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Frequently Asked Questions
Periodontal (gum) diseases, including gingivitis and periodontitis, are serious infections that, left untreated, can lead to tooth loss. The word periodontal literally means "around the tooth." Periodontal disease is a chronic bacterial infection that affects the gums and bone supporting the teeth. Periodontal disease can affect one tooth or many teeth. It begins when the bacteria in plaque (the sticky, colorless film that constantly forms on your teeth) causes the gums to become inflamed. In the mildest form of the disease, gingivitis, the gums redden, swell and bleed easily. There is usually little or no discomfort. Gingivitis is often caused by inadequate oral hygiene. Gingivitis is reversible with professional treatment and good oral home care. Untreated gingivitis can advance to periodontitis. With time, plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque irritate the gums. The toxins stimulate a chronic inflammatory response in which the body in essence turns on itself, and the tissues and bone that support the teeth are broken down and destroyed. Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Often, this destructive process has very mild symptoms. Eventually, teeth can become loose and may have to be removed.
Periodontal scaling & root planing is a conservative cleaning procedure meant to remove contamination and infection from beneath the gum. Scaling removes deposits of bacterial plaque, calculus, food debris, and pus that have accumulated in the infect pocket due to periodontitis. Root planing smoothes and cleans the root of the tooth so that the gum tissue may heal next to the tooth. Scaling and root planing is usually performed in one section of the mouth at a time using local anesthesia for your comfort. This non-surgical treatment is often effective in allowing complete healing of early stages of periodontitis and may reduce the extent of surgical treatment needed when performed in more advanced stages of gum disease.
This type of sedation induces an altered state of consciousness that minimizes pain and discomfort through the use of pain relievers and sedatives. Patients, who receive conscious sedation usually are able to speak and respond to verbal cues throughout the procedure, communicating any discomfort they experience. A brief period of amnesia may erase any memory of the procedure.Conscious sedation provides a safe and effective option for patients undergoing minor surgeries or diagnostic procedures. The number and type of procedures that can be performed using conscious sedation have increased significantly as a result of new technology and state of the art drugs. Conscious sedation allows patients to recover quickly and resume normal daily activities in a short period of time. Who Can Administer Conscious Sedation? Conscious sedation is extremely safe when administered by qualified providers such as those on the staff at Premier Periodontics. Certified Registered Nurse Anesthetists (CRNAs), anesthesiologists, other physicians, dentists, and oral surgeons are qualified providers of conscious sedation. Specifically trained Registered Nurses may assist in the administration of conscious sedation. Who Should Monitor Conscious Sedation? Because patients can slip into a deep sleep, proper monitoring of conscious sedation is necessary. Dr. Sam and his staff monitor patient heart rate, blood pressure, breathing, oxygen level and alertness throughout and after the procedure. We remain with the patient at all times during the procedure. What are the Side Effects of Conscious Sedation? A brief period of amnesia after the procedure may follow the administration of conscious sedation. Occasional side effects may rarely include headache, hangover, nausea and vomiting or unpleasant memories of the surgical experience. What Should Patients Expect Immediately Following the Surgical or Diagnostic Procedure? Written post operative care instructions should be followed. Patients should not drive a vehicle, operate dangerous equipment or make any important decisions for at least 24 hours after receiving conscious sedation. A follow up phone call is made by the by our staff to check on the patient's condition and answer any remaining questions.
Periodontal procedures such as Crown Lengthening are available to lay the groundwork for restorative and cosmetic dentistry and/or to improve the esthetics of your gum line. You may have wondered about procedures to improve a 'gummy' smile because your teeth appear short. Your teeth may actually be the proper lengths, but they are covered with too much gum tissue. To correct this, Dr. Sam can perform crown lengthening. During this 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. Dr. Sam may also recommend 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. Whether you have crown lengthening 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.
