Oral Prophylaxis & Gum Surgery
Oral prophylaxis is a dental procedure that removes plaque, calculus & stains from the teeth through polishing and scaling. (Plaque is a sticky substance that builds up on teeth as a by-product of bacteria feasting on the food you eat. Calculus, also known as tartar, occurs when plaque & minerals in your mouth harden.) This cleaning occurs only on the visible part of the tooth, known as the crown.Through the advent of micro-surgical procedures, the procedures have become more predictable and comfortable for the patients. Gum grafts are usually performed by periodontists who are trained in these procedures, though general-purpose dentists may offer the procedures themselves.
Reasons for prophylaxis/teeth cleaning
Prophylaxis is an excellent procedure to help keep the oral cavity in good health and also halt the progression of gum disease.
Periodontal disease and gingivitis occur when bacteria from plaque colonize on the gingival (gum) tissue – either above or below the gum line. These bacteria colonies cause serious inflammation and irritation which in turn produce a chronic inflammatory response in the body. As a result, the body begins to systematically destroy gum and bone tissue, making the teeth shift, become unstable, or completely fall out. The pockets between the gums and teeth become deeper and house more bacteria which may travel via the bloodstream and infect other parts of the body.
Here are some of the benefits of prophylaxis:
- Tartar removal – Tartar (calculus) and plaque buildup, both above and below the gum line, can cause serious periodontal problems if left untreated. Even using the best brushing and flossing homecare techniques, it can be impossible to remove debris, bacteria and deposits from gum pockets. The experienced eye of a dentist using specialized dental equipment is needed in order to spot and treat problems such as tartar and plaque buildup.
- Aesthetics – It’s hard to feel confident about a smile marred by yellowing, stained teeth. Prophylaxis can rid the teeth of unsightly stains and return the smile to its former glory.
- Fresher breath – Periodontal disease is often signified by persistent bad breath (halitosis). Bad breath is generally caused by a combination of rotting food particles below the gum line, possible gangrene stemming from gum infection, and periodontal problems. The removal of plaque, calculus and bacteria noticeably improves breath and alleviates irritation.
- Identification of health issues – Many health problems first present themselves to the dentist. Since prophylaxis involves a thorough examination of the entire oral cavity, the dentist is able to screen for oral cancer, evaluate the risk of periodontitis and often spot signs of medical problems like diabetes and kidney problems. Recommendations can also be provided for altering the home care regimen.
What does prophylaxis treatment involve?
Prophylaxis is generally performed in several stages:
- Supragingival cleaning – The dentist will thoroughly clean the area above the gum line with scaling tools to rid them of plaque and calculus.
- Subgingival cleaning – This is the most important step for patients with periodontal disease because the dentist is able to remove calculus from the gum pockets and beneath the gum line.
- Root planing – This is the smoothing of the tooth root by the dentist to eliminate any remaining bacteria. These bacteria are extremely dangerous to periodontitis sufferers, so eliminating them is one of the top priorities of the dentist.
Prophylaxis is recommended twice annually as a preventative measure, but should be performed every 3-4 months on periodontitis sufferers. Though gum disease cannot be completely reversed, prophylaxis is one of the tools the dentist can use to effectively halt its destructive progress.
Types of surgical procedures:
- Gingival Flap Surgery
If pockets are greater than 5 millimeters in depth, the periodontist would conduct this procedure to reduce the periodontal pockets that were noted in a patients chart. Most patients who have been diagnosed with moderate to severe periodontitis would go through this procedure. The periodontist would cut the gum tissue to separate the gum tissue from the teeth, conduct a thorough deep cleaning with an ultrasonic scaling device as well as hand instruments to remove tartar, plaque and biofilm below the pockets.
- Gingivectomy
This procedure is conducted to remove excess gum tissue that may be overgrown on the teeth to provide a better area to clean the teeth. The periodontist would numb the patients gum tissue and cut and eliminate the extra gum tissue in the mouth.
- Gingivoplasty
This type of gum surgery is used to reshape healthy gum tissue around the teeth to make them look better. If a person has tooth recession where the gum is pushed away from the tooth, a gingivoplasty can be done. A gum graft can be done where the tissue is taken from the roof of the mouth (this is called a graft) and then stitched into place on either side of the tooth that is recessed.
- Bone grafting
When the bone that surrounds the root of the tooth is damaged or destroyed, a person may need a bone graft. This procedure involves replacing the damaged bone with new bone. This bone may be the person’s bone, a manufactured bone, or donated bone.The goal of bone grafting is to hold the tooth in place and help it to regrow.
