What is Periodontics?

Periodontics is a dental specialty. The word “periodontics” comes from two Greek words: “peri”, which means “around” and “odont”, which means “tooth”. So, the field of periodontics treats conditions that affect the tissues around your teeth, such as bone loss, gum recession and periodontal (gum) disease. Contact us today to schedule an appointment and experience the difference of Essential Endodontics.

Periodontal Disease

Periodontal disease, also known as gum disease, often begins as a buildup of plaque on the surface of the tooth near the gum line. If this plaque is not removed by brushing and flossing regularly, it can harden into what your dentist calls tartar…..

Crown Lengthening

Crown lengthening involves removing excess gum tissue around the upper teeth to make them look longer. If the gum line is uneven, crown lengthening can also sculpt the gum line to produce a more symmetrical, balanced smile. Crown lengthening may be….

Gingival Recession

Gum grafting will cover the exposed roots to protect them from decay, help reduce tooth sensitivity, and improve the aesthetics of your smile. Whether you have a gum graft to improve function or aesthetics, you’ll probably receive….

Periodontal Disease

If you’ve been diagnosed with gum disease, there are a variety of treatment options depending on the details of your situation and the severity of the problem. We always start with the least invasive options, which are non-surgical. However, in more serious cases, surgery may be necessary.

Non-Surgical Treatment

The first line of defense against gum disease is a unique type of cleaning called “scaling and root planning.” In this procedure, an ultrasonic cleaning device is used to remove plaque and tartar from your teeth where regular cleaning devices can’t reach: under the gum line, on the tooth, and around the root. Then, the rough surface of the tooth and the root are smoothed out (planed). This provides a healthy, clean surface that makes it easier for the gum tissue to reattach to the tooth.

If you address your gum disease before it becomes severe, scaling and root planning may be the only treatment you need. However, as with any dental procedure, after-care is vital. In order to keep your teeth in good shape and resist future occurrences of gum disease, you must brush and floss daily, eat a healthy diet, avoid tobacco use, and have regular dental checkups. Even after a successful scaling and root planning, if you don’t attend to your teeth properly, it’s quite likely that you’ll develop gum disease again.

Surgical Treatment Options

If the tissue or bone surrounding your teeth is too damaged to be repaired with non-surgical treatment, several surgical procedures are available to prevent severe damage and to restore a healthy smile. We will recommend the procedure that is best suited to the condition of your teeth and gums. Following is a list of common types of periodontal surgery:

  • Pocket Depth Reduction
    In a healthy mouth, the teeth are firmly surrounded by gum tissue and securely supported by the bones of the jaw. Periodontal disease damages these tissues and bones, leaving open spaces around the teeth that we call pockets. The larger these pockets are, the easier it is for bacteria to collect inside them, leading to more and more damage over time. Eventually the supportive structure degrades to the point that the tooth either falls out or needs to be removed. During pocket reduction procedures (also known as “flap surgery”), we fold back the gum tissue and remove the bacteria hiding underneath, as well as the hardened plaque and tartar that have collected. We may also remove any tissue that is too damaged to survive. We then sew the healthy tissue back into place. Now that the tooth and root are free of bacteria, plaque, and tartar, and the pockets have been reduced, the gums can reattach to the teeth.
  • Regeneration
    When the bone and tissue supporting the teeth have been lost due to severe gum disease, we can restore these areas with a regeneration procedure. During this process, we begin by folding back the gum tissue and removing the bacteria, plaque, and tartar. Depending on your situation, we may then perform a bone graft to stimulate new bone growth, or we may apply a special kind of protein that stimulates tissue growth to repair the areas that have been destroyed by the disease.
  • Soft-Tissue Graft
    A frequent symptom of gum disease is gum recession (also called gingival recession). As the gums recede, more of the roots are revealed. This can make teeth appear longer and can also create sensitivity to hot or cold liquids or food. It also exposes the tooth to increased damage from gum disease, as bacteria, plaque, and tartar attack the surface of the tooth and the root. During a soft-tissue graft, tissue from the top of your mouth or another source is sewed to the gum area, covering the roots and restoring the gum line to its original, healthy location. This procedure can also be performed for cosmetic reasons.

Crown lengthening

Crown lengthening involves removing excess gum tissue around the upper teeth to make them look longer. If the gum line is uneven, crown lengthening can also sculpt the gum line to produce a more symmetrical, balanced smile. Crown lengthening may be done for dental care and medical reasons as well as for cosmetic purposes. If your periodontist finds decay or fracture under the gum line, for example, crown lengthening can help expose more of the tooth’s crown in order to support a filling or restoration.

Crown lengthening is done under local anesthesia, so as the numbing effect wears off, you may feel some discomfort along your new gum line. You will most likely be prescribed pain medication, so it is important to let us know what other medications you are already taking. Usually, a follow-up appointment will be needed to check the healing process and remove any stitches.

We want your crown-lengthening procedure to be as comfortable as possible, so let us know if you have any questions. Call our office to set up an appointment, and find out if crown lengthening can give you the smile you’ve always wanted.

Gingival Recession

Gum grafting will cover the exposed roots to protect them from decay, help reduce tooth sensitivity, and improve the aesthetics of your smile. Whether you have a gum graft to improve function or aesthetics, you’ll probably receive the benefits of a beautiful new smile and improved periodontal health: your keys to smiling, eating, and speaking with comfort and confidence.

Gum Recession

Gum recession is caused by advanced gum disease. When gingivitis goes untreated, gum disease (also called periodontitis) will cause gums to pull away from the teeth, leaving deep pockets where bacteria can grow and damage the bone that supports the teeth. Gums can also shrink back from the teeth, making the teeth look longer. Teeth may then become loose, fall out, or have to be pulled out by a dentist.

