Treatments Performed by a Periodontist (Active Therapy)
The periodontist is able to perform a wide range of treatments to stop the progression of gum disease, replace missing or lost dental foundation including gum tissue and jawbone and replace lost or missing teeth in order to make the appearance and functionality of the smile and bite more esthetically pleasing and mechanically stable. This is generally handled in a phased approach.
Some of the most common treatments performed by the periodontist are:
Phase 1 (Non-surgical therapy) – As gingivitis and periodontitis progress over time, it becomes more difficult to clean the "pocket" or space between the gums and the teeth. The periodontist can conservatively provide a deeper cleaning (scaling and root planing) under the gum tissues to remove debris and infection-causing bacteria. This is normally completed utilizing a dental endoscope (small, fiber-optic camera) which is carefully placed in the pocket to better see the infection and aid in a more complete cleaning. A dental laser can also be utilized to selectively kill bad bacteria and remove infected/inflamed tissue. Periodontal specific antibiotics are generally prescribed to aid in the disinfection of bacteria. The procedures are always done with the use of a local anesthetic and generally result in only mild discomfort to no pain at all. All patients undergoing Phase 1 therapies will be re-evaluated at appropriate time intervals in order to assess disease control/improvement and the potential need for more aggressive surgical approaches.
- Phase 2 (Surgical therapy) - When a Phase 1 or non-surgical approach is not enough to control a patient's disease and fully restore periodontal health, a periodontist may recommend moving into a surgical phase of care. Gum surgery (osseous surgery) allows a periodontist to open the gum tissue for better access to the diseased root surfaces and bone. This can allow for an even more thorough cleaning of the infected area and also a re-shaping/removal of infected bone providing a more healthy foundation. At times, the periodontist can even re-build or regrow lost bone with a variety of regenerative techniques and materials. Patients receiving surgical therapies all have the option to have their procedure performed "while asleep" with a variety of IV sedation techniques.
- Gum grafting - Gum tissues that have pulled away from the root surfaces of teeth can be rebuilt by a periodontist with a variety of gum grafting techniques. Gum grafts can be utilized to cover over root surfaces in order to improve appearance and diminish sensitivities. Gum grafts can rebuild a weakened or thin protective "seal" around the necks of teeth in order to promote improved foundational health. Gum grafts can be done with transplanted tissue from other areas of a patient's mouth, donor tissues or at times genetic materials purchased through bio-medical companies. A periodontist will help a patient to decide which material and technique would provide the most predictable outcome for the desired goal.
- Implant placement - When a tooth is missing, the periodontist is able to create a natural-looking replacement by anchoring a "bionic" tooth root to the jawbone. Once healed, a restorative dentist or prosthodontist can build a tooth crown the fastens on to the new tooth root (implant). Additional dentists or restorative dental specialists are a normal part of a patient's "implant team". When several teeth are missing, dental implants can be utilized more like anchors and can support engineered bridge-work or help retain existing dental prosthetics and dentures.