Sometimes our gums become thin and weak due to lack of attached tissues. When this occurs, the area is more susceptible to bacterial penetration and trauma. If bacteria and trauma attack the area, it further causes a condition called gum recession.
Risk Factors for Recession:
- Toothbrush abrasion
- Biting overload (grinding or clenching)
- Supporting teeth for bridges or partial dentures with thin tissues
- Orthodontic therapy
- Exposed tooth roots
- Ill-fitting restorations under the gum line
When there is only minor recession, some healthy gingiva often remains and protects the tooth so no treatment is necessary. However, gum recession often results in root sensitivity to hot and cold foods as well as a "long in the tooth" appearance to the smile. Also, gum recession, when significant, can predispose the area to decay, as the root surface is softer than enamel. When these are factors that affect your gums, often treatment is necessary to keep those teeth in a healthy condition.
Fortunately, there are gum reconstruction procedures referred to as gum or gingival grafting. A gingival graft is a thin piece of tissue, which is usually harvested from the roof of the mouth or moved from adjacent areas and attached to the affected area to provide a stable band of tissue around the tooth. In a few weeks, the new tissue attaches to the existing tissue, which becomes almost undetectable to you and functions just as the gingival tissue that you had previously lost. The result is a healthier and more esthetically pleasing smile that lasts for the rest of your life.
When decay occurs below the gum line or if a tooth exhibits significant breakdown, your dentist will have trouble getting a crown stay on your tooth. If this is the case, your dentist may ask for a crown lengthening procedure before he or she makes a new crown for your tooth. A crown lengthening procedure is one which purposely exposes more of the tooth by reshaping the gum and/or supporting bone allows your general dentist adequate room to place a quality final restoration.
Also, esthetic crown lengthening may be done to facilitate a crown or veneer. Oftentimes it is indicated when the patient has a "gummy smile" with short looking teeth or when the gum line is uneven. Often times orthodontics and/or cosmetic dentistry are utilized in addition to esthetic crown lengthening surgery to attain a more ideal result.
See the American Academy of Periodontology for more information -- Crown Lengthening.
n cases where significant bony changes have accompanied periodontal disease or where pockets remain even after scaling and root planing, periodontal surgery is done to eliminate the remaining pathology. Periodontal surgery involves reflecting (folding back) the gum line to create access to adequately treat the root surfaces and the supporting bone. During periodontal surgery, certain regenerative procedures such as bone grafts and or biotechnology products may be used to enhance results. The ultimate goal is to leave the area with only healthy tissue, reduce pockets for a more maintainable situation, and to replace what nature has remove by disease. Periodontal surgery is typically done under local anesthesia and conscious sedation.
See the American Academy of Periodontology for more information -- Gum surgery
Over a period of time, the jawbone associated with missing teeth deteriorates or atrophies. This often leaves a condition in which there is poor quality and quantity of bone making placement of dental implants much more difficult. In these situations, most patients are not candidates for placement of dental implants. We now have the ability to grow bone where needed using bone grafts and biotechnology products. This not only gives us the opportunity to place implants of proper length and width, it also gives us a chance to restore the esthetic appearance and functionality better.
See the American Academy of Periodontology for more information -- Bone regeneration
Periodontal disease results in deep pockets and bone loss around the teeth. The bone can develop funnel-shaped defects (infrabony defects) that can be treated with bone grafts to stimulate bone regeneration and attachment. Regenerative procedures such as bone grafts can be done in conjunction with periodontal surgery and often times involves the placement of a membrane, which is used to cover the bone graft and prevent the gum tissue from interfering with bone healing. Recent advances in periodontal regeneration have produced biotechnology products that stimulate the body’s ability to regenerate lost periodontal structures.
Our philosophy is to administer the least amount of medications to COMFORTABLY perform the necessary procedures. This may be as little as local anesthesia only, to nitrous oxide (also known as "laughing gas"), to oral sedation (i.e. valium type sedative), to conscious sedation. Conscious sedation is performed by delivering sedative medications through an IV. We do not allow a patient to be sedated at the level of general anesthesia in an outpatient setting in our office. The purpose of sedation is to allow your treatment in a relaxed anxiety free state that is comfortable for you. If you have any sedation other than nitrous oxide, it will be necessary for you to have a responsible adult bring you to the office and back home, To insure your comfort and safety, Dr. Low has been an examiner for the California Dental Board that certifies the other offices for sedation since the inception of this requirement in 1991.