Periodontal Therapy includes both surgical and non surgical techniques to restore tissue and gum health.
Periodontal therapy can encompass a wide modality of different treatment options based on the clinical results desired. Disease control to maintain gum and bone health is just one aspect that we all desire. Bone or soft tissue grafting can be done if the goal is to increase the volume or position of that specific tissue. And sometimes, tissue needs to be removed to correctly position teeth in someone’s smile.
Periodontal disease is when the bone around your teeth is affected by the bacterial flora in your mouth. The process starts by plaque (sticky bacteria) which can cause the gums to become inflamed and if this inflammation persists, it can proceed from the gums to the underlying bone. When it advances to the bone it transitions from gum disease to bone (periodontal) disease and the bone level moves down the root, exposing more of the tooth and root to the oral environment. As the bone level moves south, the tooth can become wiggly due to lack of support and eventually the teeth may have to be extracted. Periodontal disease is prevented by good home care, brushing twice a day and flossing regularly, and by seeing a dental hygienist.
If you have advanced bone loss and haven’t seen a dentist or hygienist in a long time, the first step is an accurate diagnosis and assessment of the current bone levels and periodontal pockets surrounding your teeth. Often the bone loss is accompanied by large amount of plaque and calculus that will need to be cleaned off. We accomplish this by a procedure called scaling and root planning. The calculus is physically removed with small specialized instruments and the roots are smoothed to encourage re-attachment of soft tissue to decrease pocket depths. After the SRP is completed, a follow up and re-evaluation is done four to six weeks later and maintenance procedures are scheduled based on need.
Receding gums is the result of the bone position on the root of the tooth and the position can be a result of periodontal disease or the position and angulation of the tooth root in bone. There are several options based on possible sensitivity and cavitation of the root for correction. Grafting the area with soft tissue to replace what’s missing is often our first choice for correction.
Bone grafting is done to increase the volume, quantity and quality of bone for better esthetics or possible implant placement, or preservation of the existing bony ridge. It is commonly performed following tooth extraction to prevent the area from shrinking for future implant placement. The bone material that is grafted can come from a number of different sources depending on clinical application and patient desire.