Laser Periodontal Therapy (LANAP/LAPIP)
Over 50% of American adults have gum disease and yet it isn’t widely talked about. Patients suffering from gum disease often feel less confident and fear losing their teeth. Our office is certified in a unique laser gum disease treatment, the LANAP protocol (a patented periodontal treatment, cleared by the FDA in 2004).
The LANAP protocol is a laser-based treatment that involves no cutting and suturing. The protocol uses a specific wavelength PerioLase® MVP-7™ dental laser to vaporize bacteria deep within the pockets of the gums while leaving healthy tissue intact. Patients typically report less pain and discomfort during and after the procedure, compared to traditional periodontal surgery
Faster Healing: LANAP® is minimally invasive and allows the body to recover and heal more quickly.
Less Discomfort: Patients report less discomfort during and after surgery.
Minimal Recovery Time: Most patients can immediately return to their daily routine.
Little to No Gum Recession: Because the procedure doesn’t require cutting the gums, there is less risk of recession and your beautiful smile is maintained.
Reduction in Gum Inflammation and Bleeding: The PerioLase® MVP-7™ targets inflammatory bacteria without injuring healthy tissue.
Saves Teeth: Patients can keep their natural teeth sometimes even when the teeth have been deemed ‘hopeless’ with traditional treatments. Keeping your natural teeth has been linked to a longer lifespan!
Safe for patients with Health Concerns: LANAP® protocol is safe for patients with health concerns such as diabetes, HIV, hemophilia, or those taking medications such as Plavix or aspirin.
Gum Disease Treatment
If you’ve recently been diagnosed with periodontal disease, you probably have some questions about your treatment. Be assured that periodontists believe that periodontal therapy, including non-surgical treatment, should be achieved in the least invasive and most cost-effective way possible.
Remember that the first step toward good periodontal health begins with proper oral hygiene, which can go a long way toward preventing certain forms of periodontal disease and reversing gingivitis, an early stage of periodontal disease. Good oral hygiene includes brushing your teeth at least twice each day, flossing at least once each day, and seeing a periodontist annually for a comprehensive periodontal evaluation. If you are diagnosed with periodontal disease, common treatments include the following:
Deep Cleaning/Scaling and Root Planing
A deep cleaning, also known as scaling and root planing, is a non-invasive measure of preventing the progression of periodontal disease. A deep cleaning goes beneath the gum line to remove plaque, bacteria, and other toxins from areas that brushing and flossing cannot reach, reducing the risk of disease advancement. A routine cleaning does not require the dentist or hygienist to go below the gum line; therefore, the procedure does not eliminate the cause of disease if it is present.
Oral antibiotics as well as anti-microbial mouth rinses can be prescribed short-term to control bacteria and treat acute periodontal infection. Other medicinal treatments include antibiotic gels, slow-release antiseptic chips, microspheres, and enzyme suppressants used after scaling and root planing procedures.
If inflammation and deep pockets are present after deep cleaning and medication, a periodontist may perform flap surgery to minimize the depth of the pocket. The surgery consists of plaque removal below the gum line and then closure of the gums so that they fit snugly against the tooth. A bone and tissue graft procedure helps to regenerate any tissue or bone lost to periodontal disease through the placement of natural or synthetic bone material to promote bone growth. A soft tissue graft uses synthetic material or tissue from the mouth to cover tooth roots that have been exposed.
After a period of healing, your periodontist will evaluate your condition to determine if further treatment is necessary. If additional treatment is required, your periodontist will develop a treatment plan to help restore your smile to a state of health. If you don’t require further treatment, you’ll enter a maintenance phase, and thorough checkups on your teeth and gums will occur every few months or so.
Periodontal procedures are available to stop further dental problems and gum recession, and/or to improve the esthetics of your gum line.
Exposed tooth roots are the result of gum recession. Perhaps you wish to enhance your smile by covering one or more of these roots that make your teeth appear too long. Or, maybe you’re not bothered by the appearance of these areas, but you cringe because the exposed roots are sensitive to hot or cold foods and liquids.
Your gums may have receded for a variety of reasons, including aggressive tooth brushing, periodontal disease, or clenching/grinding your teeth. You may not be in control of what caused the recession, but prior to treatment your periodontist will help you identify the factors contributing to the problem. Once these contributing factors are controlled, a soft tissue graft procedure will repair the defect and help to prevent additional recession and bone loss.
