Periodontics focuses on treatment of the soft tissue and bone that support the teeth and jaw. As the foundation of your smile, the treatment of these items are essential to maintaining a healthy and long lasting smile. Underlying issues in the soft and hard tissue of the mouth can lead to the loss of teeth if not addressed promptly. All of the services discussed below are performed in our office by Dr. Bankhead and can be done in conjunction with a variety of relaxation, sedation and anesthetic techniques.
Periodontal disease, also known as gum disease, often begins as a buildup of plaque on the surface of teeth near the gum line. If not removed by regular brushing, flossing and dental hygiene visits, the plaque can harden into tartar. Eventually the gums will become red, swollen, and irritated. This is known as gingivitis.
If left untreated, gingivitis can worsen into periodontal disease. If that is not treated, it can contribute to heart disease, diabetes, and other health problems. Periodontal disease during pregnancy has been linked to premature birth or low birth weight. Periodontal disease in the presence of other systemic syndromes can also be highly dangerous to your health. Unfortunately, periodontal disease can affect patients of all ages but can be addressed promptly when discovered.
Risk factors for periodontal disease
You may be at risk of periodontal disease if you smoke or use tobacco products, do not regularly brush your teeth and floss, have health conditions such as diabetes, heart disease, pregnancy or osteoporosis. If you have family members that have had gum disease, it can even be genetic. If you observe any of the symptoms of gum disease, schedule an appointment with our office so Dr. Bankhead and our staff can determine if treatment is necessary.
Non-surgical treatment/Scaling and Root Planing
If you’ve been diagnosed with gum disease, treatment options will depend on the particulars of your situation and the severity of the problem. We will always start with the least invasive options available, which are usually non-surgical.
When gum disease is discovered early, we address it with a cleaning technique known as “scaling and root planing.” An ultrasonic cleaning device is used to remove plaque and tartar (also called “calculus”) from your teeth where regular cleaning devices can’t reach. Scaling the root will remove bacterial toxins that create gum disease. Then the rough surface of the tooth and the root are smoothed out (planed). This creates a healthy, clean surface that makes it easier for gum tissue to reattach to the tooth.
As with any dental procedure, after-care is vital. In order to prevent recurrences of gum disease, you must brush and floss daily, eat a healthy diet, avoid tobacco use, and schedule regular dental checkups every 3 months. This is more often than normal cleanings as this is the maximum amount of time we want the areas treated to remain unevaluated. Even after a successful scaling and root planing, if you don’t attend to your teeth, you are likely to develop gum disease again.
When gingivitis goes untreated, gum disease will cause the gums to pull away from the teeth, leaving deep pockets where bacteria can grow and damage the bone. If our office has diagnosed you with gingivitis or periodontal disease, notify our office immediately if you notice:
- You have sensitivity to hot or cold temperatures, or even to sweet, spicy, or sour foods
- Your teeth appear longer than normal
- Spaces between your teeth seem to grow
- The roots of your teeth begin to show.
Gum tissue grafting
When loss of attached tissue results from gingivitis, Dr. Bankhead may perform one of three types of gum tissue grafts.
- Connective tissue graft — Tissue from under the skin of the roof of your mouth is removed or acquired from a tissue bank and stitched to the gum tissue around the exposed root. This is the most common method.
- Free gingival graft — Instead of making a flap and removing tissue from under it, a small amount of tissue is removed directly from the roof of the mouth and then attached to the gum area. This method is preferred for people who have especially thin gums and need additional tissue to enlarge them.
- Pedicle graft — Instead of the roof of the mouth, tissue is grafted from gum around or near the tooth that needs repair. The flap, called a pedicle, is only partially cut away so that one edge remains attached. The gum is then pulled over or down to cover the exposed root and sewn into place. This procedure can only be done if the patient has plenty of gum tissue near the tooth.
A bone graft is used to rebuild bone and soft supporting tissues lost due to periodontal disease. In order to avoid extractions, Dr. Bankhead may recommend re-growing bone lost around a tooth with a graft.
During the procedure, the roots will be thoroughly cleaned, and any voids in the bone will be filled with a graft material that consists of your own bone or bone acquired from a tissue bank. Over the next few months, the grafted material will be encouraged to grow, and fill in for lost bone and soft tissue.
Bone grafting is often used for ridge augmentation. After the loss of one or more teeth, your gums and jawbone may become indented where the tooth or teeth used to be. Not only does the indentation look unnatural, it also causes the replacement tooth to look too long compared to the adjacent teeth, and may create an area that is difficult to clean. Ridge augmentation can recapture the natural contour of your gums and jaw.
If gum disease has resulted in a loss of bone, bone regeneration may be a good option to rebuild jawbone and bone tissue in order to correct the damage. It can also benefit patients who are missing teeth and don’t qualify for dental implants, which require a significant amount of jawbone in order to be successful. Patients who do not want to wear a partial or full denture, but cannot have implants placed due to lost bone, may undergo regeneration as part of a long term treatment plan to incorporate implants.
A crown lengthening procedure may be done for dental care and medical reasons as well as cosmetic ones. If there is decay or fracture that extends to below the gum line, for example, crown lengthening can help expose more of the tooth’s crown in order to support a filling or restoration. Crown lengthening improves the aesthetics of your smile by exposing more of your teeth. If the gum line is uneven, crown lengthening can also sculpt it to produce a more symmetrical, balanced smile prior to the placement of a new restoration. Usually, a follow-up appointment will be needed to check the healing process and remove any stitches.
Osseous surgery, also known as “pocket depth reduction,” is a surgical procedure to fix pockets that form around the teeth because of periodontal disease. These pockets are too deep to clean with daily at-home oral hygiene due to the limits of floss and the reach of toothbrush bristles. These pockets then provide a space for bacteria to live, and leading to bone and tissue loss.
During osseous surgery, Dr. Bankhead will eliminate these pockets by surgically retracting the gum tissue and remove the bacteria before suturing the tissue back into place. If the underlying bone has been damaged, the irregular surface will also be smoothed out to limit areas where disease-causing bacteria can hide. This will also allow your gum tissue to reattach to healthy bone more effectively.