Today you are finally going to solve all your doubts regarding periodontics!
What is periodontics?
Periodontics refers to the branch of dentistry that focuses on the support structures of teeth. These structures consist of the gum, bone, and supporting fibers that attach to the tooth’s bone. If you have been referred to a periodontist by your general dentist, it is likely that you are seeking treatment related to these structures. In this blog post, we will delve into the various aspects of periodontics and what it entails.
What are the treatments covered by periodontics.
Beyond being just a treatment, periodontics represents a distinct specialty within the field of dentistry.
1. Trimming or remodeling of the gum:
One of the most frequently performed periodontal treatments involves the surgical reshaping of the gum tissue that is visible when we smile or laugh. However, before undergoing this procedure, several factors must be carefully assessed and considered.
- Prior to performing the gum reshaping procedure, it is important to ensure that the tooth’s root is appropriately proportioned and well-supported. This is crucial in order to prevent any negative impact on the tooth’s support structure when the excess gum tissue is removed.
- Assessment of the tooth’s proportions is necessary to determine whether gum trimming alone will suffice, or if additional trimming and lengthening using resin are necessary. It is important to note that dentists follow “divine proportions,” which establish an optimal balance between the width of the tooth and the visible gum tissue to achieve an aesthetically pleasing result. While achieving ideal proportions may not be feasible in all patients due to individual variations, the goal is to come as close to it as possible for an aesthetically harmonious outcome.
- Assessment is required to determine whether the gum can be corrected through reshaping, or if the excess tissue is so significant that alternative measures should be considered. In cases where the gum tissue is particularly large, exceeding the size of the tooth itself, treatment with Botox may be recommended to relax the smile and reduce the visibility of the gum. Alternatively, consultation with a maxillofacial surgeon may be necessary in some cases.
2. Dental implants
Dental implants are widely sought-after due to their highly successful track record in replacing missing teeth. Periodontists are among the dental specialists qualified to perform this surgery, which requires meticulous planning, precise execution, and close attention to bone and gum management, including bone grafting, to achieve optimal results. With careful attention to these factors, the implant can be seamlessly integrated into the mouth, resulting in a natural-looking restoration that blends in seamlessly with the surrounding teeth.
3. Periodontal plastic surgery
While the term “plastic surgery” may conjure up images of extreme body modifications, periodontal plastic surgery is a different matter altogether. This type of surgery is far less invasive and aims to address minor imperfections in the gum tissue that can have a significant impact on a person’s appearance and self-confidence, particularly when speaking or smiling. Its focus is on achieving subtle, yet noticeable improvements to the gum line and its relationship with the teeth.
Periodontal plastic surgery can address a range of concerns, including receding gums, exposed tooth roots, and gaps resulting from issues such as tumors. To address these issues, periodontists may use grafts of bone and/or gum tissue, which can be obtained from either a laboratory or the patient’s own body. For example, to cover an exposed tooth root, a graft can be taken from the patient’s palate and transplanted to the affected area, where it will heal and effectively fill the space that was previously uncovered.
4. Treatment for patients with dental mobility
When teeth exhibit mobility, they require specialized periodontal treatment in order to prevent them from eventually falling out. The treatment for dental mobility typically involves:
- Root planing.
As gum problems and tartar buildup become more severe, they can progress to the point where the teeth become loose and mobile. In these cases, a periodontist may perform root planing, which involves removing the tartar and smoothing out the rough surfaces of the tooth roots. This procedure typically requires local anesthesia and takes about an hour to complete. Depending on the severity of the case, additional sessions may be necessary to achieve optimal results.
Occasionally, it is necessary to supplement the previous treatment by using a splint to avoid excessive movement of the teeth during the healing process. This splint consists of a wire, similar to those used in orthodontics, which is placed on the back of the tooth to prevent it from being visible. The splint is left in place for the period of time that the periodontist considers necessary, depending on the progress of the tooth’s recovery.
In most cases, supplementary aid such as medicated mouthwashes or specific toothpaste is necessary for these periodontal treatments to be more effective. They may be prescribed to facilitate healing or to promote hygiene in the treated area. It is important to note that if you were prescribed a chlorhexidine rinse, it should only be used for a maximum of one week, as prolonged use can lead to significant tooth discoloration.
5. Pre-crown treatment
Periodontal treatments are closely related to the use of dental crowns, especially when the tooth has been extensively damaged due to cavities, fractures or other reasons. In some cases, the damage extends below the gum line, making it difficult to place a crown without proper periodontal treatment.
To prevent the crown from causing further damage and infection, the periodontist must first perform a thorough examination of the gums and bone structure to ensure the area is healthy and ready for treatment. If necessary, the periodontist may perform a scaling and root planing procedure to remove any plaque, calculus, and bacteria from the affected area. This is essential for a successful crown placement and overall oral health.
Additionally, the periodontist may recommend the use of medicated mouthwashes or special toothpastes to improve hygiene in the affected area, prevent further damage and promote healing. The patient should also maintain good oral hygiene habits and attend regular check-ups with the dentist or periodontist to monitor the health of the tooth and surrounding tissues.
It is important to note that in some cases, a crown may not be the best option for a damaged tooth. The periodontist will evaluate the extent of the damage and recommend the most appropriate treatment plan, which may include alternatives such as dental implants or bridges.
To prevent potential problems, a procedure called crown lengthening is performed by periodontists. This involves a special cut that repositions the gums and bone to ensure that the crown remains in good condition and fits well. This procedure is typically performed under general anesthesia and has minimal recovery time. However, the restoration of the crown should not be performed until the area has properly healed, which can take at least a month and up to three months.
6. Complex extractions.
While a general dentist usually performs simple tooth extractions, more complicated cases such as extracting wisdom teeth, supernumerary teeth, and teeth growing in unusual locations like the palate require the expertise of a specialist in periodontics. This specialist can either be a periodontist or a maxillofacial surgeon. If you have been advised to seek periodontic treatment, it is recommended to schedule an appointment at our clinic for an assessment.