Soft tissue grafts can be used to cover roots or develop gum tissue which is absent due to excessive gingival recession. During this procedure, your periodontist takes gum tissue from your palate or another donor source to cover the exposed root. This can be done for one tooth or several teeth to even your gum line and reduce sensitivity.
Benefits of this procedure?
A soft tissue graft can reduce further recession and bone loss. In some cases, it can cover exposed roots to protect them from decay; this may reduce tooth sensitivity and improve esthetics of your smile. A beautiful new smile and improved periodontal health – your keys to smiling, eating and speaking with comfort and confidence.
American Dental Association suggests teeth are usually removed due to trauma, disease or crowding. When a tooth cannot be repaired with a filling or a crown because of an accident or extensive decay, an extraction may be your best recourse. Teeth that aren’t reinforced by enough bone due to periodontal disease are also candidates for removal. Infected (abscessed) teeth that don’t respond to root canal treatment may need to be taken out, as well. Although it sounds complicated, a tooth extraction is a routine and the recovery process is usually equally simple.
Following a dental extraction, your periodontist will have a very specific set of instructions for caring for the extraction site in the hours and days following the tooth removal. Depending on the type of tooth extraction performed, the periodontist may also prescribe medication to help relieve pain for the first few days following the procedure. So long as the extraction site is kept clean and patients follow the instructions for care, the gums should heal in a matter of weeks without complication or infection.
Missing teeth can cause the jawbone to shrink overtime by the body. Bone grafting while removing a tooth is designed to preserve the natural bone contours. If a tooth has been missing for an extended period, we may recommend a bone graft to strengthen the jaw. Dental Implants require adequate bone density and volume for successful implant placement. As bone naturally resorbs, teeth can migrate and shift around in the mouth changing your bite over time. If you have been told that you do not have enough bone for implants, Tulips Periodontics & Dental Implants can help.
In order to place implants, it is necessary to rebuild the bone width and height through regenerative surgical therapy. Bone grafting of the ridge is frequently required to enable ideal placement of dental implants. The grafting is completed utilizing tissue bank and/or synthetic bone particles combined with collagen or non resorbing membranes.
Socket preservation is a type of graft that is performed immediately following a tooth extraction. Bone grafting material is placed directly in the tooth socket. The area is left to heal for 3-4 months. During that time, the body rebuilds bone where the graft is placed and new gum tissue grows over it. Once the bone and gum is healed, a dental implant can be placed in a solid foundation with healthy gum support around it.
A dental implant is an artificial tooth root placed into the jaw to hold a replacement tooth. Dental implants look and feel like natural teeth, and with proper care, they can be a long-term solution to tooth replacement.
Advantages of Dental Implants
Appearance: The replacement teeth that dental implants are built to hold will appear identical to your surrounding teeth. No one will know you have a replacement tooth.
Reliability: The success rates of dental implants are highly predictable. When placed by a periodontist and with diligent at-home maintenance, a dental implant can last for many years.
Confidence: Because they are secured into the jaw, dental implants function like natural teeth, allowing you to confidently smile, speak, and eat.
Comfort: Dental implants fuse into your jawbone, becoming permanent. Unlike dentures, they will stay comfortably in place and do not require messy adhesives.
Because the adjacent teeth are not affected by dental implants, your long-term oral health is not compromised.
Dental Implant Treatment
Your periodontist, in collaboration with your general dentist, will develop a treatment plan unique to your specific needs. The dental implant, often a small titanium post, is first placed into the jawbone where the missing tooth is. Your jawbone will grow around the dental implant through a process called osseointegration. Once the jawbone has fused with the dental implant, an abutment, which attaches to the replacement tooth, will be placed. Typically, the replacement tooth is affixed by a general or restorative dentist. The entire dental implant process—including extraction, integration of the implant, and periods of healing—can take up to several months depending on your treatment plan.
Dental Implant Care
Because dental implants look and function like natural teeth, they require the same care. The American Academy of Periodontology (AAP) recommends brushing twice a day, flossing at least once a day, and receiving regular check-ups including an annual comprehensive periodontal evaluation.