Do you have gum recession?

Gum recession does not happen overnight. You may not even notice that your gums have receded, as it is a very slow, gradual process. However, without a gum tissue graft, recession can have a detrimental effect on the health and function of your teeth. If your dentist has diagnosed you with gingivitis or periodontal disease.

Symtoms to look for

  • You have sensitivity to hot or cold temperatures, or even to sweet, spicy, or sour foods
  • Your teeth appear longer than normal
  • Spaces between your teeth seem to grow
  • The roots of your teeth begin to show

Gum Tissue Grafting

When you come to our office for your grafting procedure, a local anesthetic will be given to numb the areas involved. You may also receive medicine to help you relax. We want your experience in our office to be as comfortable as possible, so let us know if there is anything you need during your procedure.

Depending on your specific needs, your periodontist will perform one of three different types of gum tissue grafts.

Connective tissue grafts

The most common method to treat root exposure, and connective tissue grafting involves your periodontist cutting a flap of skin on the roof of your mouth (or palate) and removing tissue from under the flap, called sub-epithelial connective tissue. This tissue is then stitched to the gum tissue surrounding the exposed root. After the connective tissue, or graft has been removed from under the flap, the flap is then stitched back down.

Free gingival grafts

Similar to a connective tissue grafting, a free gingival graft involves the use of tissue from the roof of the mouth. But instead of making a flap and removing tissue under the top layer of flesh, a small amount of tissue is removed directly from the roof of the mouth and then attached to the gum area being treated. This method is used most often in people who have thin gums to begin with and need additional tissue to enlarge the gums.

Pedicle grafts

In this procedure, instead of taking tissue from the palate, it is grafted from gum around or near the tooth needing repair. The flap called a pedicle, is only partially cut away so that one edge remains attached. The gum is then pulled over or down to cover the exposed root and sewn into place. This procedure can only be done if you have plenty of gum tissue near the tooth.

Many factors will contribute to your chosen grafting technique. Your periodontist can tell you which method will work best for you, your health, and your smile.

What is a Frenectomy

A frenectomy is a simple surgical procedure that involves the removal of one or both frena from the mouth. The frenum is the connective tissue membrane that attaches one surface within the mouth to another.

There are three functions of frena:

The lingual frenum

Which is the vertical band of thin tissue that connects the tongue to the bottom of the mouth

The labial frenum

Which is the connective webbing that attaches the lips to the gums above the top two front teeth and below the bottom two front teeth

The buccal frena

Which is the three strands of tissue that connect the gums to the insides of the cheeks

What to Expect from your Biopsy

Although most biopsies are benign, it’s incredibly important to assess any unusual oral growth or lesion. During your biopsy, your NTFOS surgeon may administer local anesthesia to numb the affected area and remove a portion of tissue or the entire growth/lesion. This usually produces a small hole that might require stitching (typically with dissolvable stitches). A sample may take about 10 to 20 seconds to collect, and the entire procedure should not last longer than 20 minutes. A pathologist will then examine the biopsy tissue and provide us with written findings. We’ll work in tandem with your general dentist to evaluate the need for treatment if the results of your biopsy deem that treatment is indeed necessary.

What to expect afterwards:

As biopsies are typically simple, minimally invasive procedures, you can expect little swelling and pain after the local anesthetic wears off. Discomfort can typically be managed with over the counter painkillers, and discomfort should only last a few days. Many people are able to resume normal activities such as driving and work after the procedure.

You will most likely be given a second appointment to discuss any issues you may have with healing and to discuss the results of the biopsy anywhere from 2 to 10 days after your procedure.

Although bleeding should be prevented by stitching, some do experience this issue after the procedure. This can be stopped by applying pressure to the site for 10 minutes with absorbent material. Be sure to contact your NTFOS surgeon if the bleeding does not stop.

Other aftercare tips include being sure not to bite or strain the side of your mouth to prevent pain and bleeding. You can and should brush and floss your teeth normally, but be sure to keep from rinsing your mouth out too vigorously. You may gently rinse with saltwater or mouthwash if you find food around your stitches.

Peri-Implant Diseases

In peri-implantitis, gum inflammation is found around the soft tissue and there is deterioration in the bone supporting the dental implant. Peri-implantitis usually requires surgical treatment.

Signs of peri-implant diseases are similar to symptoms of gum disease: red or tender gums around the implants, or bleeding when brushing. And just like your natural teeth, implants require regular tooth brushing and flossing and regular check-ups from a dental professional. Other risks factors for developing peri-implant disease include previous periodontal disease diagnosis, poor plaque control, smoking, and diabetes. It is essential to routinely monitor dental implants as part of a comprehensive periodontal evaluation.

The up side to dental implants is they function just like your natural tooth. The down side is, they are capable of becoming diseased just like a natural tooth. With a proper oral health routine, your dental implant can last a lifetime.

Sinus Augmentation

Periodontal disease can cause bone loss, and because of the anatomy of the skull, the back of the upper jaw naturally has less bone than the lower jaw. If your periodontal disease has left you with too little bone in your upper jaw, sinus augmentation can allow your periodontist to create a healthy foundation for an implant to be placed.

The Procedure

Your periodontist will cut into the gum tissue and lift it away from the bone. A small area of bone will be removed, allowing your periodontist to gently push the sinus membrane up and away from the jaw. Then, a bone graft will be placed into the space where the sinus membrane was. Once in place, the gum tissue is stitched closed and the bone graft material will begin to grow, filling in the areas of lost bone. When the grafted material is fully meshed with the existing bone, your periodontist will be able to place your implant, returning your mouth to an ideal state of function and aesthetics.