Periodontics is the dental specialty that deals with the gums and bone surrounding the teeth and supporting them. With complex cases, we work with select board certified periodontist in our area who are experts in their field to provide top care to our patients.
Once per year (sometimes more often) we probe around each tooth checking the depth of the crevice between the tooth and gum tissue. In dentistry, we call this the pocket. Healthy ones are 1-3 mm deep where diseased ones are over 4mm deep. Periodontal disease is a disease where certain bacteria that live in that cervices cause inflammation and bone loss. Usually it is painless so you don’t even know you have it, but changes in probing depths alert us so we can treat the problem before it gets our of hand.
What is Tooth Scaling?
Tartar is plaque that has had time to harden and is that white (sometimes yellow) substance found at the base of the tooth just above the gumline. Tartar is usually not removed with standard brushing and flossing and usually requires coming in to see us for proper and thorough removal.
Tooth scaling is a service that involves using a tool that is specifically designed to break-apart and remove tartar. We gently run the tooth scaling tool along the front and back surfaces of teeth that have any signs of tartar which effectively cleans the gumline and smooths the tooth enamel. Every time you come in for a dental checkup, tooth scaling is performed to help prevent future dental problems such as cavities and gum disease.
What's Involved With A Root Planing Procedure?
Each person's oral health is unique and the stage and current condition of the teeth and gums will dictate how involved a deep cleaning is as well as how long it takes to heal. Usually a deep cleaning is done one-half of the mouth at a time and healing takes about a day or two.
During a deep cleaning we will numb the areas of your gums where we are working, which will keep you from feeling any discomfort during the procedure. Using a special tool, we will remove any tartar build up that is found on tooth roots below the gumline and we ensure the tooth root gets a smooth finish to allow the gum tissues to start re-attaching itself. Our office uses a special ultrasonic tool that will ensure the quickest and most comfortable deep cleaning as possible. After your root planing procedure, you may be recommended to take a medication to help control soreness from the procedure, keep away infections and to promote healing
Is Root Planing Covered by Dental Insurance?
The benefits of a root planing procedure to your teeth, gums and entire body outweigh the serious problems that can happen if gum disease is left untreated. Every dental insurance provider is different in some ways and many set a specific limit, per year, for dental coverage and includes things such as general cleanings and dental x-rays but often enough the need for a deep cleaning can go beyond this limit but it is very important to check. We will be very happy to work with your dental insurance provider to see if you're covered for a deep cleaning. Call us at (206) 282-5020 and let us know who your dental provider is and we can get some questions answered right over the phone and then schedule an appointment to have your come into our office for an evaluation.
Is it Expensive?
Fortunately, if you are left paying for a deep cleaning yourself, it is a very affordable preventive procedure that will help keep your teeth and gums their healthiest. We can work with you to come up with an easy way to pay for a deep cleaning. Please visit our payment and financing options page to learn more or call us directly at (206) 282-5020 or even request an appointment and come in to discuss your payment and financing options.
After scaling and root planing, it takes 90 days for the bacteria to re-organize on the root surfaces again. Homecare is very important during this time. Brushing and flossing along with antimicrobial mouth rinses help keep their numbers down, but it is impossible to thoroughly get under the gums and scrub the roots in deep pockets. Bacteria begin to accumulation again and a professional cleaning is necessary.
In place of a routine six month cleaning, a perio maintenance procedure is performed on patients with periodontal disease with the goal of preventing the progression of their disease. Usually, pocketing is 4mm and deeper, gum tissue bleeds easily when probed and bone loss is evident on X-rays. These cleanings are done every 3 months following scaling and root planing, to disrupt the bacterial biofilm and cleanse the root surfaces. The procedure is similar to scaling and root planing but not as aggressive and the entire mouth can be done in one appointment, usually without anesthetic. Perio maintenance will not reverse bone loss or eliminate deep periodontal pockets.
Pocket Reduction (Osseous Surgery)
As periodontal disease progresses there is more and more bone loss around the teeth. This, in turn, results in deeper pockets. At a certain point, they get deep enough that perio maintenance is not effective. The solution is then to surgically reduce the pocket depth. There are two ways to do this, the first is to make a small incision in the tissue so it can be flapped back to expose the bone. It can then be shaped to eliminate the holes the periodontal disease has caused and then reposition the gums with sutures so when healed, healthy 2-3 mm cervices result. The length of time for this surgery with vary depending on the procedure and how many teeth are involved.
The other treatment is to reflect the gums and graft bone particles into the areas of bone loss and then reposition the gums so when healed, healthy 2-3 mm probings result.
Sometimes we use a combination of both techniques.
Recession is a different process. With recession the gums shorten exposing the root of the tooth. There can be different causes ranging from trauma to the gums, tooth position and even gum disease. Recession exposes the root which may make the tooth sensitive and more prone to getting decay and if in the smile zone, recession can be unsightly.
To treat this we transplant gum tissue from the palate and place over the exposed root. After healing it is barely if at all visible.
When a tooth is lost, both bone and gum tissue compete for the vacant space. The gum tissue generates more quickly than bone, subsequently occupying the space. With a membrane placement we can keep the gum tissue from invading the space, which will ideally give the bone sufficient time to regenerate. Bone regeneration is often used to rebuild the supporting structures around the teeth, which have been destroyed by periodontal disease. Bone surgery may be used to attempt to rebuild or reshape bone. Grafts of the patient's bone or artificial bone may be used, as well as special membranes.
Clinical Crown Lengthening
Periodontal procedures are available to lay the groundwork for restorative and cosmetic dentistry and/or to improve the esthetics of your gum line. Your teeth may actually be the proper lengths, but they are covered with too much gum tissue. Crown lengthening is a procedure to correct this condition.
During this procedure, excess gum and bone tissue is re-shaped 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.
Crown lengthening can 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.
The human skull has several cavities or air spaces called sinuses. When the sinus is enlarged and intrudes on areas where we want to place dental implants, bone or bone growth stimulation material is placed into the sinus. This procedure only affects the maxillary sinuses, which are located just over the molar teeth in the upper jaw. The side of the maxillary sinus is opened and the bottom is raised so it will fill in with bone. Several months later, dental implants can be placed in solid bone.
An "Osteotome Lift" is a surgical procedure that raises the floor of the sinus directly over where the implant is placed. This can be done without actually opening the sinus.