Periodontal Procedures

Bite Adjustment

In some cases, the occlusion (bite) may require 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 diagnosed. Bite therapy helps restore a bite that can function without damage and destruction. The therapy may include:

  • Reshaping in 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 using a custom-fitted and adjusted plastic bite guard to keep the teeth supported will be designed for your specific situation.

Crown Lengthening

A Crown lengthening procedure involves adjusting the level of the gum tissue and bone around the tooth in question to create a new gum-to–tooth relationship. This allows us to reach the edge of the restoration, ensuring a proper fit to the tooth.  Crown lengthening will also provide enough tooth structure so the new restoration will not come loose in the future.  This allows you to clean the edge of the restoration when you brush and floss to prevent decay and gum disease.  The procedure takes approximately one hour.

When the procedure is completed, sutures, and possibly a protective bandage are placed to help secure the new gum-to-tooth relationship. 

You will return to the practice for a post-operative visit in one or two weeks to remove the sutures and evaluate your healing.

Dental Implants

Dental implants are designed to provide a foundation for replacement teeth that look, feel, and function like natural teeth. The person who has lost teeth regains the ability to eat virtually anything and can smile with confidence, knowing that teeth appear natural and that facial contours will be preserved. The implants themselves are tiny titanium posts that are placed into the jawbone where teeth are missing. The bone bonds with the titanium, creating a strong foundation for artificial teeth. In addition, implants can help preserve facial structure, preventing the bone deterioration that occurs when teeth are missing.

Dental implants are changing the way people live! With them, people are rediscovering the comfort and confidence to eat, speak, laugh, and enjoy life. Dr. Smith received extensive training in Implantology and has been a leader in the field since 1992. Dr. Smith attends numerous lectures and courses yearly and is also  recognized himself as a national lecturer on the subject of oral implantology, oral plastic surgery and Periodontics.

Dental implants are metal anchors that act as tooth root substitutes. They are surgically placed into the jawbone. Small posts are attached to the implant to provide stable anchors in the gums for replacement teeth.

Traditionally the placement of dental implants involves two surgical procedures. The first procedure Dr. Smith will place the titanium implant and allow sufficient time for the bone to bond to it. The amount of time varies and is dependent on factors such as your general health, and the  quantity and quality of the jaw bone the implant was placed.

After the implant has bonded to the jawbone, the second surgery is done. Dr. Smith will uncover the implants and attach a small healing collar. After two weeks your general dentist will then be able to start making your new teeth. An impression must be taken. Then posts or attachments can be connected to the implants. The teeth replacements are then made over the posts or attachments. The traditional implant procedure usually takes six to eight months to complete. Most patients do not experience any disruption in their daily life.

Gum Graft

Recession of the gum tissue is generally caused by excessive forces on the teeth. Certain habits such as clenching and grinding are the most common reasons but other factors can include over-aggressive tooth brushing, orthodontic treatment, trauma, genetics, acid reflux, and/or improper fitting restorations or partials. Recession will lead to loss of the protective barrier (attached tissue) around the teeth which can contribute to bone loss; exposure of the root causing increased sensitivity, root decay and unsightly teeth; and increased mobility of the teeth.

If there is only a small amount of root surface exposed and still sufficient attached gum tissue treatment can be as simple as just improving oral hygiene techniques and using topical fluorides to strengthen the exposed roots.

When there is more significant exposure of roots and little if no attached gum a “Gum Graft” will be suggested. The goals of gum grafting are to improve the quality of the tissue and in most cases cover the exposed root surface. The term Free Gingival Grafting generally implies improving the quality of tissue and Connective tissue grafting implies gaining quality of tissue and covering the exposed roots. In the past the donor tissue was obtained from the palate complicating the surgical procedure and post operative healing. In most situations we can now use a donor material such as AlloDerm, PerioDerm or DynaMatrixwhich drastically reduces chair time and post operative discomfort.

Scaling & Root Planning with Diode Laser Decontamination

The initial stage of treatment usually include scaling to remove plaque and tartar deposits beneath the gum line.The tooth roots will also be planed to smooth the root surface allowing the gum tissue to heal and reattach to the tooth.

Antibiotics or irrigation with anti-microbials (site specific agents or mouth rinses) may be recommended to help control the growth of bacteria that create toxins and cause periodontitis. 

Arestin- Locally applied antibiotics which are slowly dissolved can be placed in the periodontal pockets after scaling and root planing. 

Scaling and Root planning is often enough for early to moderate forms of periodontal disease or inflammation caused by oral systemic factors. The procedure usually decreases the depth of the pocket and decreases or eliminates bleeding but it does not cure the disease. A three month maintenance schedule will be recommended to maintain the new healthy state. Three month intervals are recommended because the bacteria that cause gum disease can reach their disease threshold in just eight weeks.

Following the initial treatment phase Dr. Smith will re-evaluate your periodontal status and determine if further treatment is necessary. When deep pockets persist periodontal surgery may be needed to restore you back to health.