Periodontics

NON-SURGICAL PROCEDURES

Bite Adjustment

A bite is considered to be healthy when all or most of the teeth are present and not destroyed by normal, daily usage. It is destructive when teeth show wear, looseness or when TMJ (jaw joint) damage is seen. Bite therapy helps restore a bite that can function without damage and destruction.

The therapy may include:

• Reshaping the biting surfaces of the teeth and eliminating spots of excessive pressures where the teeth are brought into contact. This is done by carefully dividing bite pressures evenly across all of the teeth.
• Bite splint therapy involves using a custom fitted and adjusted plastic bite guard to keep the teeth apart, day, night or both.
• Braces may be used to reposition mal-aligned or drifted teeth
• Replacement of old, worn out or damaged fillings.
• Reconstruction of badly worn and damaged teeth

Scaling and Root Planing

The initial stage of treatment is usually a thorough cleaning that may include scaling to remove plaque and tartar deposits beneath the gum line. In addition,  tooth roots may be planed (smoothing the root surface), allowing the gum tissue to heal and reattach to the tooth. In some cases, the occlusion (bite) may require adjustment.

When deep pockets between teeth and gums are present, it is difficult to thoroughly remove plaque and tartar. Patients can seldom, if ever, keep these pockets clean and free of plaque, which creates an environment where the damage gets progressively worse. Consequently, surgery may be needed to restore periodontal health.

SURGICAL PROCEDURES

Bone Grafting, Regeneration, Sinus Elevation

Bone grafting can repair implant sites with inadequate bone structure due to previous extractions, gum disease or injuries. The bone is either obtained from a tissue bank or your own bone is taken from the jaw. Sinus bone grafts are sometimes performed to replace bone in the back part of the upper jaw. In addition, special membranes may be utilized that dissolve under the gum and protect the bone graft, while encouraging the bone to grow or regenerate. This is called guided bone regeneration or guided tissue regeneration.

Cosmetic Periodontal Surgery

If you are unhappy with the appearance of short unsightly teeth you are not alone. However, this can be greatly improved using a combination of periodontal procedures. For example, teeth may be covered with too much gingival (gum) tissue. We can correct this by performing the periodontal plastic surgery procedure known as crown lengthening. During this procedure, excess gum and bone tissue is reshaped to expose more of the natural tooth. This can be accomplished for more than one tooth, down to your gum line, creating a beautiful smile. For teeth with recession (showing root surfaces), the soft tissue graft (subepithelial connective tissue graft) is an effective way to cover unsightly, sensitive or exposed root surfaces and to prevent future gum recession.

Crown Lengthening

Crown lengthening (or crown exposure) is required when the tooth needs a new crown or other restoration procedure, but there is not enough of your tooth crown exposed to retain the new crown or filling. Also, the edge of a needed filling may also extend deep below the gum tissue and  may not be accessible for the dentist to restore with a filling or crown. If the crown or filling is too deep, below the gum tissue, or if the margins of the crown are too close to the bone, the supporting tissue may remain inflamed, sensitive, or hard to manage or care for.

Dental Implants

Dental implants are changing the way people live. They are designed to provide a foundation for replacement teeth that look, feel, and function like natural teeth. With dental implants, the person who  lost  his/her teeth regains the ability to eat virtually anything, and develops the confidence associated with natural looking  teeth and preserved facial contours. Patients with dental implants can smile with confidence.

Extractions

Some teeth are extracted because they are severely decayed; others may have advanced periodontal disease, or are broken beyond repair. Some teeth may need removal because they are poorly positioned in the mouth (such as impacted teeth), or in preparation for orthodontic treatment. However, the removal of a single tooth can lead to many problems related to: your chewing ability, problems with your jaw joint, or shifting teeth, which can  negatively impact your dental health. To avoid these complications, in most cases, Dr. McCombs will discuss extraction alternatives, as well extraction replacement options.

Gum Grafting Procedures

Gum grafting procedures include the subepithelial connective tissue graft for root coverage, the ‘free’ gingival graft to gain attached gingival, and the lateral repositioned graft that can be used in combination with the connective tissue graft, or alone for attachment gain.

When recession of the gingival (gums) occurs, the body loses a natural and important defense against bacterial penetration and trauma. When gingival recession is a problem, gingival reconstruction using grafting techniques is an option.