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Periodontal Surgery

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 for bacteria to 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.

Your periodontist has measured the depth of your pocket(s). A pocket reduction procedure has been recommended because you have pockets that are too deep to clean with daily at-home oral hygiene and a professional care routine.

During this procedure, your periodontist folds back the gum tissue and removes the disease-causing bacteria before securing the tissue into place. In some cases, irregular surfaces of the damaged bone are smoothed to limit areas where disease-causing bacteria can hide. This allows the gum tissue to better reattach to healthy bone.

What are the benefits of this procedure?

Reducing pocket depth and eliminating existing bacteria are important to prevent damage caused by the progression of periodontal disease and to help you maintain a healthy smile. Eliminating bacteria alone may not be sufficient to prevent disease recurrence. Deeper pockets are more difficult for you and your dental care professional to clean, so it's important for you to reduce them. Reduced pockets and a combination of daily oral hygiene and professional maintenance care increase your chances of keeping your natural teeth – and decrease the chance of serious health problems associated with periodontal disease.

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Laser Periodontal Therapy

What is Laser Periodontal Therapy™?

Laser Periodontal Therapy™ is a laser based technique for the treatment of periodontal disease using the Millennium Dental Technologies, Inc., PerioLase® Laser. Fear of periodontal treatment vanishes when patients find out no scalpel or sutures will be used. Patient friendly laser treatment gets patients to agree to the treatment they need and continue with the follow-up care that is prescribed.

Our office is one of the first in the area to offer Laser Periodontal Therapy™ for the treatment of gingivitis and/or periodontitis. Following are commonly asked questions about this technology.

How does it work?

Tartar, associated with inflamed and bleeding gums, is removed form the root surface of the tooth using an ultrasonic scaler and small instruments.

Then, a small amount of light energy from a laser is directed through a tiny fiber, which is gently placed between the gum and tooth. This light energy removes a tiny amount of diseased tissue and aids in reducing the bacteria associated with the disease. After the area is thoroughly cleaned, the body can heal the area naturally.

Does it hurt?

Although the procedure itself can be virtually painless, we may anesthetize the area for the patient’s comfort. In this way we can precisely direct the laser for treatment. Post-procedure discomfort is typically minimal and of short duration.

How long does it take?

Initial treatment is focused on scaling and the use of small instruments to remove the tartar. Then, the laser portion of the treatment is performed and normally only takes a few minutes. Depending on the severity of the patient’s periodontal disease, treatment may be accomplished in one office visit or in multiple visits. The estimated treatment time is reviewed with patients when we discuss their treatment plan.

Does this treatment cost more than traditional gum surgery?

Typically we use the same billing codes as traditional gum surgery and the laser treatment is generally no more expensive than traditional surgery. There are other factors which may affect the cost, such as the severity of the periodontal disease, and how many teeth are involved. Many insurance plans pay only for a portion of this treatment. Patients should discuss their payment options with the dental office personnel as we offer financing for this treatment.

The dramatically increased comfort for our patients made the new system attractive to our office. We do encourage patients to take care of the need now to reduce further damage to their gums, teeth and bone.

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Dental Implants

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A dental implant is an artificial tooth root that a periodontist places into your jaw to hold a replacement tooth or bridge. Dental implants are an ideal option for people in good general oral health who have lost a tooth or teeth due to periodontal disease, an injury, or some other reason.

While high-tech in nature, dental implants are actually more tooth-saving than traditional bridgework, since implants do not rely on neighboring teeth for support.

Dental implants are so natural-looking and feeling, you may forget you ever lost a tooth.You know that your confidence about your teeth affects how you feel about yourself, both personally and professionally. Perhaps you hide your smile because of spaces from missing teeth. Maybe your dentures don't feel secure. Perhaps you have difficulty chewing. If you are missing one or more teeth and would like to smile, speak and eat again with comfort and confidence, there is good news! Dental implants are teeth that can look and feel just like your own! Under proper conditions, such as placement by a periodontist and diligent patient maintenance, implants can last a lifetime. Long-term studies continue to show improving success rates for implants.

What Dental Implants Can Do?

  • Replace one or more teeth without affecting bordering teeth.
  • Support a bridge and eliminate the need for a removable partial denture.
  • Provide support for a denture, making it more secure and comfortable.

