Periodontal Services

Periodontal Evaluation

The initial periodontal consultation includes an assessment of the following six areas:

  1. Your Teeth: An examination of your teeth and any restorations you might have, including dental fillings, dental implants, crowns, and dentures will be completed. During the examination of your teeth, we will note the position of the teeth and their closeness to one another.
  2. Your Plaque: The amount and location of any plaque and/or tartar will be assessed.
  3. Your Gums: An instrument called a dental probe will be inserted into the space between your tooth and gums to measure the depth of your gum pockets and to see how well your gums attach to your teeth. Any bleeding that occurs during the probing process, as well as any inflammation of your gums, will also be recorded.
  4. Your Bite: We will then observe your bite, also known as occlusion. While you bite down, we will look to see how your teeth fit together and for any signs of tooth movement or loose teeth. This is important because moving or loose teeth can be a sign of periodontal disease.
  5. Your Bone Structure: We will also examine the bone in and around your mouth since it can be affected by periodontal disease. X-rays may be taken to help evaluate the quality of bone in your upper and lower jaw areas and to determine if any bone loss has occurred.
  6. Your Risk Factors: You will be asked about a variety of risk factors for periodontal disease, including age, tobacco use, if anyone else in your family has periodontal disease, or if you have another systemic condition that may be linked to periodontal disease, such as diabetes or cardiovascular disease.

After the periodontal evaluation, we will discuss the findings with you and explain if any treatment is needed. This is a good time to ask any questions you may have about the evaluation, findings, or anything else regarding your oral health. After treatment recommendations are established, our staff will present a treatment plan with financial information. After this, they will work with you to set up an appointment. In some cases treatment can be completed the same day. We will then write a letter to your general dentist to discuss recommendations for treatment.

Scaling and Root Planing

When hard and soft bacterial plaques are found under the gumline, scaling and root planing can be used to remove them. During this procedure, the area is anesthetized and instruments are placed under the gum to clean the root surface. This treatment is effective in reducing inflammation in mild, but further treatment may be needed in moderate to severe periodontal disease.

Scaling and Root Planing

Resective or Osseous Surgery

Surgery is often needed when periodontal disease has progressed to the moderate or severe stage. During osseous surgery, the roots of the teeth are cleaned more thoroughly and the bone reshaped for a more cleansable and maintainable situation. After this procedure the space between the gum and the bone (the pocket) is reduced for better cleansability.

Resective or Osseous Surgery

Regenerative Surgery

Regenerative therapy can be used in moderate to severe cases of periodontitis. In some cases, where large bony defects are found around teeth, bone grafting can regenerate new bone and attachment to teeth. The gums need to be opened, roots cleaned, and then bone graft placed into the defect. This procedure stimulates bone to heal and can actually replace what has been lost.

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The defect on this molar shown again 8 months later (afeter bone grafting) with bone growth and a resolution in pocketing (space between gum and bone).

Laser Periodontal Surgery

Osseous surgery using a Nd:YAG laser, also known as LANAP is another treatment modality for treating moderate to severe periodontal disease. It is a minimally invasive treatment and can lead to regeneration of bone in some cases. For more info: Click Here

Laser Periodontal Surgery

Gum Grafts to Correct Exposed Tooth Roots

Gum recession as a result of gum disease causes the tooth root to become exposed, which can make teeth look long and can prematurely age a person. In fact, the phrase “long in the tooth”, used to describe the elderly, is derived from this very reason. Perhaps you wish to enhance your smile by covering one or more of these roots that make your teeth appear too long. Or, maybe you're not bothered by the appearance of these areas, but you cringe because the exposed roots are sensitive to hot or cold foods and liquids.

Your gums may have receded for a variety of reasons, including aggressive tooth brushing or periodontal disease. You may not be in control of what caused the recession, but prior to treatment we can help you identify the factors contributing to the problem. Once these contributing factors are controlled, a soft tissue graft procedure will repair the defect and help to prevent additional recession and bone loss. During this procedure, tissue from the mouth’s palate, or synthetic materials, are used to facilitate coverage of the exposed root.

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Crown Lengthening for Tooth Restoration

When a tooth breaks, or if there is severe decay, the remaining healthy tooth area is reduced and this can affect the potential for successful tooth restoration. With crown lengthening, more of the tooth’s surface will be exposed and this will help act as an anchor for future restorative work such as crowns, veneers, or more.

Your gums need at least 2mm of tooth surface area to bond with in order to prevent trapped foods and other potential problems. If part of a tooth is missing or if the decay is too deep, there might not be enough of a crown to work with. In situations like this, crown lengthening is used to recreate the required amount of exposed tooth so that restorative dental procedures will not weaken or fall off.

Gummy Smile

There are also procedures that have the ability to fix a “gummy smile” when a person’s teeth appear too short. The teeth may actually be the proper length, but they’re covered with too much gum tissue. We can correct this by performing a procedure called esthetic crown lengthening. During this procedure, excess gum and bone tissue is reshaped to expose more of the natural tooth. Think of it like pushing back the cuticles on a fingernail. The outcome is longer looking teeth and a winning smile.

Your gums are an important part of your smile. They frame the teeth and play an integral role in the overall aesthetics of your everyday appearance. While taking care of them by brushing and flossing daily is the best way to maintain a healthy mouth, talk to us about the procedures available to maximize the potential of your smile.

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