Services

Depending on the severity and extent of the disease, the scaling and root planing appointments may require one to four hours to be completed. This is typically completed in one to two appointments. There should be little discomfort after this procedure and should cause minimal disruption to daily life. If needed, standard over the counter pain relievers reduce the minimal pain that could be present.

Six to eight weeks later, a complete periodontal re-evaluation is completed to determine the patient’s response to the scaling and root planing. At this appointment, our providers will perform a clinical evaluation similar to the initial consultation to determine whether areas of active disease remain. As the gum tissue has had time to heal itself and reattach to the previously diseased root surface, a decrease in swelling and bleeding is often found at this appointment. There is also typically a decrease in the depth of the periodontal pocketing around the teeth. If there is little active disease left, the patient will be placed on a periodontal maintenance (cleaning) regimen (discussed below).

If areas of active disease remain, one of two routes of treatment will be taken. The most common next step is surgical therapy. This treatment allows better access to the difficult to reach areas of the mouth, most often including the molars. We typically see the molars as the teeth displaying the most periodontal bone loss in the mouth. When combining this fact with the tortuous anatomy on the roots of these teeth, it is no surprise these are also the least predictable teeth to treat using a non-surgical approach like scaling and root planing.

The second, and less common, treatment involves beginning a three month periodontal maintenance (cleaning) regimen. If active disease remains after 2-3 of these appointments, despite good oral hygiene home care compliance, surgical therapy would then be indicated.

1.) To gain access to the bacteria and infection located deep below the gum line;
2.) To gain access to the underlying bone in order to smooth the uneven bone contours which
contribute to periodontal disease recurrence

This procedure starts with sedation (oral or intravenous), if desired, followed by administration of a local anesthetic (Novocaine). The gum tissue is then gently separated back from the underlying tooth roots and bone. The root surfaces are then thoroughly cleansed of the disease causing bacteria, similar to when the scaling and root planing was completed. The advantage with the surgical treatment is that our providers can now see distinctly the diseased root surfaces that need to be cleaned. Attention is then turned to evening out the irregular bone contours around the teeth, limiting the areas where infection-causing bacteria can hide. The gum tissue is then secured tightly in place with sutures that dissolve on their own.

The patient is then sent home with thorough instructions on taking care of the surgical areas, dietary instructions for immediately post-surgery and medications which help keep them comfortable. Post-operative appointments are typically scheduled two weeks after the surgery, followed by a second post-operative appointment two to three weeks after the first.

People with diabetes are more likely to have periodontal disease than people without diabetes, probably because people with diabetes are more susceptible to contracting infections. In fact, periodontal disease is often considered a complication of diabetes. Those people who don’t have their diabetes under control are especially at risk. Research has suggested that the relationship between diabetes and periodontal disease goes both ways – periodontal disease may make it more difficult for people who have diabetes to control their blood sugar. Severe periodontal disease can increase blood sugar, contributing to increased periods of time when the body functions with a high blood sugar. This puts people with diabetes at increased risk for diabetic complications.

Erectile Dysfunction: As the study published in the Journal of Sexual Medicine indicates, a man’s periodontal health could affect his sexual health, finding that men in their 30s who had severe periodontal disease were three times more likely to suffer from erection problems. Another study done by the American Urological Association found that prolonged chronic inflammation, like that found in men with periodontal disease, can cause damage to blood vessels which can lead to impotence.

Root exposure that is getting worse – when the amount of root exposure is getting worse, attachment that is holding the tooth in place is being lost. Over time, this can lead to a less stable tooth.

Lack of thick, resilient gum tissue directly around a tooth – without the proper type of gum tissue around a tooth, the body is unable to protect itself as well from the trauma of bacteria, chewing foods and daily oral hygiene efforts. This can lead to progressive root exposure.

If you are experiencing one of the four items listed above, a soft tissue grafting procedure can aid in improving this problem and can help you maintain your teeth, in a state of health, function and esthetics, for as long as possible. Depending on the clinical findings in your mouth, our providers may recommend one of two types of soft tissue grafting: Connective tissue grafting or Free gingival grafting.

The need for the particular type of graft will be discussed with you in detail at your consultation appointment.

When a frenum attachment is high on the gum line, a procedure called a frenectomy can be completed to release the tension on the gum line. This, in turn, allows for greater stability of the gum line, leading to a better overall prognosis for the area. This procedure often needs to be combined with a type of soft tissue grafting in order to adequately treat the area.

With this procedure, our providers begin with sedation (oral or intravenous), if desired, followed by administration of a local anesthetic (Novocaine). The exposed root surface is thoroughly cleaned, removing any bacteria and their toxins from the site. The gum tissue in the area is then prepared to receive the gum graft. The gum graft can be obtained either from the roof of the patient’s mouth or from a donor source. The choice of material depends on your presenting clinical situation, as well as your desires. Once this material is obtained, it is placed and secured at the treatment site, resulting in an immediate esthetic improvement. Although slight pain and swelling are not uncommon with this procedure, the use of prescribed medications, in conjunction with mild activity, will help to minimize these symptoms.

With this procedure, our providers begin with sedation (oral or intravenous), if desired, followed by administration of a local anesthetic (Novocaine). The gum tissue is then gently separated from the tooth and underlying bone, exposing the deep decay or fracture line on the tooth. Small amounts of bone are then removed from around the tooth, followed by a repositioning of the gum tissue. The gum tissue is then secured in place. After 4-8 weeks of healing, the final restoration can be placed on the treated tooth.

Dental implants can help restore or enhance your oral health, function and/or esthetics in several ways:
Replace a single tooth or teeth without affecting the neighboring teeth
Replace multiple teeth to avoid the need for a removable partial or complete denture
Provide support for an existing partial or denture, making them more secure and comfortable

When replacing a single tooth, dental implants are often the most natural and complete tooth replacement option, both in function and ability to clean. They have the following advantages over a traditional tooth replacement option, a bridge:
No drilling or modification to the neighboring teeth is required. This helps to limit the potential for future cavities and nerve damage to these other teeth.
Because dental implants are made of titanium, there is no potential for cavity development.
A dental implant is a more complete tooth replacement, as it replaces both the tooth root and the crown of the tooth. Replacing the tooth root will allow for bone preservation in the area.

Patients that currently wear a traditional removable partial or complete denture can experience a true life change with the placement of dental implants. For these individuals, dental implants can be placed in the mouth, under the denture, allowing for the denture to snap securely into place. Implants that are utilized in conjunction with removable appliances provide the following benefits:
Secure fit of a removable appliance. This will help the patient regain confidence in smiling and eating as the concern with appliance movement will be decreased.
Bone maintenance. When teeth are no longer in the mouth, the bone that was securing these teeth is lost. This bone loss is accelerated when a removable appliance is in place. The presence of dental implants can help maintain your bone, thus helping to support the denture and also your facial structure.
Regain the ability to eat virtually all foods. As the denture will be more secure, the ability to bite and chew foods will be improved.
As complete chewing of foods is necessary for proper processing of foods and extraction or nutrients, a secure fitting appliance will help a patient maintain better nutrition and will help lead to fewer digestive problems.
Some studies suggest that a patient’s psychological profile is healthier when they can chew and smile more confidently with a secure set of teeth.

If there is a desire to eliminate the denture completely, dental implants can be used to provide a tooth replacement option that is fixed in the mouth. This can replace a whole set of upper and/or lower teeth, negating the need for the removable appliance altogether.