Types of Implants in Use Today

  • Endosteal (in the bone): This is the most commonly used type of implant. The various types include screws, cylinders or blades surgically placed into the jawbone. Each implant holds one or more prosthetic teeth. This type of implant is generally used as an alternative for patients with bridges or removable dentures.
  • Subperiosteal (on the bone): These are placed on top of the jaw with the metal framework's posts protruding through the gum to hold the prosthesis. These types of implants are used for patients who are unable to wear conventional dentures and who have minimal bone height.

Advantages of Dental Implants Over Dentures or a Bridge

Every way you look at it, dental implants are a better solution to the problem of missing teeth.

  • Esthetic: Dental implants look and feel like your own teeth! Since dental implants integrate into the structure of your bone, they prevent the bone loss and gum recession that often accompany bridgework and dentures. No one will ever know that you have a replacement tooth.
  • Tooth-saving: Dental implants don't sacrifice the quality of your adjacent teeth like a bridge does because neighboring teeth are not altered to support the implant. More of your own teeth are left untouched, a significant long-term benefit to your oral health!
  • Confidence: Dental implants will allow you to once again speak and eat with comfort and confidence! They are secure and offer freedom from the irksome clicks and wobbles of dentures. They'll allow you to say goodbye to worries about misplaced dentures and messy pastes and glues.
  • Reliable: The success rate of dental implants is highly predictable. They are considered an excellent option for tooth replacement.

Are You a Candidate for Dental Implants?

The ideal candidate for a dental implant is in good general and oral health. Adequate bone in your jaw is needed to support the implant, and the best candidates have healthy gum tissues that are free of periodontal disease.

Dental implants are intimately connected with the gum tissues and underlying bone in the mouth. Since periodontists are the dental experts who specialize in precisely these areas, they are ideal members of your dental implant team. Not only do periodontists have experience working with other dental professionals, they also have the special knowledge, training and facilities that you need to have teeth that look and feel just like your own. Your dentist and periodontist will work together to make your dreams come true.

What Is Treatment Like?

This procedure is a team effort between you, your dentist and your periodontist. Your periodontist and dentist will consult with you to determine where and how your implant should be placed. Depending on your specific condition and the type of implant chosen, your periodontist will create a treatment plan tailored to meet your needs. Click for more information about the treatment options described below.

  • Replacing a Single Tooth: If you are missing a single tooth, one implant and a crown can replace it. A dental implant replaces both the lost natural tooth and its root.
  • Replacing Several Teeth: If you are missing several teeth, implant-supported bridges can replace them. Dental implants will replace both your lost natural teeth and some of the roots.
  • Replacing All of Your Teeth: If you are missing all of your teeth, an implant-supported full bridge or full denture can replace them. Dental implants will replace both your lost natural teeth and some of the roots.
  • Sinus Augmentation: A key to implant success is the quantity and quality of the bone where the implant is to be placed. The upper back jaw has traditionally been one of the most difficult areas to successfully place dental implants due to insufficient bone quantity and quality and the close proximity to the sinus. Sinus augmentation can help correct this problem by raising the sinus floor and developing bone for the placement of dental implants.
  • Ridge Modification: Deformities in the upper or lower jaw can leave you with inadequate bone in which to place dental implants. To correct the problem, the gum is lifted away from the ridge to expose the bony defect. The defect is then filled with bone or bone substitute to build up the ridge. Ridge modification has been shown to greatly improve appearance and increase your chances for successful implants that can last for years to come.

What Can I Expect After Treatment?

As you know, your own teeth require conscientious at-home oral care and regular dental visits. Dental implants are like your own teeth and will require the same care. In order to keep your implant clean and plaque-free, brushing and flossing still apply!

After treatment, your periodontist will work closely with you and your dentist to develop the best care plan for you. Periodic follow-up visits will be scheduled to monitor your implant, teeth and gums to make sure they are healthy.

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Bone Grafting

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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 and pockets develop. Eventually, if too much bone is lost, the teeth will need to be extracted.

Your periodontist may recommend a regenerative procedure when the bone supporting your teeth has been destroyed. These procedures can reverse some of the damage by regenerating lost bone and tissue.

During this procedure, your periodontist folds back the gum tissue and removes the disease-causing bacteria. Membranes (filters), bone grafts or tissue-stimulating proteins can be used to encourage your body's natural ability to regenerate bone and tissue.

There are many options to enhance support for your teeth and to restore your bone to a healthy level. Your periodontist will discuss your best options with you.

What are the benefits of this procedure?

