Depending on the condition of the gums, the depths of the pockets, the amount of inflammation, plaque and calculus (tartar) present and the progression of periodontal disease, root planning is employed. This is the removal of plaque and calculus and infected root surfaces concentrating on the areas below the gum line. The roots are cleaned and smoothed to create a healthy surface for the gum tissue to attach to the tooth.
Tooth sensitivity can be caused by decay, recession with tooth root exposure or bite discrepancies. Removing decay, gum grafts to cover sensitive tooth roots and bite adjustments can reduce sensitivity. Supportive Periodontal Maintenance For people who are susceptible to periodontal (gum) disease, regular supportive treatment is necessary to prevent recurrence of the disease. Just like people who have diabetes or heart disease, people who have been treated for periodontal disease also need regular evaluations to prevent recurrence or worsening of the condition.
A healthy bite is one where the teeth are present in a good functional alignment and do not show severe or premature wear. Painful jaw joints, teeth that are loose, drifting or prematurely worn are signs of occlusal (bite) pathology. Treatment may include reshaping the biting surfaces to eliminate high spots that cause excessive pressure when the teeth come together and/or utilizing a custom fitted bite guard for people with night-time bruxism (tooth grinding) to protect the teeth from additional wear. Occasionally orthodontic braces may be used. In other cases the replacement of worn fillings and crowns may be needed. Chronic tooth grinding can cause loosening or fracturing of the teeth. Periodontal Plastic Surgery Also known as gum grafting, can be used to repair areas on teeth where recession has taken place. This can make tremendous cosmetic improvements especially in areas that are visible when you smile. Gum grafting can also be used to cover areas of recession on roots where the teeth have become sensitive.
Crown lengthening can be functional or cosmetic. It is a periodontal plastic surgery where gum tissue or bone is reshaped to expose more tooth structure. This can be cosmetic to minimize a gummy looking smile, improve the shape of the teeth or functional to expose more healthy tooth structure when a crown or other type of filling is needed.
Cosmetic Tooth Contouring-Reshaping
This can be performed as a separate procedure or in conjunction with adjusting the bite. The teeth are reshaped to make them look more even, to improve their appearance and make them look better aligned.
Sometimes a tooth cannot be saved. These conditions may include severe decay leaving insufficient tooth structure to hold a restoration, filling or crown, or fractures of the tooth, especially when the fracture is in the root of the tooth, or when there are very severe root canal infections.
When a tooth is extracted it is important to ensure that the bone and ridge that held the tooth is reserved. This is especially important when implants are to be used for tooth replacement to ensure a sufficient volume of bone is present to support an implant. When bridgework is planned, socket preservation is used to make sure the replaced false teeth have the proper size and shape of the tooth or teeth they are replacing.
There are many types of bone grafts. Bone grafts can be done to replace bone lost to periodontal disease that supports a tooth or teeth. Bone grafts are also used in socket preservation or implant site development for future implant placement and to regenerate bone that was lost from infection, trauma or bone lost after teeth have been removed.
Osseous Surgery Osseous surgery is performed on patients who have periodontal disease to reduce pocket depth, improve contours of the gums and bone and improve access for cleaning the teeth by the patient and periodontist of dental hygienist. Osseous surgery is the definitive step in cleaning the diseased tooth and creating a clean biologically healthy root that the gum tissue can attach to. Bone grafting or other regenerative procedures may be done at this time.