Periodontal Treatments

With three extra years of specialization, periodontists specialize in gum disease and dental implants. As specialists of gum disease, we offer several non-invasive and minimally invasive periodontal treatments that will improve your teeth, bone structure and overall oral health.

Non-invasive Treatments - SCALING AND ROOT PLANING

Scaling and root planning is a non-invasive and the most cost-effective treatment method to treat periodontitis and to prevent it from advancing.

The goal of scaling and root planing is to eliminate the source of periodontal infection by removing the plaque, tartar, and bacterial toxins from the root surfaces of the teeth below the gum line. The tooth roots are planed to smooth the root surface allowing the gum tissue to heal and reattach to the tooth. Early non-invasive treatment may prevent future periodontal surgery. Scaling and root planning treatment is followed by adjunctive therapy such as local/systemic delivery of antimicrobials (e.g. Arestin, Chlorhexidine), as needed on a case-by-case basis.

When you have active periodontal disease, routine cleanings are not enough because they generally remove plaque and tartar from above the gum line only.

The procedure:

To keep you comfortable, we usually anesthetize the area before root planing begins. Using specialized instruments, we carefully and meticulously remove the plaque and tartar around and below the gum line, and then smooth the root surfaces. This removes the source of infection and helps your gums heal. As they heal, your gums will tighten around your teeth.

We may schedule scaling and root planing over several appointments. This way we can promote your comfort, check the healing, and help you fine-tune your overall oral health at home.

Many patients do not require any further active treatment after this initial therapy. However, the majority of patients will require ongoing maintenance therapy to sustain optimum dental health. Non-surgical therapy does have limitations, and surgical intervention may be necessary to restore periodontal structures damaged by periodontal diseases and to facilitate oral hygiene practices.

Periodontal Maintenance

Once a healthy environment has been established with appropriate periodontal treatment (non-invasive scaling and root planning or periodontal surgery), the most important phase of periodontal therapy begins, as well as the practice of long-term maintenance. The frequency of periodontal maintenance is determined by the patient’s susceptibility to the disease. Most commonly these sessions are scheduled every two to four months, alternating between the general dentist and the periodontist.

ARESTIN® Antibiotic Therapy

ARESTIN® Contains Minocycline, a Proven, Broad-Spectrum Antibiotic, that delivers therapeutic levels of antibiotic with a microsphere delivery system.

Arestin is administered into the base of periodontal pockets during periodontal scaling and root-planing.

Once inserted in the pocket, contact with gingival crevicular fluid hydrolyzes the bioadhesive microspheres, allowing them to immediately adhere to the surrounding surfaces. This also causes water-filled channels to form inside the microspheres, providing for a sustained release of minocycline over time.2

ARESTIN® can remain active in the pocket for up to 14 days and does not require removal because it is bioresorbable.^1,2

*Two single-blind, Phase III trials comparing ARESTIN® + SRP to SRP alone and SRP + placebo (n=748). SRP was performed for all groups at baseline. ARESTIN® or vehicle was administered to periodontal pockets ≥5 mm in the adjunctive therapy groups at baseline, 3 months, and 6 months. Efficacy was evaluated over 9 months.

REFERENCES: 1. ARESTIN® (minocycline hydrochloride) Microspheres, 1 mg. Prescribing Information. Horsham, PA: OraPharma, Inc.; 2011. 2. Williams RC. Medical progress: periodontal disease. New Engl J Med. 1990;322(6):373-380.

Gum Recession

Learn more about gum recession

Why does gum recession matter?

Gum recession occurs when your root surface becomes exposed–and may be a sign of gum disease destroying the structures that support your teeth.

The role of gum tissue is to cover and protect the root of the tooth and underlying bone. When gum tissue recedes, the bone and other tissues that support your tooth’s root are also lost. This loss of gum tissue results in root sensitivity and may also make eating and drinking unpleasant or painful. It’s important to identify and treat recession early. Left unchecked, recession could advance to the point where the root becomes unprotected, your teeth loosen, and some may even fall out.

Symptoms of gum recession include:

• sensitive teeth – root sensitivity
• tender gums
• exposed roots
• loose teeth – loss of supporting bone
• unattractive smile – longer tooth line
• tooth decay
• plaque buildup
• risk of future recession

Crown Lengthening

Sometimes you may find that your gums may cover a larger portion of your teeth than you would like. This makes your teeth appear shorter and even may be unhealthy as more food may be caught in the gums. To improve this condition, your periodontist may pull back your gum line, exposing your crown more. This procedure is called crown lengthening.

During the dental 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 periodontist may also recommend dental crown lengthening to perform another dental restorative or cosmetic dental procedure. If your tooth is decayed or broken below the gum line, then you may need a crown lengthening because of an insufficient amount of tooth structure for a restoration. Crown lengthening adjusts the gum and bone level to expose more of the tooth so it can be restored.

Gingival Grafting

Gallery: Case Studies

Exposed tooth roots are the result of gum recession. Gum graft surgery can help to cover teeth that have had gum recession and help to prevent additional recession and bone loss. Gum recession is sometimes treated by retrieving soft tissue from the roof (palate) of the patient’s mouth. However, removal of a section of the palate creates unnecessary pain and discomfort. Therefore, we offer a graft material called AlloDerm RTM. Alloderm is a tissue bank material that has been used in dermatology and dentistry for many years. It can help to enhance the gingival graft without having to take tissue from the roof of the mouth.

Read more about Gum Recession in our Newsletter

Regenerative Therapy

What is regenerative therapy?

Sometimes your bone and soft tissues can degenerate because of periodontal disease, but this loss of tissue and bone can be reversed. Our periodontist may recommend a regenerative procedure to actually regrow some of the bone and soft tissue around the teeth. Products are available that can stimulate your oven cells to grow back into lost bone and soft tissue. These biological materials can be added to bone replacement grafts with or without a membrane to gain back lost bone and soft tissue. These procedures can reverse some of the damage by regenerating lost bone and tissue.

Tooth Extraction

Sometimes gum disease gets to such a serious point that a severely damaged tooth may need to be removed. Your periodontist will determine whether this procedure must be performed. If a tooth needs to be taken out, we may recommend a bone replacement graft to enhance the bone healing at the site the tooth has been extracted. This is often recommended if a dental implant is being considered.