Non-Surgical Treatments
Scaling and Root Planing
Dr. Collins stresses that periodontal health should be achieved in the least invasive and most cost-effective manner. This is often accomplished through non-surgical periodontal treatment, including scaling and root planing (a careful cleaning of the root surfaces to remove plaque and tartar from deep periodontal pockets and to smooth the tooth root to remove bacterial toxins). Dr. Collins often uses adjunctive therapy such as local delivery of antimicrobials, as needed with scaling and root planing.
After scaling and root planing, many patients do not require any further active treatment, including surgical therapy. However all patients will require ongoing maintenance therapy to sustain health. When non-surgical treatment does not adequately reduce the periodontal pocket depths and achieve periodontal health, surgery may be indicated to restore periodontal anatomy damaged by the infection and to improve access for cleaning.
Occlusal Guard Appliances
Often patients with periodontal disease experience a loosening of their teeth as a result of bone loss. Lose teeth often contribute to a clenching or grinding of the teeth. You should be aware of habits such as teeth grinding, which can put excess force on the supporting tissues of the teeth and speed up the rate at which these tissues are destroyed. Dr Collins may suggest an appliance for you to wear while sleeping if you grind your teeth at night. These appliances are known as occlusal guards or bite guards and are custom made to fit you and the way your teeth come together.
Surgical treatment
Pocket Depth Reduction
In severe cases of periodontal disease, Dr. Collins may recommend surgical pocket reduction. A pocket reduction procedure is indicated when remaining periodontal pockets are too deep to clean after scaling and root planing. During this procedure, Dr. Collins folds back the gum tissue and removes the disease-causing bacteria before securing the tissue into place. In some cases, the damaged bone is smoothed to limit areas where disease-causing bacteria can hide. This allows the gum tissue to better reattach to healthy bone and tooth. Reduced pockets and a combination of daily oral hygiene and professional maintenance care increase your chances of keeping your natural teeth – and decrease the chance of serious health problems associated with periodontal disease.
Crown Lengthening
When a tooth is broken or decay extends below the gumline, this area must be uncovered before it can be restored, for several reasons:
In order for the gum to heal against the tooth, there must be healthy tooth between the margin of a filling or crown and the crest of the bone which supports the tooth.
A tooth that is broken or decayed below the gumline is difficult, if not impossible, to restore since access and visibility are compromised. There may not be enough tooth left above the gumline to firmly hold a crown.
Even the best filling or crown will trap bacteria where it meets the tooth. If this area is below the gumline where you cannot properly clean it, the bacterial accumulation can result in both periodontal problems and new decay. A crown lengthening procedure reshapes the gum and bone to solve these problems.
CaseStudy: click here
Gingival Grafting
Teeth are surrounded by two types of tissue. The first is gingiva (gum), which is pink, thick and dense. It forms a tight seal around the tooth and is a barrier against the penetration of bacteria to underlying bone.
The other type of tissue, mucosa, found directly below the gingiva, is red, thin and loose or elastic. It does not seal tightly around the tooth. When gum recession occurs, the body loses a natural defense against both bacterial penetration and trauma. Some people have extremely thin gingiva and require grafting to prevent recession. A thin piece of tissue is taken from the roof of the mouth or moved over from adjacent areas to provide a stable band of dense gingiva around the tooth.
CaseStudy: click here
Frenectomy
The frenum is a flap of fibrous tissue that attaches your lip or tongue to your jaw bone. Sometimes it attaches too close to the teeth and can cause them to separate, or pull the gum away from the teeth. A minor surgical procedure is needed to either remove or reposition the frenum. This is called frenectomy, and is a simple procedure that is done in the office using local anesthesia.
Fiberotomy
There are thin fibers in the gum tissue that connect between the teeth and jawbone. After orthodontic treatment, these fibers can act like rubber bands, sometimes pulling the teeth back to their original position. A fiberotomy is a procedure to release these fibers. Fiberotomies are commonly performed toward the end of orthodontic treatment and help to preserve the results of straightening
Biopsy and Pathology Service
If Dr. Collins or your referring dentist detects a suspicious lesion in your mouth or on your radiograph, then a biopsy may be suggested to remove and/or identify the lesion. The biopsy itself is submitted to a pathology laboratory for identification and reports are then sent to your dentist or physician as needed.