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If your dentist has prescribed a specific treatment for you or identified a condition that requires treatment, you can find information relevant to it below.

Treatments and Conditions

Periodontal Disease

Periodontics is a dental specialty that focuses on the prevention, diagnosis and treatment of periodontitis, commonly referred to as gum disease. Periodontal disease is the leading cause of tooth loss in North America. It is progressive and leads to loss of bone and subsequently teeth. Gum disease is a serious condition that is often without symptoms. The disease process begins with a buildup of plaque and bacteria leading to gingivitis, a bacterial infection of the gum tissue only. If left untreated, the infection can progress to cause destruction of bone and soft tissue.

The good news is that tooth and bone loss and the complications of periodontal disease are NOT inevitable. The disease can be successfully managed through proper oral hygiene and treatments that aim to restore the health of gums and teeth. Treatments for periodontal disease can include something as simple as deep scaling and root planing, which removes plaque and tartar, to more aggressive treatment such as pocket reduction surgery, tissue regeneration to restore gums and dental implants to replace lost teeth.

Recession/Gum Graft

A gum graft is a collective name for surgical procedures that aim to cover an exposed root surface with grafted oral tissue. Exposed roots are usually the result of gingival recession due to periodontal disease. Other common causes include aggressive brushing, trauma, tooth position and other anatomical factors. A few of the major benefits associated with gum grafting include reduced sensitivity, improved appearance with less root visible, and improved gum health.

Gum graft before (left) and after (right)

Gum graft before (left) and after (right)

Cosmetic

People will often seek dental treatment to improve the aesthetics of their smile. A periodontist can assist with this task by helping to optimize the soft tissue component of the smile. This may include aesthetic crown lengthening to create symmetry between right and left sides, or to reduce a “gummy” smile. Soft tissue grafting can be used to cover exposed roots visible in the smile. Dental implants combined with soft tissue procedures can also be performed to replace a tooth and restore soft tissue aesthetics. Many of these periodontal procedures can be performed in conjunction with prosthetic treatments planned by your dentist. Working together with your dentist we can help create a thorough treatment plan that will give you the beautiful smile you are looking for.

Gum graft before (left) and after (right)

Gum graft before (left) and after (right)

Crown lengthening, before (left) and after (right) treatment

Crown lengthening, before (left) and after (right) treatment

Broken Tooth

While teeth are extremely strong, under certain circumstances they can break or fracture. This can occur from trauma due to a fall or injury, or in many cases while eating if the tooth is heavily restored with a large filling. If the break is small, a dental filling can be used to repair the tooth however, if the break is bigger a crown may be recommended. When the amount of tooth available after the fracture is insufficient or the fracture is deep under the gum, crown lengthening may be needed to restore the tooth back to function. In cases where the tooth is badly broken and cannot be fixed, then removal and replacement may be indicated. If the tooth is removed, a dental implant may be suggested.

Missing Teeth/Implants

Whether a tooth has recently been removed or missing for a long period of time, a dental implant is one option that can be explored to replace the tooth and restore function, or aesthetics.

A dental implant is an artificial root replacement that is placed into the jaw to hold a crown or bridge. Dental implants may be an option for teeth lost due to periodontal disease, an injury, or some other reason. The ideal candidate for a dental implant is someone with good general and oral health. There must be adequate bone in the jaw to support the implant and healthy gum tissues free of disease are also recommended. They can be used to replace a single tooth or several teeth.

A key to implant success is the quantity and quality of bone where the implant is to be placed. Deformities in the jaw can leave you with insufficient bone to place dental implants. To correct the problem, bone grafting/augmentation may be needed before an implant can be placed. We can now use special xrays called Cone Beam CT scans to determine exactly how much bone is available and whether this type of augmentation will be necessary before embarking upon surgery.

Deep Scaling and Root Cleaning

The first stage of periodontal treatment is usually a thorough deep cleaning known as scaling and root planing or periodontal cleaning. This non-surgical procedure removes plaque and tartar deposits beneath the gum line and smooths the root surfaces allowing the gum tissues to heal and reattach to the teeth. The objective of periodontal cleaning is to remove dental plaque and tartar, both sources of bacteria, which cause inflammation of the gum and tissue and bone loss. This treatment will commonly require several visits to complete. Typically a follow up visit is scheduled 6 weeks after this phase of treatment to evaluate the improvements in the health of the gums.

Antibiotic Therapies

Periodontal disease is primarily a bacterial infection in the mouth. As a result antibiotic therapies can be used to assist in the treatment of the disease process. The effects of antibiotics are short lived and do not cure the disease. Most commonly they are prescribed in conjunction with non-surgical therapy such as scaling and root planing. We have the option to provide an oral antibiotic taken several times a day for a short period, or a local delivery antibiotic that can be placed directly into a periodontal pocket. The use of antibiotics is case selective and to avoid resistance they are not prescribed for all patients. Alternatively antibiotics can be used to treat acute infections such as a gum abscess or after certain surgical procedures to reduce the risk of infection.

Pocket Reduction Surgery

A periodontal pocket develops as we lose the supporting tissue and bone around teeth. Deeper pockets, usually greater than 6mm, are more difficult for you and your dental care professional to clean. As a result, it is important to reduce them and sometimes this requires more than just a deep cleaning. Surgery to lift the gums and remove the disease causing bacteria can help reduce pocket depths. Reduced pockets and a combination of good daily oral hygiene with professional maintenance can increase your chances of keeping your natural teeth.