A key to implant success is the quantity and quality of the bone where the implant is to be placed. The upper back jaw has traditionally been one of the most difficult areas to successfully place dental implants due to insufficient bone quantity and quality and the close proximity to the sinus. If you've lost bone in that area due to reasons such as periodontal disease or tooth loss, you may be left without enough bone to place implants.
Sinus lift surgery can help correct this problem by raising the sinus floor and developing bone for the placement of dental implants. Several techniques can be used to raise the sinus and allow for new bone to form. In one common technique, an incision is made to expose the bone. Then a small circle is cut into the bone. This bony piece is lifted into the sinus cavity, much like a trap door, and the space underneath is filled with bone graft material. Your periodontist can explain your options for graft materials, which can regenerate lost bone and tissue.
Finally, the incision is closed and healing is allowed to take place. Depending on your individual needs, the bone usually will be allowed to develop for about four to 12 months before implants can be placed. After the implants are placed, an additional healing period is required. In some cases, the implant can be placed at the same time the sinus is augmented.
Undergoing sinus lift surgery has been shown to greatly increase your chances for successful implants that can last for years to come. Many patients experience minimal discomfort during this procedure.
If you are missing all of your teeth, an implant-supported full bridge or full denture can replace them. Dental implants will replace both your lost natural teeth and some of the roots.
What are the advantages of implant-supported full bridges and implant-supported dentures over conventional dentures?
Dental implants provide several advantages over other teeth replacement options. In addition to looking and functioning like natural teeth, implant-supported full bridges or dentures are designed to be long lasting. Implant-supported full bridges and dentures also are more comfortable and stable than conventional dentures, allowing you to retain a more natural biting and chewing capacity.
In addition, because implant-supported full bridges and dentures will replace some of your tooth roots, your bone is better preserved. With conventional dentures, the bone that previously surrounded the tooth roots begins to resorb (deteriorate). Dental implants integrate with your jawbone, helping to keep the bone healthy and intact.
In the long term, implants can be more esthetic and easier to maintain than conventional dentures. The loss of bone that accompanies conventional dentures leads to recession of the jawbone and a collapsed, unattractive smile. Conventional dentures make it difficult to eat certain foods.
How will the implants be placed?
First, implants, which looks like screws or cylinders, are placed into your jaw. Then, over the next two to six months, the implants and the bone are allowed to bond together to form anchors for your artificial teeth. During this time, a temporary teeth replacement option can be worn over the implant sites
Often, a second step of the procedure is necessary to uncover the implants and attach extensions. These temporary healing caps, along with various connecting devices that allow multiple crowns to attach to the implants, complete the foundation on which your new teeth will be placed. Your gums will be allowed to heal for a couple of weeks following this procedure.
There are some implant systems (one-stage) that do not require this second step. These systems use an implant which already has the extension piece attached. Your periodontist will advise you on which system is best for you.
Depending upon the number of implants placed, the connecting device that will hold your new teeth can be tightened down on the implant, or it may be a clipped to a bar or a round ball anchor to which a denture snaps on and off.
Finally, full bridges or full dentures will be created for you and attached to small metal posts, called abutments, or the connecting device. After a short time, you will experience restored confidence in your smile and your ability to chew and speak.
Every case is different, and some of these steps can be combined when conditions permit. Your dental professional will work with you to determine the best treatment plan.
Your bone and gum tissue should fit snugly around your teeth like a turtleneck around your neck. When you have periodontal disease, this supporting tissue and bone is destroyed, forming "pockets" around the teeth.
Over time, these pockets become deeper, providing a larger space for bacteria to live. As bacteria develop around the teeth, they can accumulate and advance under the gum tissue. These deep pockets collect even more bacteria, resulting in further bone and tissue loss. Eventually, if too much bone is lost, the teeth will need to be extracted.
Your periodontist has measured the depth of your pocket(s). A periodontal pocket reduction procedure has been recommended because you have pockets that are too deep to clean with daily at-home oral hygiene and a professional care routine.
During this procedure, your periodontist folds back the gum tissue and removes the disease-causing bacteria before securing the tissue into place. In some cases, irregular surfaces of the damaged bone are smoothed to limit areas where disease-causing bacteria can hide. This allows the gum tissue to better reattach to healthy bone.
