From receeding gums to gum disease, Periodontist, P.A. - Stanley L Wint, DDS and Tanu Satheesh, DDS MS is equipped to handle all your periodontic needs. To help you understand your options, we've included descriptions of some of our leading services on this page.
What is Periodontics?
Periodontics is a dental specialty that involves the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes.
Periodontal scaling and root planing (SRP) is the most common non-surgical initial treatment for periodontal disease. Because periodontal disease is a bacterial infection, it is critical to reduce inflammation and treat periodontal "pockets" so that daily plaque control methods can be effective. Scaling and root planing (sometimes referred to as a "deep cleaning") is a meticulous and detailed removal of the dental plaque and calculus (tartar) that have attached to the root surfaces of infected teeth. In addition, the root surface is smoothed (planed) to allow the overlying gum tissue to heal and ensure embedded pathogens are destroyed. One of our excellent registered dental hygienists performs this procedure in two separate appointments with the use of local anesthetic.
In many cases, scaling and root planing is the only treatment necessary to allow the patient to enter the maintenance phase of periodontal care. In some cases, scaling and root planing may need follow up surgical care in isolated areas.
Periodontal (Osseous) Surgery
If you have been diagnosed with periodontal disease, Dr. Wint or Dr. Satheesh may recommend periodontal surgery, often referred to as osseous surgery. Osseous surgery is generally prescribed for areas of the mouth that have not responded adequately to non-surgical treatment, such as scaling and root planing and excellent home care. Periodontal osseous surgery is a reshaping of the supporting bone and gum tissue around periodontally diseased teeth and a reduction of the diseased "pockets" around the teeth. The goal of the surgery is to restore normal form and function to damaged supporting structures of the teeth.
Osseous surgery is not a cure, but rather an attempt to reduce the "pockets" of diseased tissue by providing an environment that can be maintained at home on a daily basis and professionally with regularly prescribed periodontal maintenance cleanings.
Routine Periodontal Maintenance
Periodontal maintenance is the foundation of our practice. Periodontal disease is an inflammatory condition caused by bacteria. Periodontitis can never be "cured", but in most cases it can be controlled with a combination of excellent home care and professional maintenance cleanings. Because we treat periodontal disease on a daily basis, our team of expertly skilled dental hygienists have extensive experience in helping you manage your periodontal concerns.
We are often asked how a periodontal maintenance appointment is different from a regular cleaning (prophylaxis). A prophylaxis is a preventive procedure performed on a healthy mouth. A periodontal maintenance cleaning is ongoing therapy for periodontal disease. Periodontal disease may be either active or inactive, but once present will always require careful supervision and maintenance. Periodontal disease is episodic and destruction can occur without the patient's knowledge. Therefore, it is vital that the hygienist and the periodontist continue to monitor the disease to keep it under control.
From an insurance standpoint, periodontal maintenance must follow active periodontal treatment, such as scaling and root planing or osseous (bone) surgery. In other words, once you have been diagnosed with and treated for periodontal disease, your cleanings are no longer preventive, but rather designed to maintain the results of your periodontal treatment.
The interval between maintenance appointments will vary depending upon the type of periodontal disease you have, how quickly you accumulate plaque and calculus, your immune response to your treatment and a host of other factors. Dr. Wint and Dr. Satheesh will individualize the recommended interval between periodontal maintenance appointments for your particular needs. Strict compliance to your prescribed interval will be the major factor in maintaining your periodontal health for a lifetime.
It is important to note that Dr. Wint and Dr. Sathessh work together as a team with your general dentist. Once Dr. Wint or Dr. Satheesh establishes that your periodontal disease is under control, they may recommend an alternating schedule for your maintenance cleanings with your general dentist. In some cases, it may be recommended that all maintenance appointments continue with this office, but it is still very important that you continue your regular dental check ups with your general dentist. Dr. Wint and Dr. Satheesh are committed to continued communication with your general dentist.
A dental implant is an artificial tooth root that is surgically placed into the upper or lower jaw to replace a missing tooth root. If you have lost a tooth due to an accident, gum disease or decay, the doctor may recommend a tooth implant. Implants can help preserve the jawbone, preserve structure of adjacent teeth and help preserve facial contour.