Periodontal Laser Therapy/LANAP

Lasers can now be used to assist with periodontal surgery both to remove diseased tissue and to help disinfect the pocket and kill bacteria. In some cases bone regeneration may be possible utilizing the lasers in areas of bone loss. The LANAP protocol can be used to reduce pocket depths and improve bone density.

Laser therapy before (left) and after (right)

Laser therapy before (left) and after (right)

Crown Lengthening

Crown lengthening is commonly performed to expose more of the natural tooth by reshaping or re-contouring bone and gum tissue. It can be performed for a single tooth or many teeth in an area. If a tooth is decayed , broken below the gum line or simply has insufficient tooth structure for a restoration, crown lengthening is performed first and then the tooth can be restored back to function. Occasionally there is extra gum tissue around teeth making them look unnaturally short. This is referred to as a “gummy” smile. Esthetic crown lengthening can be utilized to remove the excess tissue and restore a balanced, healthy looking smile.

Crown lengthening, before (left) and after (right) treatment

Crown lengthening, before (left) and after (right) treatment

Crown lengthening before (left) and after (right)

Crown lengthening before (left) and after (right)

Crown lengthening before (left) and after (right)

Crown lengthening before (left) and after (right)

Small Field CBCT

Radiology has long been a tool used in dentistry to assist the clinician with diagnosis and treatment planning. Cavities, infections, impacted teeth and locating anatomical structures are just a few examples of why we rely on x-rays so much in our profession. Today we are able to utilize high resolution small field three dimensional scans to improve our quality of patient care. We can more precisely determine where an implant can be successfully placed, if there is pathology in the jaws or a problem with a tooth such as fracture or root resorption. These are digital images with minimal patient radiation. At Deer Ridge Periodontics we have the ability to provide Cone Beam CT images on site and provide reports for the referring dentist.

Biopsy

Whenever there is a something inside the mouth that we cannot diagnose based on appearance only, it is strongly recommended that a biopsy be performed to allow a microscopic assessment. This evaluation is often necessary for accuracy and it also allows us to establish the appropriate course of treatment. A biopsy is a quick procedure most commonly performed with local anaesthesia.

Sedation

At Deer Ridge Periodontics we understand that not everyone is comfortable visiting the dentist and having procedures completed with local anaesthetic only. We are happy to provide a variety of sedation options including oral sedation, Nitrous Oxide (laughing gas) and intravenous sedation. We are equipped to provide the necessary monitoring to keep all of our patients safe and comfortable. The level of sedation necessary can be discussed at the time of consultation.

Your First Visit

Your first visit will involve a comprehensive periodontal examination by Dr. Angela Waciuk and her team. They will assess pocket depths, recession, tooth and bone loss, as well as record other signs of periodontal disease.

If you have been referred by your dentist, please ensure you bring:

  • The referral slip and x-rays from your dentist(if they have not been sent electronically)
  • A list of medications you are currently taking
  • If you have dental insurance, please bring any forms or cards with you to the appointment. We will assist you with your insurance forms so that you may be reimbursed directly.

Payment Options

To ensure you receive the care you need as quickly as possible without financial barriers we offer a range of payment options and can submit claims directly to your insurance provider. Learn more.

Frequently Asked

Questions

Why do I need to see a Periodontist?

Most commonly your dentist has referred you to a Periodontist to evaluate a concern associated with the foundation for your teeth, such as bone and gum tissue. This may be a small area or incorporate many teeth.

Will my appointment be covered by my insurance company?

Insurance coverage is dependent on your contract with your insurance company. We will provide estimates to your insurance company on your behalf to help determine if any treatment we recommend is covered. Learn more.

What are my payment options?

We will strive to make the financial portion of your visit as easy as possible. We are a fee for service practice accepting a variety of payment options. Learn more.

If I need gum surgery will it hurt?

Gum surgery will typically come with some discomfort that lasts anywhere from 1 to 3 days post treatment. If pain medications are taken as prescribed, the discomfort can often be eliminated and patients are very comfortable.

Will I need to take time off work?

Time off is not often recommended but if it is needed, it will be discussed at the time of consultation. Doctors notes can be provided if necessary.

If I am having surgery, do I need someone to drive me home?

A responsible driver is only needed if you are having sedation along with the surgery. For any local anesthesia, a driver is not necessary.

Can I eat before I come to my surgery?

Eating is NOT permitted 6 to 8 hours before surgery IF you are having treatment with IV sedation only. A light meal 2 to 3 hours before is allowed for oral and Nitrous oxide. With local anesthesia you can eat normally.

If I see a Periodontist for cleaning, do I still need to see my regular dentist?

Yes. We encourage all of our patients to continue to see their dentist for regular check ups for decay and other tooth related dental concerns. Cleanings are also often shared so we provide cleanings on an alternating basis.

I think I need to see a Periodontist, what should I do? Should I see my dentist first?

If you are concerned with issues related to bleeding, recession, mobility or other periodontal problems, speak with your dentist and ask for a referral. Most dentists will gladly make a recommendation to a specialist.