Diagnosis: 

All new patients will be seen by one of our doctors for a thorough oral examination.  This will include an evaluation of the health of your teeth and gums.  The condition of your oral health will be explained along with any treatments that we would recommend.  You will be given an estimate of the costs of treatment and also what to expect during and after your appointments. 
Your dentist has referred you to our office because he or his hygienist have detected signs of gum disease such as gingivitis, periodontitis, receding gums, or other gum problems beyond their expertise.  Also, he may have referred you to replace your missing teeth with dental implants. 
 
What is periodontal disease ? 

 Periodontal disease is an inflamatory condition which affects the gum and tooth supporting tissue. It starts as Gingivitis  which is inflammation of the gum tissues.  The gum tissue, or gingiva, is usually red, tender, and bleeds easily with this condition.  This occurs when bacterial toxins in dental plaque and tartar attack your gums.  This condition is reversible and usually treated with a thorough cleaning and proper oral hygiene.  If left untreated, gingivitis can progress into Periodontitis which involves the tooth-supporting bone.
Periodontitis is a progressive disease which, if left untreated, may eventually lead to tooth mobility and tooth loss.  Periodontitis results in formation of periodontal pockets as the gum loses its attachment to the tooth. 
 The purpose of periodontal treatment is to arrest the disease process and help preserve the tooth supporting structures.  This will help you keep your teeth and gums healthy.   
   
 
 
 
 
 
 
 Treatments:
 
Nonsurgical periodontal treatment: 
 Most patients with periodontitis will need root planing, or a “deep cleaning.”  This involves thorough cleaning under the gumline to remove plaque and tartar from the root surfaces.  This procedure is performed under a local anesthetic since the diseased gums are usually tender.  Proper brushing and flossing techniques will be demonstrated to ensure good daily oral hygiene practice which is essential to the success of the overall periodontal treatment.  Six weeks after this procedure is completed, the response to the treatment will be evaluated.  Any treatment that might be beneficial to treat your periodontal disease will be discussed, along with a recommended recall program.
 
Surgical periodontal treatment:
In cases of severe disease, nonsurgical treatment may not be sufficient to prevent disease from progressing.  In such cases, root planing is only the first phase of treatment.  The goal of periodontal surgery is to reduce the periodontal pockets, and in some cases regenerate the lost supporting bone by using bone grafts.  Bone graft materials are derived from human, animal, or synthetic sources.  You and your doctor can discuss which material will work best for your situation if regeneration is an option.
 
 Other surgical treatments:  

 Soft tissue grafts: 
These are surgical procedures used to augment thin gums in order to stop the process of gum recession.  Other types of soft tissue grafts (Connective tissue grafts) are used to cover exposed root surfaces.  These are mostly used for cosmetic reasons and to treat sensitive roots.  
 
  

     
 
 
 
 
 

     
Mucogingival problem  Soft tissue graft
                          
 
    
 
 
 
 
 
 
 
 
 
   Gingival recessionAfter connective tissue graft

           
 
 
 Crown lengthening procedure: 
The purpose of this procedure is to gain more tooth structure above the gum line so that your dentist can place a crown on the tooth without violating the tooth supporting structures.  This is done when the tooth is fractured below the gum line, is very short, or is decayed below the gum line.
Esthetic crown lengthening is mostly done around the anterior teeth in order to improve your smile.  In such cases, patients have short teeth with excess gum showing when they smile, or a “gummy smile.”  This procedure will provide the patient with a beautiful smile with a more natural appearance
 
 
 
 
 
 
 
 
 
 
 
    Molar tooth fractured below theAfter crown lengthening
   gum-line
 
 
 
 
 
 
 
 
 
 
 
 
Canine tooth decayed belowAfter crown lengthening
the gum line
 
 
 
 
 
 
 
 
 
 
 
 
 Short teethAfter esthetic crown lengthening
 
 
 
 
 
 
 
 
 
 
 
 Short teethAfter crown lengthening
 
 
 
 
 
 
 
 
 
 
 
     Gummy smileAfter crown lengthening
   and veneers
 
 
 
Frenectomy: 
 this procedure is used to relocate the frenum (muscle attachment) away from the gingival margins in order to prevent gingival recession.  Thick frenums, especially between the upper incisor teeth, may contribute to a space between the teeth or result in relapse of orthodontic treatment and  closing of the space.  Frenectomy procedure will prevent this relapse.  
 
 
 
 
 
 
 
 
 
 

  Large upper frenum
 
 
 
 
 
 
 
 
 
 
 Large frenum3 weeks after frenectomy
 
 
 
 
 
 
 
 
 
 
 
 
 
Lower frenumOne week after frenectomy
 
 
 
 
 
 
 
 
 
 
 
 Large upper frenum4 weeks after frenectomy
 
 
 
 
 Ridge Augmentation:
 This procedure is used to treat alveolar bone deformities resulting from tooth extractions. The procedure is aimed to restore the normal anatomy of the alveolar bone thru the use of bone and soft tissue grafts.
 
 
 
 
 
 
 
 
 
 
 
 
 Deficient ridgeAfter ridge augmentation