Periodontics in Dartmouth
Conditions such as gum infections and gum disease can result in complications that not only include lost teeth but have also been linked to heart disease. We offer a variety of periodontal treatments to help keep your gums healthy.
Scaling and Root Planing
Often the first step towards your periodontal treatment involves scaling and root planing, also commonly referred to as “deep cleaning”. This process often involves local anesthesia and then removal of plaque/calculus built up deep under the gums. Specialized instruments are utilized to ensure that the root surface is free of bacteria and debris. Following this procedure, it is common for one to develop temporary sensitivity for 5-7 days. It is very important to maintain proper oral hygiene following the debridement to ensure plaque does not build up again immediately. This foundational step aims to eliminate gingival inflammation and also to reduce periodontal pockets.
Epithelial Gingival Graft
A graft is a piece of tissue that is taken from one area of your mouth (usually the roof of your mouth) and placed in an area where there is no firm attached gum tissue. They are used to provide a good base of gum tissue around the tooth to prevent gum recession from continuing.
Root Coverage Graft (sub-epithelial connective tissue graft)
A root coverage graft (also called a connective tissue graft) is a procedure used to treat areas of deficient gum tissue around the root of a tooth. It involves taking a thin piece of tissue from the roof of your mouth and placing it in the area where the gum tissue is deficient. The root of your tooth can be covered for cosmetic reasons or when exposed roots are very sensitive. Graft procedures are done in our office with regular dental freezing. After a graft you’ll need to rest for approximately 24 hours and you may need mild pain medication for a few days up to a week. If we use sutures, you’ll need to return to the office after the procedure to have the healing assessed.
Pocket Reduction Surgery
Pockets in the gums around your teeth accumulate bacteria and are difficult to clean. If the bacteria plaque isn’t removed the pocket can become deeper due to bone loss around the tooth. Over time the loss of bone can result in the loss of the tooth. To make it easier for you and your dental hygienist to remove bacteria from around your teeth pocket reduction surgery may be recommended.
After a small collar of diseased gum tissue is removed from around the tooth, the residual healthy gum is pushed closer to the new bone level to close the pockets. The gum tissue is held in place with stitches and a periodontal dressing, both of which are removed after one week. Pocket reduction is done under regular freezing and you may experience mild discomfort after your surgery.
Regeneration is another approach to reduce pockets by regenerating lost bone tissue. In this procedure the bone around the tooth is thoroughly cleaned and a material is placed to stimulate bone growth.
Large restorations such as crowns and bridges can have negative effects on the health of your gums. Crown lengthening keeps your gums healthy by allowing your dentist to place a restoration that doesn’t impact the gum tissue.
We remove a small amount of tissue from around the tooth and push the healthy gum tissue closer to the level for your gums. Your gum will be held in place with stitches and a periodontal dressing while it heals. The stiches and dressing are removed after a week.
Crown lengthening is done using regular freezing. You may feel mild discomfort in the area for about a week after your surgery.
Esthetic Crown Lengthening
Crown lengthening can also be performed as a cosmetic procedure to improve the appearance of your gums or to correct a “gummy” smile.
Sometimes permanent teeth such as the canines or pre-molars remain hidden and fail to erupt into the mouth. Depending on the location, your dentist or orthodontist may elect to force erupt these hidden teeth. Your periodontist will create an opening to find this tooth by removing the overlying gums and/or bone covering the tooth. Following this exposure, a button is glued on with a chain. In approximately 1 week, your dentist or orthodontist will attach an elastic wire that pulls on this chain slowly. This will guide the hidden tooth to erupt and be aligned in its proper position.
Soft Tissue Biopsy
Soft tissue growth or lesions can occur anywhere in the mouth. If they do not resolve with time and conservative management, a biopsy may be needed to confirm a working diagnosis. Following local anesthesia, a piece of the tissue is excised and sent to the Oral Pathology Lab at Dalhousie University to verify the diagnosis. It takes approximately 2-6 weeks for the biopsy results to return.
Frenum is a fold of tissue that attaches from the lip or cheek to the teeth and the periodontium. In some cases, this frenum is attached very near the tooth and this can cause some problems. Gum recession, opening gap between teeth after orthodontic treatment completion, or getting in the way of removable dentures are some of the complications associated with an abnormal or aberrant frenum. These cases will benefit with an excision or repositioning of the frenal tissue.
One of the main goals for your periodontist is to maintain teeth in healthy function. When there is bone loss around teeth, pockets are created. Depending on the type of damage, some periodontal procedures can be performed to regrow some lost bone and to reduce the pocket. These procedures are very technique sensitive and only indicated in certain cases. Once successful, however, they do require regular maintenance to ensure long term success.