What is gum (periodontal) treatment?
The most common type of gum treatment brings together two components:
Oral hygiene (home care plaque control)
Meticulous removal of plaque and calculus (tartar) from the gum pockets (debridement).
In this way, treatment targets the causes and effects of gum disease, namely the bacteria initiating disease on the tooth surface next to the gum margin and the bacteria progressing the disease within the gum pockets, causing progression of the disease.
Home care - plaque control
Your susceptibility to gum disease means that your gums tolerate very little plaque without inflammation (irritation) developing. Therefore successful long-term control of your gum problems depends on a high level of daily oral hygiene. To help you achieve this, we will offer you advice and coaching to help you to remove plaque bacteria from the gum line.
In the deeper pockets that you cannot reach, we will carefully clean the root surfaces of the teeth. Also called root planing or deep scaling, we usually use local anaesthetic for this procedure. For deeper pockets or those that do not respond to this treatment, surgery may be required to improve the health of your gums.
Different cases require different management. Periodontal treatment can be divided into Non-surgical, and Surgical treatments. With all treatment regimens, good home care and regular periodontal maintenance will be required for sustained long term results.
Non-Surgical Periodontal Treatment
Periodontal health should be achieved in the least invasive and most cost-effective manner. This is often accomplished through non-surgical periodontal treatment.
Non-surgical periodontal treatment does have its limitations. When it does not achieve periodontal health, surgery may be indicated to restore periodontal health.
Scaling and Root Planing
Scaling and root planing, often carried out with Local Anaesthetic, is a careful cleaning of the root surfaces to remove plaque and calculus [tartar] from deep periodontal pockets and to smooth the tooth root to remove bacterial toxins. In some cases, curetting the inflamed lining of the gum is warranted.
Most periodontists would agree that after scaling and root planing, many patients do not require any further active treatment. However, the majority of patients will require ongoing maintenance therapy to sustain periodontal health.
Surgical Periodontal Treatment
Gum Graft Surgery
Exposed tooth roots are the result of gum recession. Gum graft surgery may repair the defect and help to prevent additional recession and bone loss. Gum grafts can be used to cover roots or develop gum tissue where absent due to excessive gingival recession. During gum graft surgery, Dr. Judowski takes gum tissue from your palate or another donor source to cover the exposed root. This can be done for one tooth or several teeth to even your gum line and reduce sensitivity.
What are the benefits of gum graft surgery?
A gum graft can reduce further recession and bone loss. In some cases, it can cover exposed roots to protect them from decay. This may reduce tooth sensitivity and improve esthetics of your smile. Whether you have a gum graft to improve function or esthetics, patients often receive the benefits of both.
Procedures that regenerate lost bone and tissue supporting your teeth can reverse some of the damage caused by periodontal disease.
Dr. Judowski may recommend a regenerative procedure when the bone supporting your teeth has been destroyed due to periodontal disease. These procedures can reverse some of the damage by regenerating lost bone and tissue.
During this procedure, Dr. Judowski folds back the gum tissue and removes the disease-causing bacteria. Membranes (filters) or bone grafts can occasionally be used to encourage your body's natural ability to regenerate bone and tissue.
Eliminating existing bacteria and regenerating bone and tissue helps to reduce pocket depth and repair damage caused by the progression of periodontal disease. With a combination of daily oral hygiene and professional maintenance care, you'll increase the chances of keeping your natural teeth – and decrease the chances of other health problems associated with periodontal disease.
Dental Crown Lengthening Procedure
You may wish to improve a "gummy" smile because your teeth appear short. Your teeth may actually be the proper lengths, but they're covered with too much gum tissue. To correct this, Dr. Judowski performs a dental crown lengthening procedure.
During the dental crown lengthening procedure, excess gum and bone tissue is reshaped to expose more of the natural tooth. This can be done to one tooth, to even your gum line, or to several teeth to expose a natural, broad smile.
Your dentist may also recommend dental crown lengthening to make a restorative or cosmetic dental procedure possible. Perhaps your tooth is decayed, broken below the gum line, or has insufficient tooth structure for a restoration, such as a crown or bridge. Crown lengthening adjusts the gum and bone level to expose more of the tooth so it can be restored.
Periodontal Pocket Reduction Procedures
Your bone and gum tissue should fit snugly around your teeth like a turtleneck around your neck. When you have periodontal disease, this supporting tissue and bone is destroyed, forming "pockets" around the teeth.
Over time, these pockets become deeper, providing a larger space for bacteria to live. As bacteria develop around the teeth, they can accumulate and advance under the gum tissue. These deep pockets collect even more bacteria, resulting in further bone and tissue loss. Eventually, if too much bone is lost, the teeth will need to be extracted.
The depth of your pockets have been measured. A periodontal pocket reduction procedure may be recommended because you have pockets that are too deep to clean with daily at-home oral hygiene and a professional care routine.
During this procedure, Dr. Judowski folds back the gum tissue and removes the disease-causing bacteria before securing the tissue into place. In some cases, irregular surfaces of the damaged bone are smoothed to limit areas where disease-causing bacteria can hide. This allows the gum tissue to better reattach to healthy bone.
Reducing pocket depth as well as eliminating existing bacteria may be beneficial in preventing damage caused by the progression of periodontal disease and to help you maintain a healthy smile. Eliminating bacteria alone may not be sufficient to prevent disease recurrence. Deeper pockets are more difficult for you and your dental care professional to clean, so it's important for you to reduce them. Reduced pockets and a combination of daily oral hygiene and professional maintenance care increase your chances of keeping your natural teeth – and decrease the chance of serious health problems associated with periodontal disease.
Periodontal Plastic Surgery Procedures
Periodontists are often considered the plastic surgeons of dentistry. If you are looking to improve your smile, Dr. Judowski may be able to help.
Gummy Smile or Uneven Gum Line
Do you feel your teeth look too short and your smile is too gummy or your gums cover too much of some teeth while leaving the others the right length? If so, dental crown lengthening might be the solution for you. During this procedure, excess gum tissue is removed to expose more of the crown of the tooth. Then your gumline is sculpted to give your new smile just the right look.
Long Teeth/Exposed Roots
Sometimes gum recession causes the tooth root to become exposed, which makes your teeth look long and can make you look older than you are. This recession can happen as a result of a variety of causes, including periodontal diseases.
Gum graft surgery and other root coverage procedures are designed to cover exposed roots, to reduce further gum recession and to protect vulnerable roots from decay.
Indentations in the Gums and Jawbone
Tooth loss can cause an indentation in the gums and jawbone where the tooth used to be. This happens because the jawbone recedes when it no longer is holding a tooth in place. Not only is this indention unnatural looking, it also causes the replacement tooth to look too long compared to the adjacent teeth.
Ridge augmentation can fill in this defect recapturing the natural contour of the gums and jaw. A new tooth can then be created that is natural looking, easy to clean and beautiful.