scaling and root planing Archives - Atlanta Dental Implants

Periodontal Disease and Dental Implants

Posted on February 28, 2018 by AllSmiles.

Periodontal Disease and Dental Implants

Hi, My periodontist recently replaced one of my missing teeth with a dental implant. It had fallen out because I have periodontal disease that went untreated for many years. I was very happy about replacing the tooth, not only because it just looks much better, but because I felt it was the answer to my periodontal disease, at least for that tooth. I must have misunderstood something because I was surprised when he told me I could still get periodontal disease around that tooth. Somehow, I thought that the titanium implant would be impervious. Can you explain?

Deb in Atlanta

Hi Deb,

While the titanium root from of a dental implant may be less susceptible to the effects of untreated periodontal disease, you still need to continue periodontal maintenance to prevent losing the implant itself. Periodontal disease doesn’t just attack the tooth root, it undermines the soft tissues and jawbone that support the root, so even if the titanium were “impervious,” as you said, there would still be a need to address the periodontal disease.

If you have lost teeth to periodontal disease, you may already know that it is a chronic condition that is never really “cured.” It may have been disappointing to learn that your new tooth will not somehow be able to withstand the effects of gum disease, but with continued periodontal maintenance, the outcome will be much better than it would have been otherwise.

Take a look at these two diagrams. The first one shows the progression of periodontal disease from completely healthy tooth, gum, and bone structure on the left of the tooth to the more advanced stage where the soft tissues and the jawbone that surround the tooth root are undermined. Then look at the second diagram, which shows a dental implant surrounded by soft tissue and bone. The comparison should make it more clear why your new dental implant will need continuing periodontal maintenance. Even if the titanium root form were left completely untouched by the surrounding disease, it would eventually not have enough bone and soft tissue to support it.

Good luck to you in maintaining your dental health.

This Blog is brought to you by David Pumphrey of Pumphrey Periodontics of Atlanta.

What is periodontal maintenance?

Posted on February 13, 2018 by AllSmiles.

What is Periodontal Maintenance?

I recently had scaling and root planing performed by my periodontist, and now she wants me to come back four times a year for periodontal maintenance. I am a little concerned because I have always heard that you should go to the dentist for cleaning and maintenance twice a year. Why the extra maintenance?

Michael in Florida

Hi Michael,

It’s great that you got your periodontal disease treated with scaling and root planing, but it sounds like maybe your periodontist just didn’t provide enough information about the follow-up treatment. Periodontal maintenance is needed to keep your periodontal disease from returning. So let’s see if we can’t give you the reassurance you need to continue keeping your teeth healthy.

Periodontal disease is a chronic condition. There is no “cure” for it, but with proper treatment and continued maintenance, you can keep it from loosening your teeth and causing other health problems.

Scaling and root planing is usually performed to eradicate the current causes of the disease: these are pockets of bacteria that form under the gums that undermine the underlying structures that support the teeth. That is why this disease is so damaging. It breaks down the tooth itself as well as the soft tissues and bone that hold it in place.

Once scaling and root planing have removed the current sources of disease, it is imperative to maintain the new state of health. You can see in this illustration how plaque builds up and eventually begins to undermine the soft and bone tissues under the gums, where we can’t see what is going on. The left part of the tooth in this diagram shows healthy tooth, bone, and gum, and the right part shows what happens in periodontal disease.

Periodontal maintenance is a two-fold process with both at-home and in-office steps. The at-home steps involve effective hygiene. This means that you will need to be very careful about brushing and flossing every time you eat. Once you have periodontal disease, you can no longer afford to skip this step.

The corresponding in-office step is the maintenance cleanings your periodontist recommended. They need to be more frequent to prevent the disease from returning. In addition, these maintenance cleanings require that the hygienist have more training and skill, and you can expect that they will take longer as well.

Think of it this way: if you do all you can to keep up with your at-home hygiene and return regularly for your maintenance cleanings, you may never have to experience another scaling and root planing procedure or the more severe aspects of untreated periodontal disease.

Good luck to you in maintaining your dental and overall health with regular cleanings.

This Blog is brought to you by David Pumphrey of Pumphrey Periodontics in Atlanta.

Can the Pinhole Surgical Technique permanently reverse gum recession?

Posted on January 15, 2018 by AllSmiles.

Hi and thanks for your thoughtful postings. I was told I was a good candidate for pinhole gum surgery, but I am worried that the effects of the treatment will not be lasting. I want to treat my gum disease and recession permanently, and not have to come back over and over again.

Christopher, Atlanta, Georgia

Hello Christopher,

The Chao Pinhole Surgical Technique® can permanently treat gum recession. Furthermore, it can do so without the scalpels, sutures, and gum grafts that used to be necessary. Let’s first take a look at gum disease and its treatment. Then we can examine the role of the pinhole surgical technique in permanently treating gum recession.

