Periodontal (Gum) Disease Therapy

Gum disease, also known as periodontal disease or periodontitis, is a bacterial infection that inflames the soft tissue around your teeth and becomes more severe if left untreated. Over time, gum disease will erode the bone that supports your teeth, leading to tooth mobility and loss.

Depending on the stage of progression, gum disease causes red, swollen, tender, receding, and bleeding gums, periodontal pockets, halitosis, pus-filled abscesses, gapping, and changes in the bite. When prevention is no longer an option, especially in the later stages when damage is permanent, nonsurgical and surgical treatments are available to reduce the effects of gum disease.

Gum Disease Treatments

Treatment is always going to be dependent on the stage of gum disease. There are many options available, both nonsurgical and surgical.

Nonsurgical Treatments

Antibiotics: Oral antibiotics, either in pill or topical form, may be enough to fight off infection.

Scaling and root planing: Similar to a routine dental cleaning, SRP cleans much deeper. Local anesthesia will need to be used to numb your gums while your dental hygienist cleans away bacteria underneath your gum line and smooths the tooth roots to prevent further plaque and bacteria from accumulating beneath your gum line.

Surgical Treatments

Flap surgery: Your periodontist will make an incision along your gum line, temporarily shifting the gum tissues away from your teeth. With the tooth roots more easily seen, your periodontist is able to clean them more thoroughly. If bone loss has occurred, your periodontist may re-contour your bone ridge to make it easier for your daily oral hygiene routine.

Dental bone grafts: If a significant amount of bone loss has occurred, bone-grafting material will be placed in areas where there is a lack of bone tissue. Dental bone grafts serve as a “scaffolding” to encourage new bone growth.

Gum grafts: Gum disease causes gum recession, so a gum graft might be necessary to restore lost tissue around your teeth. Tissue is obtained from the roof of your mouth or a tissue bank and is sutured into the areas lacking gum tissue.

Guided tissue regeneration: A biocompatible membrane will be placed between your existing bone and tooth, keeping unwanted tissue from growing in the area and allowing bone to grow instead.

Platelet-rich plasma (PRP): This procedure helps regenerate bone or gum tissue. Platelet-rich plasma is taken from a sample of your blood, is then placed in a centrifuge to separate red and white blood cells, and finally the plasma is placed in areas lacking bone or tissue to encourage growth.

Cosmetic Gum Surgery

Cosmetic gum surgery, or gum contouring, can solve a variety of cosmetic issues relating to the proportions of your teeth and your gums. For example, too much gum tissue may make your teeth appear short, while too little gum tissue will make your teeth appear too long. You may also have a combination of the two, where the tooth-to-gum ratio varies from tooth to tooth.

Types of Gum Contouring

Gum Reduction Surgery

Cosmetic gum surgery If you have a “gummy smile” or too much gum tissue covering your teeth, your teeth might appear smaller than you’d like. With the use of a laser or scalpel for soft tissue, your periodontist can remove excess gum tissue to achieve a more proportional smile.

Gum Grafting Surgery

For some people, their gums are either too thin or are receding. Gum recession occurs when the gum tissue pulls away from your teeth, which is typical of an ongoing infection like periodontitis. This pulling away from the teeth not only looks unsightly but also creates other oral issues, such as decreased stability and support of the teeth and exposure of the tooth root. By using tissue elsewhere in your mouth or from a tissue bank, the grafts encourage the recreation of gum tissue. Your teeth will once again have the support they need to remain healthy, as well as the aesthetics you desire.

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.

Cosmetic Periodontal Surgery

Your smile is the first thing someone notices about you. People form their first impressions based on the appearance of your smile. There was a time when, unless you made a lot of money or were born with perfect teeth, you had to live with your smile. Today, a wide range of cosmetic procedures is available to the average citizen at a cost they can afford. If you have a gummy smile, uneven gum line, or elongated teeth, cosmetic periodontal surgery is for you.

Cosmetic periodontal surgery sculpts the gum line so that it is even and in proportion to the amount of exposed tooth versus gum. This procedure removes the excess gum and exposes more of the tooth crown. If your gums have receded, and your teeth appear overly long, then soft tissue grafts can extend the gum line to create an aesthetic balance. The grafts also reduce the gum pockets that are prone to future periodontal disease.

If you are unhappy with your smile, give us a call to discuss your options. After all, you only have one chance to make a first impression.

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.

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.

Gum Grafting

Gingivitis and, in its advanced state, periodontitis, have a profound effect on the gums. As gingivitis progresses, more and more bacteria and plaque build-up, causing the gums to stretch. The end result is large pockets that, once cleaned out, remain on your gum line. These pockets cause the gums to recede, which is aesthetically not pleasing to the eye. When the gums recede, an abnormal amount of tooth structure is exposed.

Gum grafting is the corrective procedure that restores the gum to its natural, healthy state. Using soft gum tissue from the roof of the mouth, the receded gums are grafted. The goal if the graft is to cover exposed tooth and root surfaces with grafted-on oral tissue. This grafting encourages new tissue growth that will enable the gums to return to their original position around the teeth. The procedure is routine and entails a minimal amount of downtime and discomfort.

Osseous Grafting

Osseous surgery is a procedure that reshapes the bone that 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

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.

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 a greater risk of 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 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.