Periodontal Procedures

Periodontic Procedures

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Dental Implants

A dental implant is an artificial tooth root that fits, feels, and functions just like a natural tooth.

Are implants safe? What is the success rate?

Implants are very safe. They are considered the best option for tooth replacement for patients who are candidates. Implants have a success rate of 95% to 98%.

How long before I will have my new tooth?

The length of treatment depends on your bone, where the implant is placed, and how many implants are placed. Treatment time for most implants varies from six to twelve weeks. In certain situations, a tooth can be placed on the implant at the same time the implant is placed. If this is not possible, you will have a temporary tooth replacement so that you never have to go with an empty space where you are missing the tooth.

Are implants painful?

Implants are not painful. Most patients tell us that implants are less invasive than tooth extraction.

Dental Implant illustration

Will I need to take time off work?

Most patients return to work the day after implant placement. Complex cases can require some time for recuperation.

Are implants covered by my dental benefits?

There are many types of dental benefit plans, and coverage for implants is varied. We will be happy to assist you in obtaining any benefits to which you may be entitled.

How much do implants cost?

Conventional bridges typically need to be replaced approximately every ten years. As implants have much greater long-term success rates and longevity, they are the most long-term cost effective treatment. As with other choices in life -- such as purchasing medical or automobile insurance or buying a home – the least expensive option is not always the best option. The actual cost depends on the specific needs of each patient, so we will first need to evaluate to determine if you are an implant candidate.

What about a dental bridge instead of the implant?

With a bridge, the dentist must “cut down” your two adjacent teeth into pegs possibly introducing further problems down the road. Dental implants often the most conservative treatment to replace missing teeth.

I have been told that I am not a candidate for dental implants because I do not have enough bone for implants. Is there any other options?

Over a period of time, the jawbone associated with missing teeth atrophies or is reabsorbed. This often leaves a condition in which there is poor quality and quantity of bone suitable for placement of dental implants. In these situations, most patients are not candidates for placement of dental implants.

Today, we have the ability to grow bone where needed. This not only gives us the opportunity to place implants of proper length and width, it also gives us a chance to restore functionality and esthetic appearance.

There are many different situations that can be treated with bone grafts including ridge augmentation, sinus lift procedures, and socket augmentation grafts.

Restorative Abutment Final Crown

Soft Tissue Grafting

Do you look older than you are because of gum recession? Gum recession is the exposure of root surfaces, which make teeth appear longer. This can be caused by trauma from a tooth brushing habit or from gum infection. Exposed root surfaces are unappealing and leave you at risk for tooth sensitivity and decay.

Soft tissue grafting is designed to cover exposed roots and will predictably stop further recession. This will protect the vulnerable root surface from decay and temperature sensitivity. The result is a natural, pleasing appearance to the gum tissue and a repair to the damage caused by gum recession.

After soft tissue graft

Before soft tissue graft

I have been aware of my gum recession for a long time. What is the risk of not treating this recession?

Gum recession will not repair itself naturally. It may appear to be stable in your mouth, however, there is a gradual decrease in the bone support over the root surface, which results in an increase in gum recession over time. The vulnerable exposed root surface is also at risk for decay and temperature sensitivity. Soft tissue grafting is a predictable repair for gum recession.

How is the treatment for gum recession accomplished ?

Donor tissue is used from the roof of your mouth (palate) or a piece of tissue bank collagen material (Alloderm®) is used as the graft. This is carefully attached over the exposed root surfaces after cleaning them thoroughly. To provide a natural appearance to the grafted site, your existing gum tissue is moved down over the graft and secured in place.

Treatment of Periodontal (Gum) Disease

Periodontal disease, or gum disease, is a serious infection caused by harmful bacteria in the plaque that forms on teeth. In the United States, approximately 35% of adults have some form of gum disease involving bone loss, while 13% of adults have a moderate-to-severe level of gum disease.

When gum disease occurs, supporting tissue and bone around the teeth are destroyed, forming “pockets” around the teeth. This can result in tooth loss if left untreated. It may also lead to acute (sudden) infections and tooth decay.

Diagrams of gingivitis, mild periodontitis, and advanced periodontitis

What are the symptoms of gum disease?

Gum disease is normally a “silent” disease, not causing any pain. Warning signs of gum disease can include persistent red, bleeding, and swollen gums. Other symptoms include:

Bleeding of the gums during brushing or flossing
Occasional swelling or tenderness of the gum, although frequently with no accompanying pain
Drainage (pus) between teeth and gums
Persistent bad breath
Receding gums, making the teeth appear longer than before
Development of spaces between the teeth
Changes in the way teeth fit together when biting

Many scientific studies have found that gum disease may also affect overall health due to passing of harmful bacteria and bacterial toxins into the bloodstream. Research indicates that gum disease may increase the risk for heart attack and stroke. For individuals with diabetes, periodontal disease may have a negative effect on glycemic control (control of blood sugar). For pregnant women, periodontal disease may increase the likelihood of premature and low birth weight. It is important to take action quickly to protect your gums, teeth, and health.

How is gum disease treated?