- Cosmetic Gum Contouring
Gum contouring, also known as a gum lift, is a surgical cosmetic procedure for patients who are unhappy with the size and proportion of their gums. Your dentist can conservatively reshape your gums with a laser or a conventional scalpel to help your teeth appear more prominent and restore balance to your smile. Many patients choose gum contouring as part of their cosmetic dentistry treatment to achieve the most comprehensive results. - Gingival Grafts (Gum Tissue Grafts)
Grafts are used to correct some defects such as gum line recession. This is the process in which the gum has migrated away from the crowns, leaving the roots exposed.
- Guided Tissue Regeneration
Guided Tissue Regeneration surgery consists of placing membranes inside the gums to stimulate the regeneration of attachment previously lost between the gums and the surface of roots.
- Frenectomy and Frenotomy
The frenum is a small fold of soft tissue that connects the gums to the inside of the lips, restricting their motion. A frenectomy or frenotomy are different procedures involving a complete or partial removal of the frenum attachments. Sometimes the frenum needs to be removed or cut because it may pull away the gums from the tooth or it may interfere with the alignment of teeth.
- Crown Lengthening
If you are receiving dental crowns but do not have enough exposed tooth surface to attach your crowns, your dentist may recommend crown lengthening. Similar to cosmetic gum contouring, this simple procedure can be accomplished with a laser or a scalpel and can help your teeth appear longer and more prominent. Undergoing a crown lengthening prior to dental crowns can help reduce the risk of a crown falling off and give you more room for proper oral hygiene.
FAQ
The term “periodontal” simply means “around the tooth.” Periodontal disease affects the gums and bones supporting the teeth. Also known as gum disease, periodontal disease or “gum disease” often is attributed to the bacteria in dental plaque, which causes the gums to become inflamed and infected. Other factors, such as smoking or tobacco use, poor nutrition, stress or pregnancy, may put you at risk of developing gum disease.
Although it is not an airborne disease, research has indicated that the bacteria that causes gum disease can be passed through saliva. Therefore, families and couples who may be in close contact with a person with gum disease are also at risk. We recommend being screened for periodontal disease regularly if you are potentially at risk, particularly if you have a family history of periodontal disease or tooth loss.
Healthy gums should not bleed when you brush your teeth. This is one of the early signs of gum disease. You should schedule an appointment with your periodontist for a complete periodontal screening.
A good oral hygiene regimen is imperative in preventing periodontal disease. Proper brushing and flossing, in conjunction with regular dental visits for professional cleaning twice a year, will help keep your smile healthy for life. If you have periodontal disease that is treated, research clearly demonstrates that professional cleanings should be performed every 3 months to maintain disease stability.
Whether you need surgery or not will depend on how advanced your periodontal disease is. There are non-surgical treatments, such as scaling and root planing available, for those with mild gum disease. If you are in the advanced stages of gum disease, you may benefit from having surgery. With the latest technology and advanced techniques available today, many surgical procedures can be performed in an office setting with little discomfort.
Maintenance therapy is used to help prevent further infection from occurring in patients who have already received periodontal treatment. Your periodontist will tailor a program to fit your needs, which will include periodontal checkups, plaque and tartar removal and sometimes polishing your teeth or checking your bite. The frequency of visits varies from case to case from every few weeks to four times per year.
In advance cases, that have not reached stability, we suggest that you continue to see us for all maintenance visits. Once we are certain that you have reached a steady state of health, we will ask you to see both your general dentist and us, on an alternating basis, to best preserve an optimal result. Research has proven to us that this is the best treatment for our patients.
Periodontal disease is a progressive, painless infection. Delay can cause further bone loss and more expense.
A procedure called aesthetic crown enhancement can correct “gummy” smiles. “Gummy” smiles make teeth appear too short because either the gum and/or supporting bone did not passively reposition lower around the tooth after its eruption into the mouth. With aesthetic crown enhancement, the gums and supporting tissues are reshaped/repositioned to expose the natural length and form of the tooth.
If left untreated, gum recession can lead to tooth loss. Gum recession can be a sign of serious bone recession. Soft tissue grafts can fix this condition and also prevent further recession or bone loss. In the procedure, gum tissue can be taken from your palate or another donor source. This tissue is then placed over the exposed roots, which helps to even out the gum line and reduce sensitivity to hot and cold temperatures.
Periodontal disease is a progressive, painless infection. Delay can cause you further bone loss and more expense. If your teeth are lost, dentures are never as effective as your own natural teeth.