Gum Treatment – Non Surgical
When treating gum disease, it is often best to start with a non-surgical approach consisting of one or more of the following.
Scale & Root Planing
The initial stage of treatment for periodontal disease is usually a thorough cleaning that may include scaling and root planing. These are non surgical procedures to remove plaque, tartar or calculus, which can cause gingival inflammation and gum disease.
When scaling is performed, calculus and plaque that attaches to the tooth surfaces is removed. This process especially targets the area below the gum line, along the roots of the teeth. Scaling is performed with a special dental tool called an ultrasonic scaling tool. The scaling tool usually includes an irrigation process that can be used to deliver an antimicrobial agent below the gums to help reduce oral bacteria.
Root Planing is performed in order to remove cementum and surface dentin that is embedded with unwanted microorganisms, toxins and tartar. The root of the tooth will be smoother which encourages healing, and also helps prevent bacteria from easily colonizing in the future.
In some cases antibiotics or irrigation with antimicrobials may be needed in order to control the growth of bacteria that creates toxins, and cause periodontitis.
Finally, scaling and root planing may make the mouth more aesthetically pleasing and should reduce bad breath caused from food particles and bacteria in the mouth.
As gum disease progresses, periodontal pockets and bone loss can result in the formation of tiny, hard to reach areas that are difficult to clean with handheld instruments. Sometimes it’s best to try to disinfect these relatively inaccessible places with a prescription antimicrobial rinse or (usually containing chlorhexidine) or even a topical antibiotic applied directly to the affected areas. This is used on a short term basis since it isn’t desirable to suppress beneficial types of oral bacteria.
If you have any loose teeth, they may need to be protected from the stresses of biting and chewing – particularly if you have teeth-grinding or clenching habits. It is possible to make small changes to upper and lower teeth in order to reduce they way teeth come into contact with each other which reduces their mobility. We can provide you with a bite guard that you can wear when you are most likely to grind or clench your teeth.
Often, non surgical treatment is enough to control a periodontal infection, restore oral tissues to good health, and tighten loose teeth. Again, good oral hygiene habits are essential to remain disease-free.
Gum Treatment – Surgical
Some treatments for gum disease are surgical. Some examples are:
Treating Gum Recession With Gingival Grafting
After a thorough examination and assessment of your teeth, gums and overall health, the gingival grafting procedure may be recommended. If you have gum tissue that has receded in an area of your mouth Dr. Nading can place a small layer of tissue into this site. It is sutured into place and will serve to protect the exposed root as living tissue. This procedure is very predictable with a very high
success rate. It can be done under local anesthesia, in the dental office. A soft diet is recommended for a week following this procedure allowing the tissues to heal completely. Otherwise you can resume your normal activities.
When a tooth breaks or has a large amount of decay, it may need to be restored with a filling or a crown. In some instances, there may not be enough of the tooth exposed above the gum line to restore it. Crown lengthening is a surgical procedure performed to remove gum tissue or bone. The procedure exposes more of the tooth and allows for the restoration of the tooth.
Crown lengthening can also be used to correct a gummy smile. A gummy smile is used to describe an instance where teeth are covered with excess gum tissue resulting in a less esthetically-pleasing smile. The procedure involves reshaping or recontouring the gum tissue and bone around the tooth in question to create a new gum-to-tooth relationship. Crown lengthening can be performed on a single tooth, many teeth, or the entire gum line.
All of these procedures can be done in our office, with our Periodontist, Dr. Nading.
A frenectomy is simply the removal of a frenum in the mouth. A frenum is a muscular attachment between two tissues. There are two frena in the mouth that can sometimes obstruct normal function and are candidates for a frenectomy. These frena are called the lingual frenum, which connects the tongue to the floor of the mouth, and the maxillary labial frenum, which connects the inside of your upper lip to your gums, just above your upper two front teeth.
The lingual frenum connects the tongue to the floor of the mouth. Sometimes, the lingual frenum can run all the way to the tip of the tongue, causing a person to be “tongue-tied.” This is a common occurrence in young children. If the attachment exceeds all the way to the tip of the tongue, then a frenectomy may be the only choice to give the child normal tongue function.
A Lingual frenectomy is a simple procedure and involves numbing the tongue with an anesthetic. A small incision is made to free the tongue from the floor of the mouth. The incision then will be sewn up to allow the tissue to heal.
A prominent maxillary labial frenum can cause a large gap to occur between the upper two front teeth. However, unless the frenum is causing a lot of pain on the upper lips and gums, immediate treatment is not necessary. Treatment should not be done until the upper permanent teeth have come in.
Flap Surgery/Pocket Reduction Surgery
During this procedure the gums are lifted back from the teeth and the tarter is removed. Sometimes the irregular surfaces of the damaged bone are smoothed to limit the areas where the disease causing bacteria can hide. The gums are then placed so that the tissue fits tightly next to the teeth. Since the space between the teeth and gums is minimized it reduces the areas where harmful bacteria can grow. This also helps reduce your chances of serious health issues associated with periodontal disease.
This procedure involves using pieces of your bone, synthetic bone, or donated bone to replace bone which has been destroyed by gum disease. These bone grafts allow the new bone to grow to restore stability to your teeth.
Guided Tissue Regeneration
When the bone supporting your teeth has been destroyed this procedure stimulates bone and gum tissue growth. This procedure is done along with Flap Surgery. A small piece of mesh-like fabric is put between the bone and gum tissue. The mesh keeps the gum tissue from growing into the area where the bone should be, allowing the bone and tissue to grow to better support the teeth.
For some patients, the non-surgical procedures are all that is needed to treat gum disease. The surgical procedures are needed when the tissue around the teeth is unhealthy and cannot be repaired with a non-surgical procedure.