Periodontal

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What type of procedures does a periodontist perform?

A periodontist offers various periodontal services, such as periodontal maintenance, scaling and root planing, and diverse types of periodontal surgery, ensuring comprehensive care for your gum health.

Periodontal maintenance

Periodontal maintenance is a specialized teeth cleaning procedure that a periodontist or hygienist performs on a patient to ensure optimal gum health. In addition to cleaning your teeth, they assess gum health and measure pocket depths around your teeth, crucial indicators of bone loss. These cleanings are typically recommended every three to four months for those requiring periodontal maintenance, with a personalized schedule advised by your periodontist based on your specific needs.

Scaling and root planing (periodontal cleaning)

"Scaling and root planing" (SRP) is a comprehensive dental cleaning procedure often referred to as a deep cleaning. Unlike regular cleanings, SRP involves local anesthesia to ensure comfort as your hygienist cleans deep below the gum line, targeting hidden bacteria. Additionally, they meticulously smooth the surfaces of your tooth roots to deter plaque and bacteria accumulation. Periodontists commonly advise SRP for individuals in the early stages of gum disease.

Periodontal surgery

A periodontist regularly conducts various gum surgeries to address different periodontal conditions. These surgical treatments include:

Gingival flap surgery

Also known as pocket reduction surgery, it targets moderate to severe periodontitis by moving the gums away from the teeth to access deep-seated infections. After cleaning the tooth roots, the gums are repositioned and stitched back into place.

Gum grafts

Used to treat gum recession, this procedure involves adding tissue to areas with thin gums, often sourced from the roof of the mouth or a tissue bank.

Tooth extractions

Periodontists specialize in removing difficult-to-extract teeth, especially those broken at the gum line.

Dental bone grafts

To regenerate bone loss caused by periodontal infection, bone grafts are placed in the affected area, often obtained from a tissue bank or the patient's own bone.

Surgical crown lengthening

When there's insufficient space for a dental crown due to a tooth breaking near the gum line, your periodontist can remove gum and bone tissue to create the needed space.

Smile lift

Excessive gum tissue covering teeth during smiling can be corrected through a smile lift, involving the removal of gum and sometimes bone tissue to enhance the smile's appearance, either as a standalone procedure or in combination with veneers.

Frenectomy

This procedure addresses issues caused by tight frenum bands, such as tongue-tie or gum recession, by surgically releasing the frenum to alleviate tension.

These surgical interventions are vital for addressing various periodontal issues and improving overall oral health and aesthetics.

What is a Gingivectomy?

Gingivectomy involves the surgical removal of excess or overgrown gum tissue (gingiva). Periodontists, specialists in gum health, perform gingivectomy to address certain types of periodontal (gum) disease. Additionally, it serves as a popular cosmetic dentistry option for correcting a "gummy smile," where excessive gum tissue gives the appearance of short or "boxy" teeth.

Types of Gingivectomy

There are two primary types of gingivectomy procedures:

  1. Conventional Gingivectomy: This method involves the use of a scalpel to eliminate surplus gum tissue. Occasionally, a small portion of the underlying bone might also be removed. Closure of any incisions and control of bleeding may involve the use of stitches.
  2. Laser Gingivectomy: In this approach, a surgeon utilizes a handheld laser to eliminate excess gum tissue. The laser's ability to cauterize gum tissue often eliminates the need for stitches.

Who is a candidate for gingivectomy?

If you experience any of the following, a gingivectomy procedure might be suitable for you:

  1. Gingivitis.
  2. Periodontitis.
  3. Aesthetic concerns like a "gummy smile" that gives the appearance of shorter teeth.
  4. Formation of periodontal pockets, where the gums have receded from the teeth.
  5. Utilization of braces or other orthodontic devices.
  6. Tooth misalignment leading to excess gum tissue. Additionally, certain medications such as amlodipine for hypertension or cyclosporine as an immunosuppressant can contribute to gum tissue overgrowth. Should you notice swollen or overgrown gums following the initiation of a new medication, it's essential to inform your healthcare provider. They can consider adjusting your medication or dosage accordingly.

Procedure Details

How should I prepare for Gingivectomy?

Prior to a patint's Gingivectomy, the periodontist will discuss the procedure details with the patient to ensure you know what to anticipate. Typically, there's no additional preparation required on the patient's part.

What happens during Gingivectomy surgery?

Below are the typical stages of a gingivectomy procedure:

  1. Anesthesia: Before beginning the procedure, your surgeon administers local anesthesia to numb your gums. If you've chosen sedation, they'll also provide medications to help you relax.
  2. Removal of excess gum tissue: Using a scalpel or laser, your surgeon eliminates any surplus or overgrown gum tissue.
  3. Gum reshaping: After removing the excess gum tissue, your surgeon reshapes the remaining gums to ensure they are proportionate to your teeth.
  4. Bone reshaping: In some cases, your surgeon may need to reshape the underlying bone, requiring small incisions along your gum line.
  5. Stitches: Your surgeon closes the incisions with stitches to minimize bleeding. For laser gingivectomy, this step may be unnecessary.
  6. Dressing: Your surgeon may apply a soft putty over the surgical area for protection. Typically, this dressing falls out on its own, but if not, your surgeon will remove it during your first follow-up appointment.

How long does a Gingivectomy take?

Typically, a gingivectomy procedure lasts between 30 to 60 minutes. If you require a gingivectomy for multiple teeth, the duration may be slightly longer.