Eliminating existing bacteria and regenerating bone and tissue helps to reduce pocket depth and repair damage caused by the progression of periodontal disease. With a combination of daily oral hygiene and professional maintenance care, you'll increase the chances of keeping your natural teeth – and decrease the chances of serious health problems associated with periodontal disease.

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Gum Grafting

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Periodontal procedures are available to stop further dental problems and gum recession, and/or to improve the esthetics of your gum line.

Exposed tooth roots are the result of gum recession. 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 your periodontist 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.

Soft tissue grafts can be used to cover roots or develop gum tissue where absent due to excessive gingival recession. During this procedure, your periodontist takes gum tissue from your palate or another donor source to cover the exposed root. This can be done for one tooth or several teeth to even your gum line and reduce sensitivity.

What are the benefits of this procedure?

A soft tissue graft can reduce further recession and bone loss. In some cases, it can cover exposed roots to protect them from decay. This may reduce tooth sensitivity and improve esthetics of your smile. Whether you have a soft tissue graft to improve function or esthetics, patients often receive the benefits of both: a beautiful new smile and improved periodontal health – your keys to smiling, eating and speaking with comfort and confidence.

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Periodontal Plastic Surgery & Crown Lengthening

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Periodontal procedures are available to lay the groundwork for restorative and cosmetic dentistry and/or to improve the esthetics of your gum line.

You may have asked your periodontist about procedures to improve a "gummy" smile because your teeth appear short. Your teeth may actually be the proper lengths, but they're covered with too much gum tissue. To correct this, your periodontist performs crown lengthening.

During this procedure, excess gum and bone tissue is reshaped to expose more of the natural tooth. This can be done to one tooth, to even your gum line, or to several teeth to expose a natural, broad smile.

Your dentist or periodontist may also recommend crown lengthening to make a restorative or cosmetic dental procedure possible. Perhaps your tooth is decayed, broken below the gum line, or has insufficient tooth structure for a restoration, such as a crown or bridge. Crown lengthening adjusts the gum and bone level to expose more of the tooth so it can be restored.

What are the benefits of this procedure?

Whether you have crown lengthening to improve function or esthetics, patients often receive the benefits of both: a beautiful new smile and improved periodontal health – your keys to smiling, eating and speaking with comfort and confidence.

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Soft Tissue Pathology

The inside of the mouth is normally lined with a special type of skin (mucosa) that is smooth and coral pink in color. Any alteration in this appearance could be a warning sign for a pathological process. The most serious of these is oral cancer. The following can be signs at the beginning of a pathologic process or cancerous growth:

  • Reddish patches (erythroplasia) or whitish patches (leukoplakia) in the mouth.
  • A sore that fails to heal and bleeds easily.
  • A lump or thickening on the skin lining the inside of the mouth.
  • Chronic sore throat or hoarseness.
  • Difficulty in chewing or swallowing.

These changes can be detected on the lips, cheeks, palate, and gum tissue around the teeth, tongue, face, and/or neck. Pain does not always occur with pathology and, curiously, is not often associated with oral cancer. However, any patient with facial and/or oral pain without an obvious cause or reason may also be at risk for oral cancer. We would recommend performing an oral cancer self-examination monthly and remember that your mouth is one of your body's most important warning systems. Do not ignore suspicious lumps or sores. Please contact us so we may help.

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Frenectomy

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A frenum (also called frenulum) is a band of tissue that connects or holds down a part of the body such as the tongue, lip, or cheeks. The band of tissue connecting the tongue to the floor of the mouth is called the lingual frenum, while the band connecting the lip to the gum in front of the teeth is called the labial frenum.

Occasionally a frenum might be exceptionally short, thick, or tight, or may extend too far down along the tongue or the gum. When a frenum is positioned in such a way as to interfere with the normal alignment of teeth or to constrict the movement of the tongue or lips, it can be excised with a very simple surgery called a frenectomy.

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Periodontal Maintenance

Periodontal maintenance consists of periodic removal of bacterial plaque and calculus from both above and beneath the gum line in patients who have undergone treatment for periodontal disease ("Periodontitis"). It is typically performed on a two to four-month interval so that removal of bacterial colonies can be completed before they become sizable and aggressive enough to cause more damage to the patient's gingival attachment and bone. Localized scaling & root planing (SRP) may be necessary to control areas of active inflammation, but periodontal maintenance does not generally include performance of SRP throughout the mouth.

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