In the past, the treatment of periodontal (gum) disease was considered to be painful and disfiguring. For many years, the best way to achieve the ultimate goal of therapy (shallow, maintainable pockets) was to do resective surgical procedures that often resulted in the exposure of sensitive root surfaces and the appearance of "long" teeth. Today, Dr. Sam is often able to restore or regenerate missing bone and attachment around teeth subjected to long standing periodontal disease. In addition, if you have lost a tooth due to trauma or disease, we can restore or regenerate bone prior to the placement of bridges or implants. Guided Tissue Regeneration (GTR) refers to procedures that attempt to regenerate lost periodontal structures (bone, periodontal ligament, and connective tissue attachment) that support our teeth. This is accomplished using biocompatible membranes, often in combination with bone grafts and/or tissue stimulating proteins. Guided Bone Regeneration (GBR) refers to procedures that attempt to regenerate bone prior to the placement of bridges or, more commonly, implants. This is accomplished using bone grafts and biocompatible membranes that keep out tissue and allow the bone to grow.
A Frenectomy is the surgical removal of a frenum in the mouth. A frenum is a fold of tissue that passes from the movable lip or cheek to the gum. When a frenum is positioned in such a way as to interfere with the normal alignment of teeth or results in pulling away of the gum from the tooth surface causing recession, these are often removed using a surgical process known as a frenectomy.
A gingivectomy is necessary when the gums have pulled away from the teeth or receded down the root, creating deep pockets. The pockets make it hard to clean away plaque. Gingivectomy is usually done before gum disease has damaged the bone supporting your teeth.If you maintain good dental care after surgery, a gingivectomy is likely to help stop gum disease. Your gums should become pink and healthy again.
- Gingivectomy may help keep gum disease from further damaging your gum tissue, teeth, and bones by helping you to clean better around and between your teeth. If bones are damaged, it is more likely that you will lose your teeth.
- Gum disease usually will progress if you do not brush and floss regularly after surgery or if you continue to use tobacco.
- To promote healing, stop all use of tobacco because it decreases your ability to fight infection of your gums and delays healing.
- Regular follow-up with your dentist is important. If your gum disease gets worse, you may need a different type of surgery.
This procedure makes corrections to the bite associated with loose, shifting teeth or teeth that are biting too hard. Balancing and evenly distributing the biting and chewing forces on a tooth reduces the looseness and relieves excessive pressures on the supporting gum and bone structures.
Osseous surgery is designed to modify and reshape deformities in the alveolar bone surrounding the teeth. It is a common requirement in effective treatment of more involved periodontal diseases. In some instances, the bony support of the tooth assumes an unusual configuration as a result of uneven progression of the disease. When this occurs, modification of the altered bone support may be indicated. This surgical procedure is used to smooth/correct defects and irregularities in the bone surrounding the diseased teeth with the ultimate goal of reducing or eliminating the periodontal pockets.
This procedure is designed to replace or enhance the amount of gum supporting a tooth. Coverage of root surfaces exposed due to previous recession is also possible to achieve. These procedures are performed when there is inadequate gum remaining to help support a tooth or excessive recession has occurred exposing the root of the tooth. There are basically TWO types of Gum Grafts (Free gingival grafts): Sub-marginal Graft: This type of graft is the most predictable and is not meant to cover the root surface that has been exposed. It is meant to be placed at the current gum margin and to protect the underlying bone with a layer of tougher keratinized gum tissue that has been transplanted from another site. (usually the roof of the mouth). Root Coverage: This type of gum graft is designed to cover the root surface. It is not as predictable as the sub-marginal graft and is meant to be placed in areas that are highly visible such as the upper front teeth. This type of graft can be performed in several ways and may sometimes take two surgical steps. The most common method is a Connective Tissue Graft. The gum is taken from the palatal sub-mucosal tissue and then placed directly over the root; there tends to be more discomfort post-surgically. Recently, there has been developed synthetic tissue without the need for a donor area (palate); this makes the procedure much more pleasant, but again is not fully predictable.