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Periodontics


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More About Periodontics


Periodontics is the branch of dentistry specializing in areas of the mouth that surround and support the teeth. These areas include your gums, alveolar bone, cementum and your periodontal ligament. Along with inflamed gums and bleeding, here are other signs of periodontal disease:

Bad Breath

Receding Gums

Tooth Sensitivity

Abscesses

Loose Teeth

If your gums are inflamed, or tend to bleed quite easily, you may need to see a periodontist to identify potential damage that could lead to tooth loss.

Many patients are not aware that periodontal maintenance is the only sure way to keep gum disease from returning. Periodontal maintenance is regularly performed at certain intervals after procedures such as scaling and root planing. Periodontal maintenance includes the removal of plaque and tartar, scaling and tooth planing, and polishing. Your dentist will determine the frequency the periodontal maintenance is needed.

Our periodontist will diagnose your individual situation and recommend an appropriate treatment or procedure. Procedures can be either non-surgical or surgical depending on the best option for you.

To learn more about our periodontist and how we can help you on the path to oral health, please call our office to speak with our friendly team.


Types of Periodontic Treatments


BONE GRAFTING

Bone grafting is where the jawbone is built up to accommodate a dental implant or other restorative device. Bone grafting is a common procedure that is used frequently for dental implants and other periodontal procedures. The bone used to graft is taken from a sample from the patient. Many times, the bone is taken from another area of the mouth when drilling takes place. The bone fragments are suctioned from the mouth and used for the graft. Cadaver bone fragments are also used. They are harvested by bone banks and are a very safe source for bone donation.

CANINE EXPOSURE
Canine exposure has nothing to do with leaving your dog outside, exposed to the elements. It is a procedure to expose impacted teeth. An impacted tooth is one that has not erupted in the mouth, but instead becomes stuck in the surrounding bone or tissue.  Any tooth may become impacted, but generally, the wisdom teeth and canine teeth are the most likely candidates.  Canine teeth are critical for function. The mouth will also appear aesthetically odd without the canines. The procedure is quite simple. It involves the dentist cutting a small hole in the gum, which allows the tooth to erupt. The dentist also uses a dental brace to guide the tooth into its correct position.
 

Impacted teeth are sometimes obvious to the naked eye, but in some instances, an –x-ray is necessary to identify the extent of the impaction. Many times, there is an impacted canine tooth where the baby tooth remains in the mouth. A loose tooth is also a sign that an impacted tooth may be present.

CROWN LENGTHENING

It is no secret that dentists are committed to saving teeth. This is why we fill a cavity, instead of pulling the tooth.

Cavities can decay to tooth to the point where restoration is virtually impossible without a procedure called crown lengthening. Crown lengthening is a routine surgical procedure, which remodels the contour of the gum line. The procedure does not actually lengthen the crown, but rather lowers the gum line. When there is not enough tooth structure to affix a crown, this is the only option. Sometimes a tooth has been broken below the gum line. In this instance, crown lengthening is very successful in exposing more of the tooth, so that the dentist has something to work with.

FRENECTOMY

A frenulum is a piece of tissue that prevents an organ from moving. There is a frenulum that attaches your upper lip to the gums, while another connects the lower lip to the gums. A frenulum that is too short or thick, will cause problems in speech patterns and tooth misalignment. In infants, a shortened frenulum underneath the tongue will inhibit breastfeeding. When the frenulum disrupts movement, growth, or development, corrective action is necessary to resolve the situation.

A frenectomy is a minor surgical procedure that is performed in your dentist’s office. It can be performed with either a scalpel or laser and takes less than 15 minutes. Using a laser causes very little bleeding and does not require stitches. A laser also results in less postoperative discomfort and a shorter healing time. Young children and infants are put under general anesthesia for the procedure and adults have the procedure performed using local anesthesia. If your child needs a frenectomy, there is nothing to worry about. The procedure is very successful and causes minimal discomfort.

OCCLUSAL ADJUSTMENT

Do you wake in the morning with sore jaws? 

When you bite, do you feel like your jaw is lopsided? If so, then you may need an occlusal adjustment.

An occlusal adjustment corrects the alignment of the bite, that is a result of loose, shifting, crowded, or missing teeth. The result is an evenly distributed bite that eliminates irregular pressure on one side of the mouth.  Once your bite is adjusted, your teeth will meet properly. Occlusal adjustment causes minimal pain, and only a little discomfort. The adjustment is made by using a dental drill using a fine filing stone. In addition to the actual adjustment, removal mouthpieces are also utilized, to protect the tooth surface, and relax the jaw muscles once the adjustment is completed.

Who is a good candidate for an occlusal adjustment?  Patients with loose or shifting teeth will often not meet correctly. Patients who grind or clench their teeth will have an uneven bite and pressure distribution in the mouth, which is also corrected through an occlusal adjustment. Sometimes tooth sensitivity can be corrected through an occlusal adjustment as the treatment reduces pressure on the sensitive tooth.

