Periodontal Surgery
What is Periodontal Disease?
Periodontal disease refers to the inflammatory processes that occur in the tissues that surround the teeth in response to bacterial accumulations, or dental plaque, on the surface of the tooth.
The bacterial accumulations cause an inflammatory response from the body. This inflammation, triggered by chronic and progressive bacterial infection of the gums, leads to alveolar bone destruction and loss of tissue attachment to the teeth.
Am I prone to getting Periodontal Disease?
Periodontal disease is increased by several risk factors including but not limited to:
- Cigarette smoking
- Systemic diseases
- Medications such as steroids, anti-epilepsy drugs and cancer therapy drugs
- Ill-fitting crowns and bridges
- Loose or poorly placed fillings
- Pregnancy
- Oral contraceptive use
How does periodontal disease affect my overall health?
Several evidence-based studies have implicated periodontal disease with effects on patients’ general health.
So far, association between periodontal disease and systemic conditions such as cardiovascular disease, type 2 diabetes mellitus, adverse pregnancy outcomes, and osteoporosis have been established ... and recently, a strong link between gum disease/periodontal disease has been suggested to Alzheimers.
How do I treat gum disease/periodontal disease?
If you’ve been diagnosed with gum disease, you have a variety of treatment options, depending on the details of your situation and the severity of the problem. We always start with the least invasive options, which are non-surgical. However, in more serious cases, surgery may be necessary.
Non-Surgical Treatment
The first line of defense against gum disease is a unique type of cleaning called scaling and root planing. In this procedure, an ultrasonic cleaning device is used to remove plaque and tartar from your teeth where regular cleaning devices can’t reach: under the gum line, on and around the root.
Then the rough surface of the tooth and the root are smoothed out (planed). This provides a healthy, clean surface that makes it easier for the gum tissue to reattach to the tooth.
If you address your gum disease before it becomes severe, scaling and root planing may be the only treatment you need. However, as with any dental procedure, after-care is vital.
In order to keep your teeth in good shape and resist future occurrences of gum disease, you must brush and floss daily, eat a healthy diet, avoid tobacco use, and schedule regular dental checkups.
Even after a successful scaling and root planing, if you don’t attend to your teeth properly and follow the doctor’s instruction, it’s quite likely you’ll develop gum disease again.
Surgical Treatment Options
If the tissue or bone surrounding your teeth is too damaged to be repaired with non-surgical treatment, several surgical procedures are available to prevent severe damage and restore a healthy smile. We will recommend the procedure that is best suited to the condition of your teeth and gums.
The following is a list of common types of periodontal surgery:
Pocket Depth Reduction
In a healthy mouth, the teeth are firmly surrounded by gum tissue and securely supported by the bones of the jaw. Periodontal disease damages these tissues and bones, leaving open spaces around the teeth that we call pockets.
The deeper these pockets are, the easier it is for bacteria to collect inside them, and lead to increased damage over time. Eventually, the supportive structure degrades to the point where the tooth either falls out or needs to be removed.
During pocket reduction procedures (also known as “flap surgery”), we fold back the gum tissue and remove the bacteria hiding underneath, as well as the hardened plaque and tartar that have collected. We may also remove any tissue that is too damaged to survive.
Then we suture the healthy tissue back into place. Now that the tooth and root are free of bacteria, plaque, and tartar, and the pockets have been reduced, the gums can reattach to the teeth.
Regeneration
When the bone and tissue supporting the teeth have been lost due to severe gum disease, we can restore these areas with a regeneration procedure. During this process, we begin by folding back the gum tissue and removing the bacteria, plaque, and tartar.
Depending on your situation, we may then perform a bone graft to stimulate new bone growth, or we may apply a special kind of protein that stimulates tissue growth to repair the areas that have been destroyed by the disease.
Soft-Tissue Graft
A frequent symptom of gum disease is gum recession (also called gingival recession). As the gums recede, more of the roots are revealed. This can make teeth appear longer and also create sensitivity to hot or cold liquids or food. It also exposes the tooth to increased damage from gum disease as bacteria, plaque, and tartar attack the surface of the tooth and the root.
During a soft-tissue graft, tissue from the top of your mouth or another source is placed over the gum area with sutures. This will cover the roots and restore the gum line to a healthy location. This procedure can also be performed for cosmetic reasons.
Laser assistant surgery (LANAP)
The LANAP protocol is a minimally invasive gum disease treatment that uses a specific dental laser, the PerioLase® MVP-7™. The LANAP protocol is the first and only protocol to receive FDA clearance for True Regeneration, which is re-growing new cementum, new periodontal ligament, and new alveolar bone. These three components are needed for full oral function. The LANAP protocol has been in widespread use by the dental community for many years.
What are the benefits of LANAP versus conventional surgery?
- Less pain and discomfort
- Less bleeding
- Less sensitivity
- Less gum loss
- Less swelling
- Very little downtime after treatment
- Fewer post-op infections
- Promotes regeneration of supporting gum tissues
- Healing appears to be faster and more comfortable than conventional surgery