Conservative Management of Periodontal Disease (Deep Cleaning)
Often times conservative deep cleaning, involving scaling and root planing, can significantly improve symptoms of bleeding diseased gums, bad breath and deep pockets. Administration of local anesthetic (freezing) increases patient comfort and procedural success. Adjunctive use of laser therapy may be beneficial in certain cases.
Surgical Management of Periodontal Disease
In cases where conservative management is not successful, more advanced procedures may be considered and can include pocket elimination or tissue regeneration. This may include bone grafting with autogenous (your own) or allogeneic or alloplastic (not your own) materials.
Any additional materials will be reviewed at the time of consultation should they be of benefit.
Bruxism/TMJD (Temporomandibular Joint Dysfunction)
Bruxism is a condition characterized by habitual grinding of the teeth. This parafunctional activity typically occurs when asleep and those affected are generally not aware of the habit. Bruxism is associated with periodontal disease, gingival recession, increased tooth mobility and facial/temporomandibular joint pain. A nightguard may be beneficial in select cases to address these concerns and in alleviating symptoms.
Soft Tissue Grafting
Gum recession is a very common problem. When root exposure occurs, it can be quite uncomfortable, causing root sensitivity. This can also lead to esthetic and functional impairment. Predisposing factors include genetics, vigorous tooth brushing, the use of abrasive toothpastes and mouthwashes, etc.
In certain cases, gum recession can be monitored. In other instances, gum grafting (mucogingival surgery) is required to restore the integrity of the tissues, and to improve esthetics, comfort and function. Tissue can be borrowed (usually from the palate) and relocated to the compromised site. Adherence to post-operative instructions facilitates a favorable recovery.
Implant Therapy
When tooth loss has occurred, or teeth are deemed unsalvageable, dental implants may be a viable option. Dental implants are essentially titanium screws that are surgically placed in the jaw bone to facilitate replacement of the lost tooth.
A patient’s suitability for implant therapy is determined at time of consultation. Co-ordination with the restorative dentist is critical to achieving optimal results. Dental implants can replace single or multiple missing teeth and can also be used to enhance retentiveness of complete dentures.
Oral Pathology
The oral cavity is a unique environment in which lesions may occasionally develop. These can originate from the mouth, or represent a manifestation of a systemic disease or as a consequence of prescription medication. In certain situations, biopsy may be indicated and the use of a laser may be of benefit.
Our office provides routine examinations for intraoral anomalies.
Management of Peri-implantitis
Dental implants, like teeth, require diligent homecare and regular professional maintenance. Smokers have a higher incidence of this condition.
Treatment protocols are similar to the management of periodontal disease which include conservative and/or surgical possibilities. In severe cases, the dental implant’s removal may be necessary. Pre-surgical screening and maintenance is critical to the long-term success of implant therapy.
Crown Lengthening
When a tooth is decayed, or broken below the gum line, crown lengthening is sometimes necessary to allow the restoring dentist to place a crown (cap) or filling to repair the defect. This involves exposing additional tooth surface so that the cap or filling is secure. Appointments must be coordinated with the referring dentist in order to optimize outcomes. Crown lengthening may also be applicable in cases of excess gingival display and when esthetics are a concern.
Sedation (Oral/Nitrous Oxide)
Dental appointments can generate anxiety for patients. Our practice offers oral sedation (in the form of prescription medication) as well as nitrous oxide sedation to help patients obtain a sense of comfort and relaxation throughout the course of procedures. Our main concern is your satisfaction and we aim to create very positive experience.
Sinus lift procedure (indirect/direct)
The maxillary sinus is an airspace in the facial region which articulates with the roots of the upper posterior teeth. Prior to implant therapy, it may be necessary to ‘bump’ the maxillary sinus in this region (upper molar/premolar area) if there is a lack of bone height. Sometimes, a bone graft will accompany this procedure to ensure an implant can be placed in a predictable fashion. Whether an implant can be placed concurrently will be determined by the quality of native bone present at the site, and whether good implant stability can be established.
Guided bone regeneration (bone grafting)
Bone grafting can be performed prior to definitive prosthetic work (tooth replacement). In some cases, we encounter areas that have been edentate (lacking a tooth) for an extended period. This causes the bone to remodel, and in some cases, present with deficient volume for implant therapy. Bone grafting is required to augment the ridge, and provide sufficient bone volume for implant placement.
Extraction/Socket preservation
Although it is preferable to maintain the natural dentition, teeth can also become non-restorable and require removal. Severe periodontal disease (amongst other conditions) can also lead to tooth loss. Socket preservation involves maintaining the socket integrity and local bone volume, as otherwise the ridge can shrink following tooth removal or tooth loss. When extracting a tooth, a bone graft can be performed to maintain the bone volume for subsequent treatment (including implant replacement).
Guided tissue regeneration (improves tooth support)
Periodontitis is a very common chronic disease, and its affects can worsen with age. Guided tissue regeneration is a procedure by which bone lost as a result of periodontal disease can be recovered through the use of biomaterials. Periodontitis can also expose molar furcations, making teeth susceptible to decay or the formation of abscesses/infections. GTR can help to re-establish a healthy environment, improving the prognosis of involved teeth and helping maintain them over time.