Reducing pocket depth and eliminating existing bacteria are important to prevent damage caused by the progression of periodontal disease and to help you maintain a healthy smile. Eliminating bacteria alone may not be sufficient to prevent disease recurrence. Deeper pockets are more difficult for you and your dental care professional to clean, so it's important for you to reduce them. Reduced pockets and a combination of daily oral hygiene and professional maintenance care increase your chances of keeping your natural teeth – and decrease the chance of serious health problems associated with periodontal disease.
You may have asked your periodontist about procedures to improve a "gummy" smile because your teeth appear short. Your teeth may actually be the proper lengths, but they're covered with too much gum tissue. To correct this, your periodontist performs a dental crown lengthening procedure.
Before Dental Crown Lengthening Procedure
After Dental Crown Lengthening Procedure
During the dental crown lengthening procedure, excess gum and bone tissue is reshaped to expose more of the natural tooth. This can be done to one tooth, to even your gum line, or to several teeth to expose a natural, broad smile.
Your dentist or periodontist may also recommend dental crown lengthening to make a restorative or cosmetic dental procedure possible. Perhaps your tooth is decayed, broken below the gum line, or has insufficient tooth structure for a restoration, such as a crown or bridge. Crown lengthening adjusts the gum and bone level to expose more of the tooth so it can be restored.
A frenectomy is a surgical procedure that removes or loosens a band of muscle tissue that is connected to the lip, cheek or floor of the mouth. It is usually performed under local anesthetic with uneventful healing.
There are times where the frenum is attached between the two upper front teeth. In order to remove it, a procedure called a labial frenectomy is performed. This condition is usually seen in children after their permanent upper front teeth have erupted in their mouths. It may also be seen earlier. Sometimes it can be spotted before the baby teeth have come in. If the tissue is attached too far down on the gum then space may be created between the two front teeth. Even if an orthodontist closes this gap, the frenum can still push the teeth apart once more. The frenum can also be attached in such a way that the baby teeth cannot erupt into the mouth. If this is the case, then you will notice the abnormal frenum sooner.
Adults who are getting dentures may need a frenectomy as the position of the frenum interferes with the way the denture will fit. Sometimes this will happen between the cheek and the gum in the back of the mouth or in the middle of the lower lip and the upper lip.
Your surgeon will use a scalpel or a laser to remove the frenum.
Platelet Rich Fibrin
Platelet Rich Fibrin (PRF) is a second-generation platelet and leukocyte (white blood cell) concentrate which is utilized as a scaffold containing completely natural growth factors. PRF is derived from patient’s own blood which aids in healing after dental procedures, such as tooth extraction, as well as to promote healing around the bone or soft tissue grafts and dental implants. Utilizing the PRF process, our doctor is able to take advantage of your body’s natural healing capacity. The concentrated platelets and white blood cells in this newly formed scaffold not only immediately magnify the release and recruitment of growth factors and white blood cells but also allow for these benefits to be preserved at the designated site for a longer period of time helping to ward off infection. This specialized centrifugation process of the patient’s own blood allows the body’s natural healing potential to become exponentially more effective and efficient.
With a simple blood draw and an advanced technology protocol, PRF serves as a natural alternative with superior results and lower risks compared to artificial components. This platelet therapy helps to regulate inflammation and increase the speed of the healing process. The end results are improved healing response and significantly less recovery time.
Sedation Dentistry uses medication to help you relax for a better dental care experience and can help patients with severe dental anxiety. This can be very useful if you need complex or multiple treatments in a single appointment.
In every case, your sedation is closely monitored by our experienced dental professionals who ensure your safety and comfort.
Nitrous Oxide Sedation
Nitrous Oxide, commonly known as laughing gas, is a mild dental sedation medication. Once inhaled, it induces a state of mild relaxation and reduces sensitivity to pain. Regardless of age, Nitrous Oxide is safe for virtually every patient. Following treatment, oxygen is used to neutralize the effects of the nitrous oxide and upon completion, you will be fully alert and able to drive home.
Oral Conscious Sedation
Oral Conscious Sedation provides a stronger level of sedation than Nitrous Oxide. Many patients prefer to use this method for the deeper relaxation it provides. Though you are still able to stand, walk, or answer questions, you remain in a calm and drowsy state throughout the treatment. With Oral sedation, many patients have found they have little memory of the procedure afterwards. This can be a great benefit for patients with dental anxiety.