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Frederick, MD  21703

Periodontal Services

Arestin

Arestin: Fighting infection where it starts

You may have heard about gum disease, also known as “periodontitis” or “periodontal disease.” Maybe a dental professional or hygienist recently told you that you have this infection.

But do you really know the difference between periodontal disease and other types of complications that can affect your mouth, such as gingivitis?

Do you know why it’s so important to treat periodontal disease-and why brushing and flossing alone won’t do the trick?

Most importantly, did you know that periodontal disease is today’s #1 cause of tooth loss among American adults? Or that, although a causal relationship between periodontal disease and an elevated risk for systemic events has not been established,recent data suggest a possible association between periodontal disease and other health issues including cardiovascular disease, diabetes, and preterm low birth-weight babies?

Fight infection right where it starts
ARESTIN® (minocycline hydrochloride) Microspheres, 1 mg is an effective antibiotic treatment that comes in powder form. This powder is placed inside infected periodontal pockets just after the dental professional finishes the scaling and root planning (SRP) procedure.

Canine Exposure for Orthodontics

Canine exposure has nothing to do with leaving your dog outside, exposed to the elements. It is a procedure to expose impacted teeth. An impacted tooth is one that has not erupted in the mouth, but instead becomes stuck in the surrounding bone or tissue. Any tooth may become impacted, but generally, the wisdom teeth and canine teeth are the most likely candidates. Canine teeth are critical for function. The mouth will also appear aesthetically odd without the canines. The procedure is quite simple. It involves the dentist cutting a small hole in the gum, which allows the tooth to erupt. The dentist also uses a dental brace to guide the tooth into its correct position.

Impacted teeth are sometimes obvious to the naked eye, but in some instances, an –x-ray is necessary to identify the extent of the impaction. Many times, there is an impacted canine tooth where the baby tooth remains in the mouth. A loose tooth is also a sign that an impacted tooth may be present.

Biopsy

Throughout the medical field, a biopsy is simply the removal of a tissue sample to determine if it is diseases. In dentistry, teeth and gums are sent for biopsy. The role of a biopsy in the dental industry is to diagnose oral cancer. In these instances, a brush biopsy is used to identify oral lesions that warrant further attention.

If you have unexplained lesions in your mouth, they need to be examined by a dentist. They may or may not be cancerous, but they need medical attention nonetheless.

Bone Grafting
Bone grafting is where the jawbone is built up to accommodate a dental implant or other restorative device. Bone grafting is a common procedure that is used frequently for dental implants and other periodontal procedures. The bone used to graft is taken from a sample from the patient. Many times, the bone is taken from another area of the mouth when drilling takes place. The bone fragments are suctioned from the mouth and used for the graft. Cadaver bone fragments are also used. They are harvested by bone banks and are a very safe source for bone donation.
Crown Lengthening

It is no secret that dentists are committed to saving teeth. This is why we fill a cavity, instead of pulling the tooth.

Cavities can decay to tooth to the point where restoration is virtually impossible without a procedure called crown lengthening. Crown lengthening is a routine surgical procedure, which remodels the contour of the gum line. The procedure does not actually lengthen the crown, but rather lowers the gum line. When there is not enough tooth structure to affix a crown, this is the only option. Sometimes a tooth has been broken below the gum line. In this instance, crown lengthening is very successful in exposing more of the tooth, so that the dentist has something to work with.

Frenectomy

A frenulum is a piece of tissue that prevents an organ from moving. There is a frenulum that attaches your upper lip to the gums, while another connects the lower lip to the gums. A frenulum that is too short or thick, will cause problems in speech patterns and tooth misalignment. In infants, a shortened frenulum underneath the tongue will inhibit breastfeeding. When the frenulum disrupts movement, growth, or development, corrective action is necessary to resolve the situation.

A frenectomy is a minor surgical procedure that is performed in your dentist’s office. It can be performed with either a scalpel or laser and takes less than 15 minutes. Using a laser causes very little bleeding and does not require stitches. A laser also results in less postoperative discomfort and a shorter healing time. Young children and infants are put under general anesthesia for the procedure and adults have the procedure performed using local anesthesia. If your child needs a frenectomy, there is nothing to worry about. The procedure is very successful and causes minimal discomfort.

Gingival/Gum Grafting

Gingivitis and in its advanced state, periodontitis, has a profound effect on the gums. As gingivitis progresses, more and more bacteria and plaque builds up, causing the gums to stretch. The end result it large pockets, that once they are cleaned out, remain on your gum line. These pockets cause the gums to recede, which aesthetically not pleasing to the eye. When the gums recede, an abnormal amount of tooth structure is exposed.
Gum grafting is the corrective procedure that restores the gum to its natural, healthy state. Using soft gum tissue from the roof of the mouth, the receded gums are grafted. The goal if the graft is to cover exposed tooth and root surfaces with grafted on oral tissue. This grafting encourages new tissue growth that will enable the gums to return to its original position around the teeth. The procedure is routine and entails a minimal amount of downtime and discomfort.

