Periodontics

The term “periodontics” refers to the dental specialty that pertains to the prevention, diagnosis and treatment of periodontal disease that affects the gums and jawbone.  The gum tissues serve to surround and support the teeth and the underlying jawbone anchors teeth firmly in place.  Periodontists have completed several years of extra dental training and are concerned with maintaining the function, health and aesthetics of the jawbone and tissues.

Reasons for periodontal treatment

Periodontal disease is a progressive condition which begins with mild gum inflammation called gingivitis.  It is the leading cause of tooth loss in adults living in the developed world, and should be taken very seriously.  Periodontal disease (often called gum disease) is typically signified by red, swollen, painful, or bleeding gums, but in some cases has no noticeable symptoms.

Periodontal disease generally begins when the bacteria living in plaque cause an infection in the surrounding tissues of the teeth, causing them to become irritated and painful.  Eventually, this infection will cause the jawbone to recede and the tooth to become loose.

There are several reasons why periodontal treatment may be necessary:

• Moderate/advanced gum disease – This occurs when the gums are bleeding, swollen or red around most teeth and the jawbone has begun to recede.
  
• Localized gum recession – The infection which propagates moderate or advanced gum disease often begins in one area.  Gum recession may also be caused due to over brushing with a hard bristle brush, or due to a tooth that is not positioned properly.  Immediate treatment is required to prevent further spreading.
  
• Before crown lengthening – The periodontist may lengthen the crown of the tooth by removing surrounding soft tissue to provide more tooth exposure.
  
• Ridge augmentation – This procedure, often called “recontouring” may be required to correct an uneven gum line.  Before embarking on treatment, a periodontist needs to treat any bacterial infections and periodontitis.

In the case of mild/moderate periodontal problems, the focus of the periodontist will be on curing the underlying bacterial infection and then providing advice on the most appropriate home cleaning methods.

Sometimes a deep scaling is needed to remove the bacterial plaque and calculus (tartar) from the teeth and tissues.  Where periodontal disease is advanced and the jawbone has regressed significantly, more intensive cleaning may be recommended and loose teeth that cannot be saved will be removed.

The periodontist is trained in all aspects of dental implant procedures, which can restore functionality to the mouth when teeth have been affected by periodontitis.

Because periodontal disease is progressive, it is essential to remove the bacteria and calculus build up to halt the spread of the infection.  Your dentist will be happy to advise you on effective cleaning methods and treatment options.

One of the primary concerns people often have about dental braces is the aesthetic impact of the metalwork on their smile. Especially for adults, the prospect of wearing unattractive metal braces for long periods of time can be very discouraging.  Invisalign® offers an almost invisible aligning system that straightens teeth fast and contains no metal.

Invisalign® treatment consists of a series of custom-made aligning trays.  The dentist changes the trays every several weeks to fit the new tooth configuration.  In addition to the reduced visual impact, Invisalign® aligning trays can be temporarily removed for important occasions – meaning that treatment duration is patient-controlled.  A great number of people report complete satisfaction with both the Invisalign® treatment and the stunning results.

What kind of bite problems can Invisalign® correct?

Invisalign® corrects the same dental problems as traditional metal braces; the only difference is that Invisalign® trays are almost invisible to the naked eye, and can be removed at will.

Here are some problems that are commonly corrected with Invisalign®:

• Overcrowding – This occurs when there is too little space for the teeth to align normally in the mouth.  Overcrowding can cause tooth decay and increase the likelihood of gum disease.
  
• Large gaps between teeth – This can sometimes occur because teeth are missing or because the jaw continues to grow abnormally.
  
• Crossbite – This common dental problem occurs when one or multiple upper teeth bite inside the lower teeth.  As a consequence, uneven wear can lead to bone erosion and gum disease.
  
• Overbite – This problem occurs when the upper teeth project further than, or completely cover, the lower teeth.  Eventually, jaw pain and TMJ may occur.
  
• Underbite – This is the inverse of the overbite; the lower teeth project further than, or completely cover, the upper teeth.  Eventually, jaw pain and TMJ can occur.

What advantages does Invisalign® offer over traditional braces and veneers?

Traditional dental braces, Invisalign® aligning trays, and dental veneers are three different ways to perfect the alignment of the teeth.  There are many different considerations to make when deciding which treatment will be best, and each of these options works better in certain situations.

Invisalign® differs from traditional braces in that the aligning trays are fully removable.  This means that more discipline and commitment is required from the patient.  This is not usually a problem since the trays are comfortable and nearly invisible.  Almost identical results can be obtained by using either treatment.

Invisalign® is preferable to veneers in many cases because unlike veneers, Invisalign® actually straightens the teeth. Veneers are thin covers that the dentist permanently affixes to the teeth.  Teeth must be etched beforehand, meaning that to remove dental veneers, an alternative covering must be constructed.  In addition to being somewhat expensive, veneers can break and often last for less than 20 years.

What does Invisalign® treatment involve?

First, the dentist needs to devise an initial treatment plan before creating the special aligning trays.  Three-dimensional digital images are taken of the entire jaw.  These images allow the dentist to move specific teeth on the screen, view the jaw from different angles, and also foresee what the face might look like in years to come.  In essence, this technology can show how Invisalign® trays will change the facial aesthetics.

Once planning is complete, a unique set of aligners is made.  The total amount of aligners required varies with each individual case, but 20-29 sets per arch is typical.

What are some considerations when wearing Invisalign® trays?

Life with Invisalign® aligning trays may take several weeks to get used to.  The trays should be worn constantly, except when eating and drinking.  It is important to remove the trays when consuming food or drink because food can become trapped between the tray and the teeth, causing tooth decay.

Usually, new trays are necessary every two weeks, and progress between appointments can be seen with the naked eye. There is no doubt that Invisalign® aligning trays have revolutionized orthodontics.  Invisalign® is renowned for being both comfortable and effective.

If you have questions about Invisalign®, please contact our office.

It only takes twenty four hours for plaque that is not removed from your teeth to turn into calculus (tartar)!  Daily home cleaning helps control plaque and tartar formation, but those hard to reach areas will always need special attention.

Once your periodontal treatment has been completed, your dentist and dental hygienist will recommend that you have regular maintenance cleanings (periodontal cleanings), usually four times a year.  At these cleaning appointments, the pocket depths will be carefully checked to ensure that they are healthy.  Plaque and calculus that is difficult for you to remove on a daily basis will be removed from above and below the gum line.

In addition to your periodontal cleaning and evaluation, your appointment will usually include:

• Examination of diagnostic x-rays (radiographs): Essential for detection of decay, tumors, cysts, and bone loss. X-rays also help determine tooth and root positions.
• Examination of existing restorations: Check current fillings, crowns, etc.
• Examination of tooth decay: Check all tooth surfaces for decay.
• Oral cancer screening: Check the face, neck, lips, tongue, throat, cheek tissues, and gums for any signs of oral cancer.
• Oral hygiene recommendations: Review and recommend oral hygiene aids as needed. (Electric toothbrushes, special periodontal brushes, fluorides, rinses, etc.)
• Teeth polishing: Remove stain and plaque that is not otherwise removed during tooth brushing and scaling.

Good oral hygiene practices and periodontal cleanings are essential in maintaining dental health and keeping periodontal disease under control!