Periodontal Treatment Procedures

When it comes to gingival recession, it is important to keep in mind that preventative care is always the best treatment. Receding gums cannot regenerate, which means that once your gum tissue is lost, it is permanently gone and cannot grow back. There are, however, treatments that can help stop the problem from getting worse. Treatments include thorough root planing and scaling, sometimes with the insertion of topical antibiotics directly under the gums, antimicrobial mouth rinses, and dental bonding to hide or camouflage the area of recession. When there is significant gum recession, tissue grafts (gum graft surgery) can be done.

Gum graft surgery is used to replace your missing gum tissue. This is most often done by removing a small amount of tissue from the roof of your mouth or using tissue from another donor source and then transplanting it to the affected site. Soft tissue grafts can help to reduce further gum recession, cover any exposed roots, and give your teeth a more aesthetically pleasing appearance. Gum graft surgery is typically performed by a periodontist and is the most long-lasting and predictable solution for gum recession.

When it comes to periodontal disease, the main aim of treatment is to clean out any bacteria from the pockets around the teeth and prevent any further destruction of the tissue and bone. It goes without saying that good oral hygiene should be followed daily at home, which includes brushing and flossing. Unfortunately, home hygiene can only clean areas of the teeth above the gum line (scaling). A professional cleaning provided by a periodontist can clean areas of the teeth not only above the gum line, but below the gum line as well (called root planing).

A professional cleaning by a periodontist can provide a ‘deep cleaning’ that home care or a dental hygiene visit simply cannot offer. Your periodontist has advanced training to remove stubborn deposits of calculus, making sure to clean all the way down to the bottom of the pocket. Every time your teeth are scaled you are one step closer to a healthy smile! Root planing will be done, which involves smoothing out your teeth roots to help your gums reattach to your teeth. Smooth root surfaces help keep plaque, bacteria, and tartar from re-adhering below the gum line. Root planing also decreases gum tissue inflammation and allows your gums to reattach themselves more firmly to your teeth. If necessary, a medicine might be administered directly into the area undergoing the procedure. The goal of regular dental cleaning is to prevent gum disease in the first place, or if present, remove plaque and calculus and restore periodontal health.

Peri-implant disease refers to the reversible peri implant mucositis and the irreversible peri-implantitis. Peri implant mucositis involves inflammation changes within the implant soft tissue, without the presence of bone loss. It is essentially ‘gingivitis’ around an implant. Peri-implant mucositis involves inflammatory changes affecting the soft tissues surrounding the implant resulting in loss of the supporting bone surrounding the implant. This can cause the implant to come out or need to be removed.  At the first sign of peri-implant disease, it is important to seek treatment from a periodontist or oral health care professional, who can use various techniques to help cure the infection while allowing the dental implant to remain in place. With specialized treatment, Peri-implantitis can be reversed successfully and your dental implants and overall smile can be restored.

Since peri-implant disease is caused by the accumulation of bacterial plaque, just as periodontal disease forms, the treatment for peri-implant disease often includes the same treatment as with periodontal disease. The goal is to control the infection and prevent the progression of the disease. Treatments include a thorough decontamination of the surface of the implant and may involve surgical intervention to treat the peri-implant disease.

If teeth or gums have been severely damaged by toot fracture or tooth decay, a crown may be recommended to give you back your smile. Crown lengthening can be performed if there is not enough of the natural tooth to allow a crown to firmly attach or if the filling on the tooth goes too far below the gum line. Crown lengthening re-contours gum tissue and bone, in order to expose more of a tooth’s surface for a crown. In other words, it adjusts the tooth’s bone level so that the size and height of the portion of the tooth that is visible can be extended, preparing the area for a new restoration, or to repair the damaged teeth. Crown lengthening also addresses excessive gingival display, or a gummy smile. By exposing more of the natural tooth by reshaping or re-contouring bone and gum tissue, a crown lengthening treatment can improve your smile by removing excess gum tissue and offering a more balanced, healthy look by improving the aesthetics of the smile.

Periodontists often collaborate with other specialists for multidisciplinary treatment. There are situations where a tooth may need to be uncovered so that an orthodontist can move it to its proper position. A periodontist may perform a procedure to expose a tooth that is malpositioned under gum tissue and prepare it for realignment by an orthodontist. A tooth that fails to emerge through the gums is known as an impacted tooth. It is important to expose and move certain teeth to their ideal position in a very timely fashion, in order to help prevent the formation of a cyst or prevent damage to adjacent teeth from pressure created by the hidden tooth. The gum on top of the emerging tooth will be carefully lifted up in order to expose the hidden or impacted tooth underneath. If there is a baby tooth present, it will be removed at the same time. Once the tooth is uncovered, a chain is bonded to it, and the gum is closed back up so that the orthodontist can properly guide the tooth to emerge by adjusting the chain during orthodontic appointments.

If you suffer from severe gum disease, you may have lost some of the bone that holds your teeth in place. A bone graft may be performed to help grow new bone to replace the bone destroyed by periodontitis. Bone cannot regenerate on its own after periodontal disease, but bone grafts can be used to promote growth in areas where bone has been lost. A bone graft is placed around an existing tooth in order to provide more support to the tooth and reduce mobility. The procedure is usually performed to allow for proper dental implant placement, or when bone loss is negatively affecting neighbouring teeth. The bone graft material can be taken from your own body, from a human tissue bank, or an animal tissue bank. Sometimes it may be synthetic material. A dental bone graft provides a support on which your own bone tissue can grow and regenerate. It may be recommended that you have a dental bone graft if you are having a tooth extracted and want to leave the option open to add a replacement tooth later on, you plan to replace a missing tooth with a dental implant, you need to rebuild the jaw before getting dentures, or you have areas of bone loss due to gum (periodontal) disease. Bone grafts are quite effective and have a high success rate.

Dental implants are often a successful solution for damaged or missing teeth. However, some people have difficulties in getting a dental implant because their sinuses are located too close to their jaw to allow for an implant, or because of insufficient height in the upper jaw (resulting in insufficient bone support) for implants. A sinus lift can fix these problems and allow otherwise unsuitable candidates for a dental implant to receive a dental implant and transform the look and function of their teeth. By increasing the amount of bone in the upper jaw necessary for dental implants, this common bone grafting procedure can provide those with missing teeth and jawbone (due to birth defects, natural healing, periodontal disease, or other medical conditions) to receive a dental implant. A sinus grafting is only necessary if implants are to be placed in the area of your upper molars and premolars, and it is revealed that more bone is required to secure the implants.

Many people suffer from a gummy smile, which means that your smile reveals more of your gums than you would like, caused by an excess of gingival tissue partially covering the crown of teeth. A gummy smile can affect one’s confidence and discourage people from smiling and showing off their pearly whites. If a gummy smile is something you would like to correct, there are many options available that can help, including a gingivectomy, crown lengthening, orthognathic surgery, lip repositioning, and Botox. Crown lengthening involves removal of the excess gum tissue and removal of the excess bone and shaping the jawbone. Whether both stages need to be completed, or just one, depends on each patient and how much excess gum tissue there is.

Gingival surgery is usually the most often recommended treatment for a gummy smile. Also known as gum contouring, it involves the removal of extra gum tissue to reveal more of your teeth’s surface. There are several different methods that can be used to remove the tissue so that it reveals more of the teeth and fixes the situation of a gummy smile. Using either a scalpel or laser, your gums are reshaped or trimmed to reveal more of the surface of your teeth, giving you the smile, you want.

Botox injection can be used for a gummy smile that involves overactive lip muscles.