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EARLY DIAGNOSIS AND EARLY TREATMENT ARE KEY TO CONTROLLING DISEASE AND MAINTAINING TEETH FOR A LIFETIME.
Periodontal Disease Therapy
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, Dr. Recker 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 Dr. Recker can now see distinctly the disased 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.
Mouth-Body Connection
Did you know that the health of your mouth could be affecting the health of the rest of your body? Are you aware that by treating diseases of the mouth, the overall health care costs for diabetics is lower? Have you heard that poor oral health can lead to a greater risk of developing heart disease? If you were unaware of any of this, please read on.
Over the last several years, the medical and dental communities have been discovering that they are more closely related than once thought. The unifier appears to be chronic inflammation, which is the body’s response to an infection or irritant. It has now been shown by both communities that poor oral health (chronic inflammation) is linked with poor overall health of the body.
Periodontal (gum) disease is a chronic inflammatory disease in the mouth which, according to the American Academy of Periodontology, has been shown to be linked to the following health conditions:
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.
Soft Tissue Grafting
Do you have sensitivity in your mouth when you drink cold beverages? Do you notice the teeth in your mouth are appearing longer? Are you concerned with dark spots along the gum line showing in your smile? If “Yes!”, then soft tissue (gum) grafting may be the procedure you need.
Temperature Sensitivity – as the root surface becomes exposed through the loss of gum tissue, the nerve in the tooth can become more easily irritated, especially in the presence of extreme temperatures
Esthetics – the root surface of a tooth is darker than the enamel of the tooth. When gum tissue is lost on a tooth, this darker root surface becomes visible.
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, Dr. Recker 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.
Frenectomy
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.
Esthetic Periodontal Procedures
Are you unhappy with the appearance of your smile?
Do you show too much gum tissue when you smile?
Are you concerned about the appearance of dark
root surfaces or long teeth in your mouth?
If you answered “Yes!” to any of these questions, Esthetic Periodontal Procedures may be right for you.
Some periodontal procedures are designed to greatly enhance a patient’s esthetics. These procedures can be performed alone, or in conjunction with restorative procedures, to produce a more pleasing appearance to the patient. Esthetic procedures can help…
A patient who is concerned with the appearance of his or her teeth looking too short
A patient who has concerns with the gumminess of his or her smile
A patient’s gum line is that uneven
A patient who has darkened root surfaces which cause cosmetic concerns
With this procedure, Dr. Recker begins 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, Dr. Recker begins 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
Are you currently missing a tooth? Do you have a removable appliance that moves around in your mouth? Would you like a new, strong set of teeth that are secure and do not need to be removed? If you answered “Yes!” to any of these questions, dental implants may be a solution for you to improve your life.
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.
Implant Site Preparation
When a tooth is removed from the mouth, the supporting bone starts to break down. If an implant is the accepted next step in the treatment plan, then a procedure called socket preservation can be performed at the time the tooth is removed. This will maintain the supporting bone structure until the implant is placed. Going without a tooth or implant for a long period of time can result in a substantial loss of the supporting bone.
Occasionally, bone loss is such that there is not enough bone into which a dental implant can be successfully placed. In these situations, additional procedures (bone grafting) may be required to regenerate sufficient bone structure into which a dental implant could then be placed.
Sedation
The Advanced Periodotics & Implants team understands that some people can experience apprehension or anxiety when at the dentist. We do all that we can to make our patients as comfortable as possible during their procedures. In order to accomplish this goal, we offer relaxing medications for use before and during the procedures.
You, the patient, will have maximum input regarding your experience during a procedure. Some people choose to have only local anesthesia (Novocaine) and be fully aware during surgery. Many people, however, feel uncomfortable with this and prefer Nitrous Oxide, Oral, or IV sedation as to be less aware or not aware of the activities of surgical procedures. Dr. Recker can help you choose the option that will make your experience as comfortable as possible. Please review our different sedation options available below to determine which best would accommodate your needs.
The IV form of medication is a stronger form of sedation. For this form of sedation, there is no need to arrive early. Upon being seated in the dental chair, Dr. Recker will start an IV, typically in your hand or arm. The effects of the sedation medication will be felt almost immediately. Most patients fall asleep and stay asleep through the entire procedure and have minimal to no recollection of the procedure as the medication wears off.
While you are sedated, you will be continuously monitored by Dr. Recker and his team to ensure the highest level of comfort and safety. As with the oral form of sedation, you will need to have someone available to drive you home from the procedure. You can also expect to feel a little sleepy for a few hours after arriving home.