Periodontist in Brookline, MA
An important part of caring for your smile is making sure that your gums are healthy. When they aren’t being cleaned or properly cared for, you can be at risk for gum disease. Once gum disease sets in, it’s important to see a periodontist to discuss what treatment may be needed. Our Brookline periodontist provides a variety of services for gum disease treatment and other periodontal issues. Learn more about the services we offer below or call Coolidge Corner Dental today to schedule an appointment!
Periodontal Evaluation
Periodontal exams are vital in the maintenance of your oral health as they are used to assess the health of your gums and teeth. They can help your dentist diagnose gum diseases, gingivitis and periodontitis. These exams can also reveal receding gums, exposed roots, tooth grinding and other problems, making periodontal exams vital to maintaining proper oral health. Regular dental exams are important as they can reveal evidence of gum disease in its early stages.
During your periodontal examination, we will check:
- For any lumps or abnormal areas in the mouth
- Whether any of your teeth are missing or loose
- The color, texture, size and shape of your gums
- Whether you have fillings, crowns, bridges, dentures or implants
- How much plaque is on your teeth
- The depth of the space between your tooth and gum
Click Here to Schedule a Consultation Today!
Gum Disease Treatment
If you've been diagnosed with gum disease, there are a variety of treatment options depending on the details of your situation and the severity of the problem. We always start with the least invasive options, which are non-surgical. However, in more serious cases, surgery may be necessary.
Scaling and Root Planing
The first line of defense against gum disease is a unique type of cleaning called “scaling and root planing.” In this procedure, an ultrasonic cleaning device is used to remove plaque and tartar from your teeth where regular cleaning devices can't reach: under the gum line, on the tooth, and around the root. Then, the rough surface of the tooth and the root are smoothed out (planed). This provides a healthy, clean surface that makes it easier for the gum tissue to reattach to the tooth.
If you address your gum disease before it becomes severe, scaling and root planing may be the only treatment you need. However, as with any dental procedure, after-care is vital. In order to keep your teeth in good shape and resist future occurrences of gum disease, you must brush and floss daily, eat a healthy diet, avoid tobacco use, and have regular dental checkups. Even after a successful scaling and root planing, if you don't attend to your teeth properly, it's quite likely that you'll develop gum disease again.
Dental Implants
Pocket Depth Reduction Surgery
In a healthy mouth, the teeth are firmly surrounded by gum tissue and securely supported by the bones of the jaw. Periodontal disease damages these tissues and bones, leaving open spaces around the teeth that we call pockets. The larger these pockets are, the easier it is for bacteria to collect inside them, leading to more and more damage over time. Eventually the supportive structure degrades to the point that the tooth either falls out or needs to be removed.
During pocket reduction procedures (also known as “flap surgery”), we fold back the gum tissue and remove the bacteria hiding underneath, as well as the hardened plaque and tartar that have collected. We may also remove any tissue that is too damaged to survive. We then sew the healthy tissue back into place. Now that the tooth and root are free of bacteria, plaque, and tartar, and the pockets have been reduced, the gums can reattach to the teeth.
Periodontal Regeneration
When the bone and tissue supporting the teeth have been lost due to severe gum disease, we can restore these areas with a regeneration procedure. During this process, we begin by folding back the gum tissue and removing the bacteria, plaque, and tartar. Depending on your situation, we may then perform a bone graft to stimulate new bone growth, or we may apply a special kind of protein that stimulates tissue growth to repair the areas that have been destroyed by the disease.
Soft Tissue Gum Grafting
A frequent symptom of gum disease is gum recession (also called gingival recession). As the gums recede, more of the roots are revealed. This can make teeth appear longer and can also create sensitivity to hot or cold liquids or food. It also exposes the tooth to increased damage from gum disease, as bacteria, plaque, and tartar attack the surface of the tooth and the root.
During a soft-tissue graft, tissue from the top of your mouth or another source is sewed to the gum area, covering the roots and restoring the gum line to its original, healthy location. This procedure can also be performed for cosmetic reasons.
Crown Lengthening & Gummy Smile Correction
If you are concerned about excess gum tissue or an uneven gum line, crown lengthening and gum contouring are minimally invasive periodontal procedures that can improve the balance of your gums and teeth, creating a well-proportioned and symmetrical smile.
Crown lengthening, also known as a gum lift, is a procedure frequently used to treat a “gummy smile.” When excess gum tissue covers more of the teeth than is typical, teeth appear shorter and smaller. During a gum lift, small areas of excess tissue are removed to reveal more of the tooth’s structure, making teeth look longer and more proportional.
Like crown lengthening, gum contouring is a common cosmetic surgical procedure. An uneven gum line can cause one or more teeth to appear misshapen or shorter than the rest, producing a “crooked smile.” Gum contouring aesthetically reshapes the gum tissue for a natural-looking, even gum line.
These procedures are also used in dental restorations. If needed, crown lengthening can provide sufficient tooth surface for the application of veneers. When teeth have suffered injuries or serious decay near the gum line, a gum lift, or gum contouring can expose enough of the remaining tooth to support a crown. Contouring can be used with gum grafting to restore a gum line damaged by periodontal disease.
Bone Grafting
Bone grafting is a common surgical procedure which replaces and repairs damaged bone. Bone loss in the jaw can have serious consequences for your dental health. Bone loss leads to loosening and eventual loss of teeth. Teeth shift, affecting your bite. Lack of bone density makes the placement of dental implants or implant-supported dentures impossible. Further, facial muscles and features lose structural support, causing a sunken appearance in the lips, cheeks, and chin.
Conditions that Cause Bone Loss
- Resorption: When a tooth is lost, the bone ridge under the missing tooth gradually begins to shrink, a process called resorption. Without the stimulation of biting and chewing, new bone cells aren’t produced quickly enough to replace older bone tissue.
- Periodontitis: Gum disease is progressive, and a leading cause of tooth loss. Left untreated, periodontitis causes gum recession, exposing bone and connective tissue to destructive bacteria and infection.
- Trauma: Bone damage caused by trauma might require bone replacement or recontouring.
- Bone Structure and Size: Sometimes the alveolar ridge is too narrow or shallow to support an implant, especially in the back of the upper jaw near the sinus cavity. In this case, the bone will need to be built up before an implant can be placed.
Bone Graft Procedure
To prevent bone loss from affecting your quality of life, your dentist might recommend a bone graft. During this procedure, grafting material is implanted in the damaged area, where it serves as a platform for your own bone tissue to regenerate and restore bone volume and density.
A bone graft is typically performed using local anesthesia. A protective membrane may be placed over the graft to stabilize it and to prevent gum tissue from growing into the graft area. The gums will be closed with sutures. The membrane and sutures may dissolve over several days or weeks, or you may need to return to have them removed. You’ll receive detailed instructions for after care and follow-up visits. The time it takes for you to heal completely will depend in part on the size and type of your graft.