Gum Disease Causes Gum Recession

It’s very important to understand the underlying causes of gum recession, because without proper treatment and maintenance, it will likely come back. Until you have resolved the periodontal or gum disease that causes gum recession, it is not a good idea to treat the recession itself.

Gum or periodontal disease is a chronic inflammatory disease that can be successfully treated but not cured. It begins with irritation of the gums by plaque that has not been removed with frequent brushing, flossing, and professional dental cleanings. The plaque hardens into tartar, and it irritates the gums, which can lead to infections, or simply progress unnoticed until it is very advanced.

In the early stages, the gums can become inflamed or infected, and as it progresses, the inflammation spreads to the bone structures that support the teeth, leading to gum recession and bone loss. The diagram on the right shows this progression from a healthy tooth with full gum and bone support on the left to a diseased tooth on the right where the gum has receded, along with the bone.

Treating Gum Disease First

The gum disease needs to be treated first. This can usually be accomplished with non-surgical gum treatment involving scaling and root planing. This procedure will remove the pockets of inflammation and infection and prepare the teeth for regular periodontal maintenance.

Periodontal maintenance requires that you return for professional periodontal check-ups and cleanings about four times a year. In addition, you will need to be rigorous in your dental hygiene, brushing and flossing after every meal to make sure that new plaque does not accumulate into tarter and start the cycle over again.

The Role of the Pinhole Surgical Technique

Once the underlying gum disease has been successfully treated and you are maintaining your dental health with regular periodontal visits and cleanings, the pinhole surgical technique, or PST, can offer a permanent solution to your gum recession.

In contrast to traditional gum surgery, where gum grafts were taken from your soft palate and surgically implanted over the exposed tooth roots, the PST uses a small pinhole opening in the gums along with special instruments to loosen and reposition the soft tissues over the teeth. The technique is much less time consuming, it requires much less time to heal, and patients are often amazed when they see how much more attractive their smiles are.

In finding a dentist or periodontist to help you alleviate the causes and symptoms of gum disease, don’t be afraid to ask a lot of questions and research different professionals. The PST is currently only taught by Dr. John Chao of California, the inventor of the technique, and your professional should be a certified pinhole technique practitioner.

Good luck to you in attaining the healthy, beautiful smile you deserve.

This Blog is brought to you by Dr. David Pumphrey of Pumphrey Periodontics in Atlanta, Georgia.

Can you cure Periodontal Disease?

Posted on December 30, 2017 by AllSmiles.

My dentist told me I have gum disease. He gave me a short explanation, but I don’t really understand. Can you cure periodontal disease?

Carol in Atlanta

Hi Carol,

Periodontal disease can be prevented and successfully treated. And while there is currently no “cure,” non-surgical gum treatment and professional periodontal maintenance can help you live without further damage or negative consequences.

Periodontal disease has many stages, and without knowing what stage you are in, it will be difficult to pinpoint you most need to know. But an overview of the progression of the disease and an explanation of current non-surgical treatment and periodontal maintenance should give you an idea of what you might expect.

In general, if you have periodontal disease, it’s a good idea to talk over treatment options with your dentist or to seek out a well-trained and experienced periodontist, who will have the qualifications and equipment to provide the most effective treatment.

Periodontal Disease

Long before periodontal disease causes any damage to our teeth and their surrounding structures, lack of basic dental hygiene like regular brushing and flossing can lead to gingivitis, or infection of the gums. This can easily be treated with a good, professional cleaning and follow-up care.

When plaque is allowed to stay on the teeth and build up, however, it hardens into tartar, which causes inflammation of the gums. The gums withdraw, compromising the tooth root and the surrounding bone structure, as shown in the diagram to the left.

At this point periodontal disease is well established, undermining the health of our teeth and possibly also contributing to other health conditions. At this level, it is called periodontitis, and if left untreated, it will eventually dissolve away so much of the surrounding soft tissue and bone structure that teeth will become loose and fall out. This condition is the reason most adults begin to lose teeth as they age.

Periodontal Treatment

Treatment for periodontitis usually begins with scaling and root planing, a procedure that used to involve surgical techniques and call for a long healing process. Non-surgical periodontal treatment uses advanced instruments like a perioscope and a dental laser. The perioscope is a high-tech camera that allows the periodontist to see the extent of inflammation and damage that has taken place below the gum line. And dental lasers now make it possible to remove damaged soft tissue and bone without surgery, using both heat and water for a painless procedure.

Periodontal Maintenance

Once the initial treatment has been accomplished, you will need to continue with ongoing periodontal maintenance. You will have to have professional periodontal cleanings more than just twice a year, and you’ll need to be much more vigilant with your regular brushing and flossing. But the good news is that once treated and with ongoing maintenance, you can enjoy a health smile for the rest of your life.

Good luck to you in finding the best treatment for your dental health.

This blog is brought to you by Dr. David Pumphrey of Pumphrey Periodontics in Atlanta.