Periodontal Care in South Loop, Chicago, IL

The initial stage of treatment for periodontal disease is usually a thorough dental deep cleaning that may include scaling or root planing. The objective of these non-surgical procedures is to remove etiologic agents such as dental plaque and tartar, or calculus, which cause gingival inflammation and disease. Periodontal scaling and root planing can be used as a stand-alone treatment, or a preventative measure. They are commonly performed on cases of gingivitis and moderate to severe periodontal disease.

In some cases, a local anesthesia may be used during the procedure.

Scaling

When scaling is performed, calculus and plaque that attaches to the tooth surfaces is removed. The process especially targets the area below the gum line, along the root. 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

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 is literally smoothed, which promotes healing, and also helps prevent bacteria from easily colonizing in the future.

Antibiotics or irrigation with anti-microbials (chemical agents or mouth rinses) may be recommended to help control the growth of bacteria that create toxins and cause periodontitis. In some cases, your dentist may place antibiotic fibers in the periodontal pockets after scaling and planing. This may be done to control infection and to encourage normal healing.

Crown lengthening is usually performed to improve the health of the gum tissue, prepare the mouth for a procedure, or 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.

Crown lengthening is often required when your tooth needs a new crown or other restoration. The edge of that restoration is deep below the gum tissue and not immediately accessible. It is also usually too close to the bone or below the bone.

Crown lengthening allows us to reach the edge of the restoration, ensuring a proper fit to the tooth. It should 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.

Crown lengthening surgery takes approximately one hour but will largely depend on the amount of teeth involved and if any amount of bone will need to be removed. The procedure is usually performed under local anesthetic and involves a series of small incisions around the tissue to separate the gums from the teeth. Even if only one tooth requires the procedure, it will probably be necessary to adjust the surrounding teeth to enable a more even reshaping. In some cases, extraction of a small amount of bone will be necessary as well.

When your doctor is satisfied that the teeth have sufficient exposure and the procedure is completed, the incisions will be cleaned with sterile water. Sutures and a protective bandage are then placed to help secure the new gum-to-tooth relationship. Your teeth will look noticeably longer immediately after surgery because the gums have now been repositioned. You will need to be seen in one or two weeks to remove the sutures and evaluate your healing. The surgical site should be completely healed in approximately two to three months following the procedure.

After you have completed the active phase of periodontal treatment, your periodontal disease will be under control. The staff will provide you with a personalized maintenance program of care to keep your gums healthy.

Maintenance therapy is an ongoing program designed to prevent disease in the gum tissues and bone supporting your teeth. Adherence to a program of conscientious home oral care and regularly scheduled maintenance therapy visits with your dentist will give you an excellent chance of keeping your teeth for your lifetime.

As you have learned, you are susceptible to gum disease. And, you have probably learned, too, that the main cause of gum disease is bacterial plaque, a sticky, colorless film that constantly forms on your teeth. The bacteria in this plaque produce toxins, or poisons, which constantly attack your gums and teeth. Unless plaque is removed, it hardens into a rough, porous deposit called calculus, or tartar. Daily brushing and flossing will help to minimize the formation of calculus, but it won’t completely prevent it. No matter how careful you are in cleaning your teeth and gums, bacterial plaque can cause a recurrence of gum disease from two to four months after your last professional cleaning. Therefore, a dental professional must check for hidden problems and remove the hardened plaque at time intervals appropriate for you so that your teeth and gums stay healthy.

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 seen. Bite therapy helps restore a bite that can function without damage and destruction. The therapy may include:

• Reshaping 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 apart, worn during the day, at night, or both.
• Braces to reposition mal-aligned or drifted teeth.
• Replacement of old, worn out, or damaged fillings.
• Reconstruction of badly worn and damaged teeth.

Osseous surgery, sometimes referred to as pocket reduction surgery or gingivectomy, refers to a number of different surgeries aimed at gaining access to the tooth roots to remove tartar and disease-causing bacteria.

Osseous surgery is used to reshape deformities and remove pockets in the alveolar bone surrounding the teeth. It is a common necessity in effective treatment of more advanced periodontal diseases. The ultimate goal of osseous surgery is to reduce or eliminate the periodontal pockets that cause periodontal disease. Despite the word “surgery” the procedure is reported to feel more like a thorough cleaning. The specific goals of surgery include:

Reducing Bacterial Spread: Bacteria from the mouth can spread throughout the body and cause other life-threatening conditions such as heart disease and respiratory disease. Removing deep tartar and thereby bacteria can help reduce the risk of bacteria spreading.

Preventing Bone Loss: The immune system’s inflammatory response prompted by periodontal bacteria can lead to bone loss in the jaw region, and cause teeth to fall out. Osseous surgery seeks to stop periodontal disease before it progresses to this level.

Enhancing the Smile: Mouths plagued with periodontal disease are often unsightly. Brown gums, rotting teeth, and ridge indentations can leave a person feeling depressed and too self-conscious to smile. Fortunately, osseous surgery can help reduce bacteria and disease and thereby restore your mouth to its former radiance, while restoring confidence at the same time.

Facilitating Home Care: As the gum pocket deepens, it can become nearly impossible to brush and floss adequately. Osseous surgery reduces pocket size, making it easier to brush and floss, and thereby prevent further periodontal disease.

The gum tissue can be very thick and large covering the tooth surface making the teeth look short. This can happen because of medications, bone that extends too close to the surface of the teeth, or inflammation due to gum disease.

A gingivectomy is a periodontal procedure that eliminates excess gum tissue. The term “gingivectomy” is derived from Latin:

• “gingiva” means gum tissue,
• “-ectomy” means to remove.

