Periodontal diseases (gum diseases) are diseases caused by bacteria. This infectious process results in destruction to tooth-supporting tissues, including the gums and the bone around the teeth. If left untreated, gum diseases will result in tooth loss.
In its most common form, gum disease affects patients in their 4-5th decade. It is one of the most common infectious diseases with over 90% of adults affected. Rare forms can affect young patients, as early as in teenage years.
The main cause of periodontal disease is the bacterial biofilm (plaque). When not properly removed, plaque (and calculus) will cause Gingivitis - a painless and completely reversible inflammatory process which may cause swollen and red gums, bleeding when brushing or even spontaneous bleeding, or bad breath (Halitosis).
Periodontitis is a more advanced disease, which involves bone loss around the affected teeth. In addition to the inflammatory symptoms described for gingivitis (that may be more severe), patients may also notice temperature sensitivity, receding gums, larger spaces between teeth, tooth mobility, and some discomfort. Unfortunately, in most cases, early symptoms are mild, and patients are not aware of the presence and progression of the disease until acute symptoms and/or severe tooth mobility occur. Therefore, regular dental care is key for early diagnosis and to initiate treatment before significant tissue destruction.
Following a full periodontal examination (both clinical and radiographic exams) and based on your diagnosis, periodontal treatment will be prescribed.
Initial treatment (Phase 1) includes specific oral hygiene instructions and scaling and root planing (dental cleaning). This may be completed with or without dental anaesthesia (freezing) depending on the severity of the disease.
4-6 weeks later, a re-evaluation examination will be performed. We will repeat all periodontal measurements (similar to initial exam). This will allow us to assess the response to Phase 1 treatment and determine the need for further treatment (repeat of non-surgical treatment, surgical treatment, or maintenance treatment).
Systemic or local antibiotics may be prescribed at any time based on the clinical findings and treatment goals.
As with all periodontal surgeries, the goal of resective surgery is to create a healthier periodontal environment following the damage (i.e. bone loss) caused by Periodontitis (gum disease).
During the surgery, we will retract the gum tissue in order to gain direct access to the diseased site. We will then remove all infected and excess gum tissue, and create a uniform outline of the bone and the overlying gingival (gum) tissue. This will result in reduced pocket depth and improve gingival health.
Although resective surgeries help to restore gingival health and help in long-term tooth maintenance, they are usually characterized by further tissue reduction, resulting in longer teeth and increased spaces between teeth.
A dental implant is a screw-like device that replaces the tooth root. Its goal is to support a prosthetic device which will replace missing teeth (Implant-supported crown; Implant-supported bridge; Implant-supported denture).
Dental implants are made of titanium alloy. Once the implant is inserted into the jawbone the titanium allows for bone growth around the implant, resulting in direct bone-implant contact. It is important to remember that implants, just like any other dental restoration, have an expected lifespan.
The surgical procedure is simple and completed under local anaesthesia. During the procedure, the supporting bone is exposed and prepared for implant insertion. Once the site is deep and wide enough, the implant is inserted into the prepped site.
Depending on the clinical findings, we may choose to allow the implant to heal under the gums (submerged). In which case, a second, minimal procedure will be completed to expose the implant 3-6 months after implant insertion. In other cases, we can keep the implant exposed through the gums, in which case a titanium healing abutment will be placed over the implant. In any case, a 3-6 month healing period is required before the prosthetic device can be fabricated and inserted.