together when you bite
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A change in the fit of partial dentures
Did you know that Laser Periodontal Therapy takes less time and requires fewer follow up visits than traditional surgery.
Laser Periodontal, or gum related care
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 medi cations
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.
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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.
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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.
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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.
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​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.
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.
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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.
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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.
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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.
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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.
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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.
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.
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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.
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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.
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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.
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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.
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Gingivoplasty: Gingivoplasty is a procedure in which we surgically reshape and re-contour the gum tissue for cosmetic, physiological, or functional purposes.
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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.
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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.
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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.
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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
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.
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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.
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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.
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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.
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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.
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Splinting: This technique attaches weak teeth together, combining them into a stronger single unit, making them more sable and offering more comfortable chewing.
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Please contact us to setup a consultation.
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.
Who is a periodontist?
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.
Is there a relationship between tobacco use and 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.
What are Causes of Periodontal Disease
​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.
Smoking/Tobacco Use
​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.
Genetics
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.
Pregnancy and Puberty
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.
Stress
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.
Medications
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.
Clenching or Grinding Your Teeth
​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.
Diabetes
​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.
Poor Nutrition
Diseases that interfere with the body's immune system may worsen the condition of the gums.
Other Systemic Diseases
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.
​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.
What are pockets?
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.
Could my periodontal disease be genetic?
​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.
Can I pass my periodontal disease to others?
Prevention
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.
What can I do to avoid 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.
I'm over 55. Does this mean I'm more likely to get periodontal disease?
If you value your oral as well as overall health, anytime is a good time to see a periodontist for a periodontal evaluation.
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Sometimes the only way to detect periodontal disease is through a periodontal evaluation. A periodontal evaluation may be especially important in the following situations:
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If you notice any symptoms of periodontal disease, including:
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Gums that bleed easily, such as during brushing or flossing
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Red, swollen or tender gums
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Gums that have pulled away from the teeth
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Persistent bad breath
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Pus between the teeth and gums
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Loose or separating teeth
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A change in the way your teeth fit together when you bite
When should I see a periodontist?
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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.
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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.
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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.
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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.
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If you are not satisfied with your current tooth replacement option, such as a bridge or dentures, and may be interested in dental implants.
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Have a sore or irritation in your mouth that does not get better within two weeks.
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 can I expect the first time I visit a periodontist?
​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.
What is Flap and Bone Surgery
Gingivectomy and Gingivoplasty (Gum Removal) FAQ
​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.
My gums have become loose and larger than normal. What's wrong?
​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 gingivectomy and what does it entail?
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.
What is a gingivoplasty?
​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.
How is a gingivoplasty done?
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.
A couple of weeks after the gum removal procedure, the area will be completely healed.
How long do the effects of a gingivectomy take to heal?
Once your gum removal surgery has healed, you should notice how much more natural this area looks.
Will I be able to see the results of my gingivectomy right away?
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.
I have periodontitis (severe gum disease). Why has my dentist recommended a gingivectomy?
​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.
It sounds painful. Is it safe?
Oral Care Products
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.
What kinds of oral care products should I use?
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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.
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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.
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Oral irrigators (water spraying devices) will not remove plaque from your teeth unless used in conjunction with brushing and flossing.
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Another aid is the rubber tip, often found on the handle end of a toothbrush used to massage the gums after brushing and flossing.
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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.
Choose products that carry the American Dental Association Seal of Acceptance – an important symbol of a dental product's safety and effectiveness.
How should I choose oral care products?
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 is 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 causes 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.
What are symptoms of gum disease?
​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