The following are some reasons a gingivectomy might be needed:

Cosmetics: To make the teeth look normal in size when the gum is covering too much of it, making the teeth look longer and more proportional.

Functional/Esthetics: To remove excess gum tissue (gingival overgrowth) that has formed as a result of certain drugs such as anti-seizure and organ-transplant medications, and certain high blood pressure medications.

Bone and gum health around the teeth: To shrink deep gum pockets. This procedure might require some bone work as well.

A frenum is a naturally occurring muscle attachment, normally seen between the front teeth (either upper or lower). It connects the inner aspect of the lip with the gum. A lack of attached gingiva, in conjunction with a high (closer to the biting surface) frenum attachment, which exaggerates the pull on the gum margin, can result in recession. Additionally, an excessively large frenum can prevent the teeth from coming together resulting in a gap between the front teeth. If pulling is seen or the frenum is too large to allow the teeth to come together, the frenum is surgically released from the gum with a frenectomy. A frenectomy surgery is simply the surgical removal of a frenum.

When orthodontic treatment is planned or initiated, the removal of an abnormal frenum, with or without a gingival graft, can increase stability and improve success of the final orthodontic result.

When recession of the gingiva occurs, the body loses a natural defense against both bacterial penetration and trauma. When gum recession is a problem, gum reconstruction using grafting techniques is an option.

When there is only minor recession, some healthy gingiva often remains and protects the tooth, so that no treatment other than modifying home care practices is necessary. However, when recession reaches the mucosa, the first line of defense against bacterial penetration is lost.

In addition, gum recession often results in root sensitivity to hot and cold foods as well as an unsightly appearance of the gum and tooth. When significant, gum recession can predispose to worsening recession and expose the root surface, which is softer than enamel, leading to root caries and root gouging.

A gum graft is designed to solve these problems. A thin piece of tissue is taken from the roof of the mouth or gently moved over from adjacent areas to provide a stable band of attached gingiva around the tooth. The gingival graft may be placed in such a way as to cover the exposed portion of the root.

The gum graft surgery procedure is highly predictable and results in a stable, healthy band of attached tissue around the tooth.

Gum disease has traditionally been treated by eliminating the gum pockets by trimming away the infected gum tissue and by re-contouring the uneven bone tissue. Although this is still an effective way of treating gum disease, new and more sophisticated procedures are used routinely today. One of these advancements is guided bone regeneration, also referred to as guided tissue regeneration. This procedure is used to stabilize endangered teeth or to prepare the jaw for dental implants.

As periodontal disease progresses, pockets of degenerated bone develop in the jaw. These pockets can promote the growth of bacteria and the spread of infection. To address these pockets, your doctor may recommend tissue regeneration. During this surgical procedure, the pockets are cleaned thoroughly, and a membrane is installed between the soft tissue and the pocket in the bone. Some of these membranes are bio-absorbable and some require removal. The membrane covers the pocket so that fast-growing soft tissue is blocked, and slower-growing bone can begin to grow, or “regenerate” itself.

The effectiveness of the procedure generally depends on the patient’s willingness to follow a strict post-operative diet and careful oral care. Your doctor will help you determine if bone regeneration surgery is right for you.

Cosmetic periodontal procedures are a conventional way to cover unsightly, sensitive, or exposed root surfaces and to prevent future gum recession. If you are unhappy with the appearance of short, unsightly teeth, this can be greatly improved by a combination of periodontal procedures and cosmetic dentistry by your dentist.

Although your teeth appear short, they may actually be the proper length. The teeth may be covered with too much gum tissue. We can correct this by performing the periodontal plastic surgery procedure, crown lengthening. During this cosmetic gum surgery, excess gum and bone tissue are reshaped to expose more of the natural tooth. This can be done to more than one tooth, to even your gum line, and to create a beautiful smile.

Another cosmetic procedure is the soft tissue graft. It is used to cover unattractive tooth roots, reduce gum recession, and protect the roots from decay and eventual loss.

Tooth loss causes the jaw bone to recede and can lead to an unnatural looking indentation in your gums and jaw, and appearance of general aging. The original look of your mouth may not be recaptured because of spaces remaining under and between replacement teeth. They may appear too long compared to nearby teeth.

Bone grafting following tooth loss can preserve the socket/ridge and minimize gum and bone collapse. There is less shrinkage and a more aesthetic tooth replacement for either an implant crown or fixed bridge around the replacement teeth.

The oral cancer test is completely painless. Your doctor will look for abnormalities and feel the face, glands, and neck for unusual bumps. Lasers may be used to highlight pathologic changes, and can “look” below the surface for spots and lesions invisible to the naked eye. Some of the signs that will be investigated are red patches and sores. Red patches on the floor of the mouth, or the front of the tongue, and bleeding sores which fail to heal easier, can be indicative of cancerous changes. Leukoplakia is a hardened white or gray, slightly raised lesion that can appear inside the mouth, and may be cancerous. Signs of these will be examined as well. Finally, soreness, lumps or the general thickening of tissue anywhere in the throat or mouth can signal pathologic signs, and will be examined.

If abnormalities, lesions, lumps, or leukoplakia are apparent, your doctor will implement a treatment plan that is right for you. Treatment options vary according to the precise diagnosis, but may include: excision, radiation therapy, and chemotherapy.

It is also important to note that over 75% of oral cancers are linked with avoidable behaviors such as smoking, tobacco use, and excessive alcohol consumption. We can provide you with literature and options about quitting dangerous behaviors such as tobacco use. Oral cancer screenings are important to allow for early treatment, if needed.