Periodontal Procedures

Our goal is to provide you with the highest quality of care in a compassionate and safe environment. In order to do this, we use the most current periodontal procedures, instruments, medications, and sterilization techniques.

In this ever changing world one of the most important ingredients is trust. We go to great lengths to always be honest, dependable and professional. The following is a brief description of our procedures.

We know that preventing the spread of infectious diseases such as AIDS, herpes, hepatitis and even the cold virus is critical and take sterilization very seriously. For this reason we use extensive sterilization procedures, going well beyond those recommended by the American Dental Association and Centers for Disease Control.

We use barrier techniques such as disposable masks and gloves and change them for every patient. Every piece of equipment is wiped-down with antibacterial solution prior to every dental procedure. Sterile water delivery systems are utilized. We use chemclave sterilization for all instruments prior to dental examination and treatment. You can be assured that our staff has been specifically trained on sterilization procedures and their importance.

While no dental procedure is 100% comfortable, we go to great lengths to minimize any discomfort you might feel. Many of our patients make statements like, "This wasn't even painful? How did you do that?"

Patient comfort is one of the most important aspects of care. Different patients have different needs for pain and anxiety control medication. Depending upon the procedure and your wishes, there are many medications we can prescribe.

Injections of dental anesthesia can become more painful if not precisely done or if the injection is done at too rapid a rate. We give topical pre-anesthesia before injections and take extra care to be slow and precise.

For those patients that would feel more comfortable, we are pleased to offer nitrous oxide analgesia. This technique will make you feel relaxed and at ease. Although you will be awake, you will not be aware of your surroundings.

We strive to stay on the leading edge of periodontal techniques and equipment. In order to do this, we take a great deal of continuing education. We also utilize advanced equipment in our office. This includes:

	Low Radiation Digital X-Rays which are safer than traditional X-rays and are more convenient when planning treatment with your general dentist. These allow us to view your x-rays instantly on our operatory computer systems.
	Panoramic Radiography to be able to more precisely diagnose and treat periodontal disease. It also allows us to more accurately place dental implants.
	Dental Laser Therapy is used for a variety of treatment procedures. Dr. Kirsch knows which types of patient care are more patient friendly with a laser than with alternative traditional methods. Dr. Kirsch has devoted training time and expense to be able to bring you the many advantages of this exciting new technology.

Basic Periodontal Treatment

Periodontal disease is a bacterial infection that gets under the gums and into the bone around your teeth. This infection must be removed and the area given a chance to heal. There are two generally accepted treatments for this depending upon the severity of your infection.

The upper level of infection in the pockets around your teeth can be removed using specialized instruments. This procedure is called Scaling and Root Planing. It is done under local anesthesia and is quite different from the routine dental cleaning or “deep cleaning” that is traditionally done in the general dentist's office. Using an instrument called an ultra-sonic scaler, plaque and tartar are carefully removed down to the bottom of each periodontic pocket. The tooth's root surfaces are then smoothed or planed to remove toxins and allow the gum tissue to heal.

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.

Other Procedures

Dental implants have their own section which describes their benefits and procedures. Click here to view the page on dental implants.

During this 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 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.

Your jawbone is what supports your teeth and gums. Unfortunately, periodontal disease dissolves parts of your jawbone. This causes bone loss and eventual loss of teeth. The first step is to remove the periodontal disease and stop the bone loss. Then, in many cases, various bone grafting techniques can be used to grow back some of the jawbone that was lost, enabling the jaw bone to support tooth replacement procedures.

Soft tissue grafts can be used to cover roots or develop gum tissue where 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.

Some localized, topical antibiotics can enhance your periodontal treatment. In certain isolated circumstances, placement of antibiotic medicine can also reduce infection.

Sometimes when you lose one or more teeth, you can get an indention in your gums and jawbone where the tooth used to be. This happens because the jawbone recedes when it no longer is holding a tooth in place.

Not only is this indentation unnatural looking, it also causes the replacement tooth to look too long compared to the adjacent teeth.

A periodontist can fill in this "defect" with a procedure called ridge augmentation, recapturing the natural contour of your gums and jaw. A new tooth can then be created that is natural looking, easy-to-clean and beautiful.

Occasionally the position of the sinus in the upper posterior areas may be too low for the proper placement of implants. For this reason, a grafting method to raise the floor of the sinus back up, graft bone underneath, and thus create enough space for implant placement, has been developed. It has a highly predictable success rate. This can sometimes be done as a single procedure along with the placement of the implant.

Each procedure is done with your comfort and safety in mind. We work closely with your general dentist to ensure you get the best possible result in accordance with your general dentist's wishes. Please feel free to ask questions before, during, or after any of these procedures.