Periodontal (gum) disease

Periodontal (gum) disease is insidious. It is an infection of the gums that starts out as plaque, an opaque film on the teeth that hardens to form tartar. As tartar accumulates, it harbors bacteria that attack the soft tissue around the gums. This is the early stage of gum disease known as Gingivitis. Left untreated, Gingivitis becomes Periodontitis which ultimately destroys the tissue surrounding your teeth AND the bone that holds your teeth in place. Except for bad breath and gums that bleed, there are very few early warning signals. The disease advances silently, often without pain, and before you know it, you are losing your teeth and you don’t know why.

Tooth loss is only the most obvious indicator of gum disease. Scientific research has discovered linkage between gum disease and stroke, heart disease, diabetes – even an increased risk for pregnant women. When your gums become diseased, your entire immune system is weakened.

In the past, fear of painful dental surgery has kept people with gum disease from seeking the care they needed. Well, those days are gone forever.

Periodontal Splinting (Weak Teeth)

Loose teeth are uncomfortable, especially when you try to eat food or chew gum. The feeling of the tooth pulling away from the gum is enough to send chills down your spine. It seems like an eternity, waiting for either the tooth to become loose enough to be extracted or strong enough to no longer be a problem.

Teeth become loose because of lost gum tissue, injury, orthodontic treatment, or pressure caused by tooth misalignment. A new technique called periodontal splinting attaches weak teeth together, turning them into a single unit that is stable and stronger than the single teeth by themselves. The procedure is most commonly performed on the front teeth. The procedure is as simple as using composite material to attach, or splint, the loose teeth to the adjoining stable teeth. Tooth splinting is a common procedure that has gained popularity due to its effectiveness.
Life is too short to live with loose teeth.

Osseous Surgery/Pocket Reduction

Sometimes the effects of periodontal disease create permanent changes in the tooth and gum structure that will cause issues in the future. Enlarged gum pockets between the tooth and the gum line are common after having advanced gum disease. Sometimes these gaps are cosmetic in nature, and affect the appearance of the gums. More commonly, the gaps put the teeth at future risk for tooth and gum disease, as they are just one more place that plaque and bacteria can collect. Pocket reduction surgery is designed to thwart the after effects of periodontal disease and restore your mouth to a healthy state.

The goal of periodontal surgery to gain access to the tooth root and to clean the damaged areas. Once the dentist can visually see the damage, it can be removed completely. Removing the plaque and decayed gum tissue leaves a pocket between the gum and the tooth. Sometimes the gum returns to its original position, but still the pocket is present. The pocket requires more frequent cleanings as the patient is unable to get to the pockets with regular brushing and flossing. Once the swelling from the periodontal treatment has subsided, the dentist may need to suture the gum to where the bone has resorbed. The goal is to create a space large enough so it can be reached through daily oral hygiene, but small enough that it is not a breeding ground for plaque and bacteria.

Cosmetic Periodontal Surgery

Your smile is the first thing someone notices about you. People form their first impressions based on the appearance of your smile. There was a time when, unless you made a lot of money or were born with perfect teeth, you had to live with your smile. Today, a wide range of cosmetic procedures is available to the average citizen, at a cost they can afford. If you have a gummy smile, uneven gum line or elongated teeth, cosmetic periodontal surgery is for you.

Cosmetic periodontal surgery sculpts the gum line so that it is even and in proportion to the amount of exposed tooth versus gum. This procedure removes the excess gum and exposes more of the tooth crown. If your gums have receded, and your teeth appear overly long, then soft tissue grafts can extend the gum line to create an aesthetic balance. The grafts also reduce the gum pockets that are prone to future periodontal disease.

If you are unhappy with your smile, give us a call to discuss your options. After all, you only have one chance to make a first impression.

