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Periodontal Procedures

Periodontic Procedures begin with an initial consultation at our offices. During this time, the doctor will make a diagnosis and discuss treatment needs. Patients will be educated regarding their periodontal status and all the treatment options and recommendations specific to a case will be discussed. Together with your referring doctor, you will be guided accordingly to obtain the best treatment outcomes. Our goal is that you leave our office with a complete understanding of your condition and the available treatments needed to restore you to optimal oral health.

The following information provides background on some of the treatment options that we may recommend.

Non-Surgical Therapy

Scaling and Root planing

Scaling and root planing or ‘deep cleaning’ is a careful cleaning of the root surfaces to remove plaque and calculus [tartar] from deep periodontal pockets and to smooth the tooth root to remove bacterial toxins. It is usually performed using local anesthetic. This will typically be performed in a single visit in keeping with the concept of ‘full mouth disinfection’. A follow-up visit for re-evaluation will be completed to assess the outcome of this procedure and determine further periodontal needs. Scaling and root planing is sometimes followed by adjunctive therapy such as local delivery antimicrobials, systemic antibiotics, and host modulation, as needed on a case-by-case basis.

Most periodontists would agree that after scaling and root planing, many patients do not require any further active treatment. However, most patients will require ongoing maintenance therapy to sustain health. If the disease cannot be controlled with non-surgical therapy, surgery will likely be recommended to eliminate the pockets and improve health.

Surgical Therapy

The results of non-surgical therapy are assessed at periodontal re-evaluation. If disease is still present, as evidenced by deep pocket depths and other parameters, periodontal surgery may be recommended. The primary purpose of surgery is to provide access for the debridement of root surfaces to eliminate harmful bacteria toxins. During this procedure, the gums are moved back so that your doctor can clean the roots and assess the bone. The goal of periodontal treatment is to reduce pocket depths thereby lowering the bacterial load surrounding the tooth. This can be achieved by either resective or regenerative techniques or both.

Periodontal Regeneration
Root Coverage Techniques
Crown Lengthening
Gingival Recontouring

Periodontal Regeneration

Procedures that regenerate lost bone and tissue supporting your teeth can reverse some of the damage caused by periodontal disease.

Your periodontist may recommend a regenerative procedure when the bone supporting your teeth has been destroyed due to periodontal disease. 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. Barrier membranes, bone grafts or tissue-stimulating proteins/growth factors can be used to encourage your body’s natural ability to regenerate bone and tissue.

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 other health problems associated with periodontal disease.

Root Coverage Techniques

Root surfaces may become exposed for several reasons. This can lead to increased sensitivity, compromised oral hygiene and poor esthetics. Gum graft surgery is performed to either cover exposed root surfaces or to replace missing gum tissue. While gum grafts are often taken from the palate (roof of the mouth), alternative gum grafts are available. The gum graft is used to replace the missing gum tissue and to cover exposed root surfaces when possible. Treatment can halt gum recession, decrease susceptibility to future recession and often result in improved esthetics and comfort.

Crown Lengthening

During the esthetic crown lengthening 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 functional 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 successfully.

Gingival Recontouring

Sometimes teeth appear quite small in relation to the gum tissue. This can create an unattractive “gummy” smile. An uneven gum line can also be esthetically displeasing especially in the smile zone. This can be caused by excess gum tissue only or a combination of excess bone and gum tissue.

The gum line, and the bone just beneath the gum line, can be lowered to change the appearance of your smile. This can create a more even gum line or make the teeth appear longer. “Gingival (gum) contouring” is the process of recontouring the gum only. “Crown lengthening” refers to recontouring of both gum and supporting bone.

A proper assessment by the periodontist will determine the cause of the ‘gummy’ smile and the appropriate treatment needed.

Periodontal Maintenance

Regular examinations are very important to keep track of the present status of your disease and any disease progression over time. Your periodontist will work with you to create a maintenance schedule depending on how advanced your periodontal disease is at that time. Based on many variable factors such as your overall health, the severity of bone loss, and risk factors such as smoking and genetics, your periodontist will constantly tailor your care so your periodontal disease does not progress further.

Periodontal disease, like many inflammatory diseases, is never cured but only controlled. These visits are different from routine cleaning appointments in that they are designed to assess and treat changes in the periodontal status on an ongoing basis.

Multiple studies have shown that in the absence of proper maintenance care, disease will recur and progress often without symptoms. An interval of 3 months is considered most effective. These visits may be performed alternately between our office and your general dentist depending on the individual case and type of treatment completed.

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