New technology allows dentists to accurately identify the areas, which need adjustments. The dentist utilizes a computer scan of the mouth, which records hundreds of bite registrations per minute, and notes even the slightest irregularity. That data allows the dentist to make only the adjustments that are absolutely necessary, which ensures a well aligned bite and minimal tooth wear.

OSSEUS GRAFTING

Osseous surgery is a procedure that reshapes the bone which holds your teeth in place. Osseous surgery commonly treats periodontitis. Patients with periodontitis experience defects in the bone around their teeth. The osseous surgery removes those defects. Prior to the surgery, the patient undergoes a periodontal treatment that consists of scaling and root planing. A local anesthetic is administered to minimize the pain. Once the roots are cleaned, the dentist uses a drill and sharp dental tool to reshape the bone surrounding the teeth. Depending on the extent of the defects, the deformed bone is removed, and the rest is shaped.

Bone grafting material is used where the defects are too large to be treated with only reshaping. Once the bones are back to their original state, the gums are stitched back into place. Osseous Grafting is a routine procedure, with a high success rate.

OSSEOUS SURGERY / POCKET REDUCTION

Osseous surgery is a procedure that reshapes the bone which holds your teeth in place. Osseous surgery commonly treats periodontitis. Patients with periodontitis experience defects in the bone around their teeth. The osseous surgery removes those defects. Prior to the surgery, the patient undergoes a periodontal treatment that consists of scaling and root planing. A local anesthetic is administered to minimize the pain. Once the roots are cleaned, the dentist uses a drill and sharp dental tool to reshape the bone surrounding the teeth. Depending on the extent of the defects, the deformed bone is removed, and the rest is shaped. Bone grafting material is used where the defects are too large to be treated with only reshaping. Once the bones are back to their original state, the gums are stitched back into place. Osseous Grafting is a routine procedure, with a high success rate.

PERIODONTAL SPLINTING (WEAK TEETH)

Loose teeth are uncomfortable, especially when you try to eat food or chew gum. The feeling of the tooth pulling away from the gum is enough to send chills down your spine. It seems like an eternity, waiting for either the tooth to become loose enough to be extracted or strong enough to no longer be a problem.

Teeth become loose because of lost gum tissue, injury, orthodontic treatment, or pressure caused by tooth misalignment. A new technique called periodontal splinting attaches weak teeth together, turning them into a single unit that is stable and stronger than the single teeth by themselves. The procedure is most commonly performed on the front teeth. The procedure is as simple as using composite material to attach, or splint, the loose teeth to the adjoining stable teeth. Tooth splinting is a common procedure that has gained popularity due to its effectiveness.

Life is too short to live with loose teeth.

RIDGE AUGMENTATION

When you lose teeth, and do not replace them, the jawbone deteriorates where the tooth socket once was. This makes it difficult, and in some instances impossible, to get dental implants or dentures later on. You may not have had the financial means at the time of the extraction for restorative surgery, but you may have the money now.

The good news is that we can perform a process called ridge augmentation to restore the bone structure that is needed for restorative procedures such as dental implants. The process involves lifting the gum from the ridge to expose the defected area of the bone. Then the dentist uses a bone like substance to fill the defected areas. The ridge augmentation greatly improves the appearance of the mouth and increases the chances for success with the implants. With ridge augmentation, your implants will last for years.

SCALING & ROOT PLANING

Gingivitis is a generative disease that left untreated, will cause significant tooth and gum deterioration. Just the word gingivitis can strike panic in a patient’s mind. The reality is that the treatment is simple and performed right in your dentist’s office.

Plaque and tarter that sits on the teeth provides an environment, which allows bacteria to thrive and multiply.  The bacteria cause the gums to become inflamed and bleed. The condition becomes more noticeable when you brush your teeth or sometimes when you eat. These are signs of the early stage of gingivitis. Gingivitis is easily treated by having the hygienist scale and polish the teeth.  If gingivitis is left untreated, the condition will progress and the roots will need planing. The difference between scaling and root planing is simple –  scaling is the removal of the dental tartar from the tooth surface and root planing is the process of smoothening the root surfaces and removing the infected tooth structure.

As a non-surgical procedure, scaling and planing is performed without any anesthesia and in the dentist’s office. While the procedure is usually painless, advanced stages of gingivitis may make it necessary to numb the area for complete comfort. Deep scaling and root planing is usually broken down into one section of the mouth per appointment. This allows for adequate healing time, and reduces the time for each appointment.

SOFT TISSUE GRAFT

A soft tissue graft is used when there has been a significant amount of gum recession in a particular area. Slight gum recession can usually be fixed with a few changes to your oral hygiene routine to take better care of your teeth and gums. When the gingiva recedes further it exposes you to greater risk for infection and bacterial penetration. You will likely be more sensitive to hot and cold foods when you have receding gums. If the gums recede enough as to expose the root you can set yourself up for more serious problems. The root is softer than the enamel making it more vulnerable to bacteria and plaque.

To restore proper gum level and functionality a soft tissue graft can be performed. This is done by either removing soft tissue from the roof of the mouth, or repositioning healthy gum tissue from adjacent teeth. This procedure is very predictable and has a high success rate. This procedure should be performed before more serious problems develop and periodontal surgery is necessary.

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