Osseous Grafting/Guided Tissue Regeneration
Osseous surgery is a procedure that reshapes the bone which holds your teeth in place. Osseous surgery commonly treats periodontitis. Patients with periodontitis experience defects in the bone around their teeth. The osseous surgery removes those defects. Prior to the surgery, the patient undergoes a periodontal treatment that consists or scaling and root planning. A local anesthetic is administered to minimize the pain. Once the roots are cleaned, the dentist uses a drill and sharp dental tool to reshape the bone surrounding the teeth. Depending on the extent of the defects, the deformed bone is removed, and the rest is shaped. Bone grafting material is used where the defects are too large to be treated with only reshaping. Once the bones are back to their original state, the gums are stitched back into place. Osseous Grafting is a routine procedure, with a high success rate.
Post-Op Instructions
It is important to follow instructions after you have oral surgery to ensure proper healing and to avoid complications. As a rule of thumb, you should always wait two hours after surgery before eating to let the anesthesia wear off. Trying to eat before this could result in soft tissue damage because you are not able to feel all of your mouth. The instructions found below are guidelines. After your surgery the doctor or dental assistant will give you full instructions on how to properly recover from surgery.
Scaling and Root Planning
After this procedure your gums will probably be slightly sore and irritated for a few days. You should rinse your mouth with warm salt water (1 tsp salt/8 oz water) 2-3 times a day. This will relieve the pain and cleanse the area. Brushing and flossing should be continued right after the procedure, but you should brush gently so that you do not further irritate the area. If you experience any swelling or stiffness in the area you can place a cold compress on the area and take some pain relieving medicine. Avoid any hard or chewy foods for 2-3 days after the surgery to ensure the area heals correctly. If you continue to experience pain or swelling after a few days contact your dentist.
Occlusal Adjustment

Do you wake in the morning with sore jaws?

When you bite, do you feel like your jaw is lopsided? If so, then you may need an occlusal adjustment.

An occlusal adjustment corrects the alignment of the bite, that is a result of loose, shifting, crowded, or missing teeth. The result is an evenly distributed bite that eliminates irregular pressure on one side of the mouth. Once your bite is adjusted, your teeth will meet properly. Occlusal adjustment causes minimal pain, and only a little discomfort. The adjustment is made by using a dental drill using a fine filing stone. In addition to the actual adjustment, removal mouthpieces are also utilized, to protect the tooth surface, and relax the jaw muscles once the adjustment is completed.

Who is a good candidate for an occlusal adjustment? Patients with loose or shifting teeth will many times not meet correctly. Patients, who grind or clench their teeth, will have an uneven bite and pressure distribution in the mouth, which is also corrected through an occlusal adjustment. Sometimes tooth sensitivity can be corrected through an occlusal adjustment as the treatment reduces pressure on the sensitive tooth.

New technology allows dentists to accurately identify the areas, which need adjustments. The dentist utilizes a computer scan of the mouth, which records hundreds of bite registrations per minute, and notes even the slightest irregularity. That data allows the dentist to make only the adjustments that are absolutely necessary, which ensures a well aligned bite and minimal tooth wear.

If you suspect that you may need an occlusal adjustment, schedule an appointment.

Soft Tissue Graft

A soft tissue graft is used when there has been a significant amount of gum recession in a particular area. Slight gum recession can usually be fixed with a few changes to your oral hygiene routine to take better care of your teeth and gums. When they gingiva recedes further it exposes you to greater risk for infection and bacterial penetration. You will likely be more sensitive to hot and cold foods when you have receding gums. If the gums recede enough as to expose the root you can set yourself up for more serious problems. The root is softer than the enamel making it more vulnerable to bacteria and plaque.

To restore proper gum level and functionality a soft tissue graft can be performed. This done by either removing soft tissue from the roof of the mouth, or repositioning healthy gum tissue from adjacent teeth. This procedure is very predictable and has a high success rate. This procedure should be performed before more serious problems develop and periodontal surgery is necessary.

Scaling & Root Planning

Gingivitis is a generative disease that left untreated, will cause significant tooth and gum deterioration. Just the word gingivitis can strike panic in a patient’s mind. The reality is that the treatment is simple and performed right in your dentist’s office.

Plaque and tarter that sits on the teeth provides an environment, which allows bacteria to thrive and multiply. The bacteria cause the gums to become inflamed and bleed. The condition becomes more noticeable when you brush your teeth or sometimes when you eat. These are signs of the early stage of gingivitis. Gingivitis is easily treated by having the hygienist scaling and polishing the teeth. If gingivitis is left untreated, the condition will progress and the roots will need a planning. The difference between scaling and root planning is simple. Scaling is the removal of the dental tartar from the tooth surface Root planning is the process of smoothening the root surfaces and removing the infected tooth structure.

As a non-surgical procedure, scaling and planning is performed without any anesthesia, in the dentist’s office. While the procedure is usually painless, advanced stages of gingivitis may make it necessary to numb the area for complete comfort. Deep scaling and root planning is usually broken down into one section of the mouth per appointment. This allows for adequate healing time, and reduces the time for each appointment.

Cosmetic & Restorative

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20 Mountaingate Dr
Frederick, MD 21703

Phone: 301-662-0100

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