Periodontal Treatments and Procedures

AAP treatment guidelines stress that periodontal health should be achieved in the least invasive and most cost-effective manner. This is often accomplished through non-surgical periodontal treatment.

Scaling and root planing
Scaling and root planing 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. Scaling and root planing is sometimes followed by adjunctive therapy such as 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, the majority of patients will require ongoing maintenance therapy to sustain health.

You may have asked your periodontist about procedures to improve a "gummy" smile because your teeth appear short. Your teeth may actually be the proper lengths, but they're covered with too much gum tissue. To correct this, your periodontist performs a dental crown lengthening procedure. 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 dentist or periodontist may also recommend dental 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.

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. Membranes (filters), bone grafts or tissue-stimulating proteins can be used to encourage your body's natural ability to regenerate bone and tissue.

 

Exposed tooth roots are the result of gum recession. Gum graft surgery will repair the defect and help to prevent additional recession and bone loss. Gum grafts can be used to cover roots or develop gum tissue where absent due to excessive gingival recession. During gum graft surgery, your periodontist takes gum tissue from your palate or another donor source to cover the exposed root. This can be done for one tooth or several teeth to even your gum line and reduce sensitivity.

What are the benefits of gum graft surgery?
A gum graft can reduce further recession and bone loss. In some cases, it can cover exposed roots to protect them from decay. This may reduce tooth sensitivity and improve esthetics of your smile. Whether you have a gum graft to improve function or esthetics, patients often receive the benefits of both: a beautiful new smile and improved periodontal health – your keys to smiling, eating and speaking with comfort and confidence.

Periodontists are often considered the plastic surgeons of dentistry. If you are looking to improve your smile, a periodontist may be able to help.

Tooth loss can cause an indentation in the gums and jawbone where the tooth used to be. This happens because the jawbone recedes when it no longer is holding a tooth in place. Not only is this indention unnatural looking, it also causes the replacement tooth to look too long compared to the adjacent teeth.

Ridge augmentation can fill in this defect recapturing the natural contour of the gums and jaw.

When you have periodontal disease supporting tissue and bone is destroyed, forming "pockets" around the teeth.

Over time, these pockets become deeper, providing a larger space for bacteria to live. As bacteria develop around the teeth, they can accumulate and advance under the gum tissue. These deep pockets collect even more bacteria, resulting in further bone and tissue loss. Eventually, if too much bone is lost, the teeth will need to be extracted. During this procedure, your periodontist folds back the gum tissue and removes the disease-causing bacteria before securing the tissue into place. In some cases, irregular surfaces of the damaged bone are smoothed to limit areas where disease-causing bacteria can hide. This allows the gum tissue to better reattach to healthy bone.

Dental implants undergo periodontal disease.

Conditio sine qua non is to treat periodontal disease prior to implant therapy.

Peri-implantitis is a site-specific infectious disease that causes an inflammatory process in soft tissues, and bone loss around an osseointegrated implant in function. The etiology of the implant infection is conditioned by the status of the tissue surrounding the implant, implant design, degree of roughness, external morphology, and excessive mechanical load.

Numerous periodontal procedures can treat and prevent further loss of dental implants.

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