Dental implants have been successfully placed by dentists around the world for over 40 years to help patients restore oral function and esthetics. Dental implants are made of titanium, the same surgical grade material used for such medical devices as knee and hip replacements. Like mamy medical devices, dental implants have been dramatically improved over the years and now offer more predictability and long term success than ever before. In most cases, dental implants offer a permanent solution to a missing tooth or teeth.
Implants have the same basic parts as a natural tooth. Both have a root that secures the tooth to the jaw and a crown which is the visible part of the tooth. Dental implant placement is a team effort between your periodontist and your restorative dentist. Dr. Wint or Dr. Satheesh performs the actual implant surgery, initial tooth extractions and any necessary bone grafting. After an adequate period of healing for the titanium of the implant to create a strong foundation by bonding with the jawbone (a process known as "osseointegration"), your restorative dentist makes and places the permaent crown over the implant (root).
Dr. Wint and Dr. Satheesh have many years experience placing and managing dental implants and would be happy to evaluate your needs to see if you are an ideal candidate for dental implants.
Gingival (gum) recession is a common dental problem and can be caused by improper brushing techniques, periodontal disease, trauma, aging or malalignment of the teeth. In some cases, no treatment is necessary. However, when the recession is severe enough to cause hot or cold sensitivity or to weaken the support of the tooth, a soft tissue graft may be prescribed. The main goal of the soft tissue graft is to either cover the exposed root or to thicken the existing gum tissue to prevent further destruction of the remaining tissue. Depending upon the goal of treatment, one of the following grafts may be recommended:
- Connective Tissue Graft: The subepithelial connective tissue graft is the most common type of soft tissue graft used for treatment of root exposure. The goal of this graft is to obtain as much root coverage as possible. The two most common reasons for choosing a connective tissue graft are to treat root sensitivity and to improve esthetics. The connective tissue graft is accomplished by using tissue from the roof of the mouth or by using artificial tissue. Dr. Wint and Dr, Satheesh can discuss which type of donor would be best for your situation.
- Free Gingival Graft: This type of graft is most commonly used to thicken existing tissue when sensitivity and esthetics are not a concern. Tissue from the roof of the mouth or synthetic tissue is used to promote growth of natural tissue.
- Pedicle Graft: This graft uses tissue that is "shared" from the affected tooth and an adjacent tooth. A flap of tissue is moved sideways from the adjacent tooth to cover the root of the affected tooth. This type of graft is usually recommended when there is adequate tissue to "share". Although indications are somewhat limited, the pedicle graft has a very good prognosis because the shared flap has excellent blood supply.
If soft tissue grafting is necessary for increased comfort, improved esthetics or improved gum health, Dr. Wint or Dr. Satheesh can discuss which type of graft woud be of most benefit for you.
Osseous (bone) grafts are one type of therapy used to treat defects (holes) in the supporting bone around a tooth. This procedure is commonly used in conjunction with treatment to reshape the bone surrounding a periodontally diseased tooth. The bone graft is used to help stimulate growth of new bone so that the treated tooth will have adequate support.
This procedure is commonly used to treat isolated areas that may not have responded well to more conservative initial treatment, such as scaling and root planing. Only certain types of defects (such as vertical) are chosen to receive osseous grafts. Bone grafts are highly successful and represent one of the most significant advancements in modern periodontics.
Ridge Preservation Graft
If it becomes necessary to have a tooth extracted due to gum disease, decay, abscess or injury, it is important to consider doing so in a manner that will preserve as much of the underlying jawbone as possible. The bone surrounding a tooth is specialized and exists for the sole purpose of holding the tooth into the socket. When the tooth is removed, this bone will resorb (melt away) because it is no longer needed to hold the tooth into place. To prevent this shrinkage, the doctor will often recommend the placement of a ridge preservation graft. This graft uses material that forms a matrix to encourage growth of new bone into the socket. This procedure is best accomplished at the time of extraction.
Ridge preservation grafts will not complicate post extraction recovery and will create a good foundation for replacement of the lost tooth with either a dental implant or a fixed bridge.