The treatment of advanced periodontal (gum) diseases usually involves three phases of treatment:

Initial periodontal therapy (non-surgical scaling and root planing) to remove the cause of gum disease
Periodontal corrective procedures (periodontal surgery and regeneration) to correct the damaged bone and gum tissues
Periodontal maintenance (specialized cleanings, usually every three months) to help prevent re-infection of the gums

Initial periodontal therapy

Scaling and root planing is the thorough cleaning of the root surfaces to remove plaque, calculus (tartar) and bacteria. It also involves the smoothing of root surfaces to retard recurring build up and allow for reattachment of the gingiva (gum tissues). Scaling and root planing is performed under local anesthesia (numbing) using ultrasonic and hand-scaling instruments. Antibiotics (locally applied or oral medication) are also used in certain situations to assist in the healing process. Initial therapy is performed in the general dentist’s or the periodontist’s office. Following initial periodontal therapy, a follow-up with the doctor will occur after approximately one month’s time to check the progress of initial treatment.

Periodontal corrective procedures

In areas of severe periodontal (gum) disease, “pockets” will still exist following initial therapy. These pockets are too deep to clean with daily home care and a professional care routine. They will continue to collect bacteria and result in further bone and tissue loss.

We may recommend a pocket reduction procedure (periodontal surgery). During this procedure, the gum tissue is moved back and the disease causing bacteria is removed. Irregular surfaces of the damaged bone are also smoothed to limit areas where disease-causing plaque can hide, allowing the gum tissue to better attach to healthy bone. Sutures are placed at the end of the procedure. Reducing pocket depth and eliminating harmful bacteria is necessary to prevent further damage to the bone and loss of the teeth.

In areas of severe gum disease, it may be possible to regenerate or re-grow the bone supporting teeth. This is done during periodontal surgery with the use of membranes (filters), bone grafts, or growth factors to encourage your body’s natural ability to regenerate bone and supporting tissues.

Periodontal maintenance

While there have been significant advancements in periodontal therapy, there is no cure for gum disease. Even after successful, corrective therapy and surgical intervention, your gum disease can recur. For the majority of patients with periodontal disease (~90%), regular periodontal maintenance cleanings have proven to be effective in preventing recurrence of gum disease. This phase is an essential part of treatment. Often, this can be the most important part of your therapy.

At each periodontal maintenance visit, we will review your medical history, noting any compromised health conditions (i.e. diabetes, cardiovascular disease, pregnancy, or immunosuppressive disorders) that can effect the stability of your periodontal condition. We will also perform an oral cancer exam, measure your pocket depths and note any bleeding sites, and review your plaque control effectiveness. We will also thoroughly scale and remove plaque and tarter buildup, accessing those areas where you can’t reach just by brushing and flossing.

At the end of your maintenance appointment, we will customize a “plan of attack” based on your needs to aid you in preserving your healthy, natural smile.

Laser Treatment

Laser Removal of Excess Soft Tissue and Soft Tissue Tumors

Surgical lasers have been used in dentistry for several years to remove excess soft tissue and soft tissue tumors. There are several advantages of removing this tissue by laser. These include less swelling after surgery, less pain from the tissue removal than conventional surgery, faster healing, and no scarring at the surgical site. The lack of scarring during healing gives the patient a better result than alternative methods.

The laser also seals the wound during tissue removal allowing the surgeon better visibility, no bleeding during surgery, and more control of the amount of tissue removal. The result is a more precise procedure with minimal after-effects.

Other Services

Crown Lengthening

When a tooth has deep decay or a crack below the gum line, it will require exposing sound tooth structure to be properly restored. Your restorative dentist will recommend a surgical crown lengthening procedure to accomplish this prior to making the final restoration. This allows the restorative dentist to place a full coverage crown with enough room for healthy gum tissue.

When I have a cracked tooth or deep decay why can’t my dentist just restore the tooth with a deeper restoration below the gum line?

The gum tissue health around a tooth is dependent on a width from the bone level up to the restoration of about 3 millimeters. This zone must be provided, even when decay extends well below the gum line, to prevent gum infection and further bone loss. To accomplish that result a surgical procedure to create the “biologic width” is performed.

After an appropriate period of healing, the restorative dentist can complete the new crown preparation and insure a healthy long-term result.

Esthetic Crown Lengthening

Are you unhappy with your appearance because your teeth appear too short or you have a “gummy smile?” This can often be the result of excessive wear to the teeth or a partial coverage of the natural crowns by the gum tissues. A beautiful smile begins with the proper proportions to the upper front teeth. Esthetic crown lengthening can alter the amount of gum tissue exposed by your smile and reveal a more appealing, natural appearance, to create a “Hollywood smile.”

If I have a “gummy smile” and wish to have that corrected, what is involved in an esthetic crown lengthening?

A surgical procedure is performed to remove the excess gum tissue, revealing a longer, more harmonious appearance to the upper teeth in the esthetic zone. The amount of gum tissue removed will depend on your smile line and extend to the back teeth to create a smooth gradual curve to the smile. This will also require a small amount of bone contouring around the front teeth to accept the change in the gum tissue level and allow for a healthy and beautiful smile.

Move the two pictures currently under crown lengthening into the esthetic crown lengthening section and add a caption of the left picture “before crown lengthening” and the right picture “after crown lengthening”

Assisting With Orthodontic Treatment

Uncovering of impacted teeth to assist in tooth eruption
Laser removal of abnormal attachments of the frenum (the fold that connects to the lip or tongue)
Gingival (gum) grafting to correct gum recession
Esthetic crown lengthening to correct an uneven gumline or lengthen teeth that appear too short
Placement of dental implants to replace missing teeth

Oral Medicine

Diagnosis and treatment of non-plaque related gingival (gum) diseases, such as Lichen planus

10425 Montgomery Parkway NE • Albuquerque, New Mexico 87111

(505) 291-9000 • Fax: (505) 294-3998