There is more to oral health than teeth. The soft tissues in your mouth, like gums and the mucosa that make up the insides of cheeks and lips, play a vital role in dental function and appearance. A Periodontist focuses on these parts of the mouth, as well as the placement of dental implants. We are proud here at White Wolf Dental to offer high-quality, specialized periodontal care right in our office. Our periodontal specialist works alongside the other members of the dental team with a comprehensive approach to diagnosing and treating all your dental needs. We are committed to delivering the highest quality dental care available, and often that begins with healthy gums and tissues.
Each patient’s needs are different, and not every approach is right for every case. The topics listed below represent the safe, reliable techniques and technologies we most often use in periodontal care.
WHAT IS LANAP?
LANAP is a revolution in treating gum disease. Without using a scalpel or stitching the gum, the laser is used to kill the bacteria in the space between teeth and gums and then reattach the gum to the tooth. It is conservative periodontal treatment and is often an ideal fit for people looking for nonsurgical (no scalpel, no stitches) gum treatment. The laser eliminates diseased tissue while preserving healthy gums, so scalpels and sutures are eliminated, discomfort is minimized, and the results are exceptional.
L-A-N-A-P is an abbreviation for Laser Assisted New Attachment Procedure. LANAP is a patented protocol developed by Dr. Robert Gregg and Dr. Delwin McCarthy two practicing dentists in Cerritos, California after decades of research in the use of laser energy in the treatment of periodontal disease. LANAP has revolutionized the treatment of gum disease by combining conventional treatment methods with the precision use of the PerioLase laser. PerioLase is a pulsed free-running, 6 watt, 1064 wavelength Nd:YAG laser and is the only FDA-approved laser for the treatment of gum disease.
What makes LANAP effective in treatment of gum disease is the fact that the laser energy that is emitted by the PerioLase is absorbed only by inflamed gum tissue without harming healthy gum tissue and it is also absorbed by bacterial species that cause gum disease, killing those bacteria. LANAP provides the ideal environment for your body to heal itself by regenerating bone and creating new gum attachment to the teeth.
Summary of the LANAP steps:
LANAP harnesses the gentle but effective power of laser light to treat gum disease. First the area to be treated is numbed with a local anesthetic. Some patients like to be sedated as well. The steps to LANAP are as follows:
- A periodontal probe is in place to accurately measure the depth of the bone loss.
- Pulsed laser light selectively removes the diseased and infected tissue from the inside of the pocket. The laser is so precise that it does not affect the healthy tissue. The laser light also kill the bacteria in the pocket.
- Special scalers are used to remove the tartar. The tartar has been loosened by the laser light so it comes off more easily than during traditional scaling.
- Laser light is again used, but at a different setting. This pass with the laser makes a firm clot that connects the gum to the root surface forming a fibrin clot.
- The tissue is pressed against the root surface and the fibrin clot forms at the top of the gum.
- The bite is adjusted so that the teeth do not traumatize each other when you chew. A night guard is also used to take away the excessive forces from the teeth and allow the optimal healing. We’ll also give you special dietary recommendations to optimize the results.
We have many patients that ask us why do their teeth look longer than years ago or appear to have early signs of receding gums. Most patients will report to us increased symptoms of hot or cold sensitivity when eating or drinking, food being caught between teeth, or just the appearance of their smile is no longer satisfactory. The cause for this is usually if you have thin gums or not enough attached gum tissue. When our patients come to our practice with these concerns, our periodontist will evaluate if you are a candidate for certain procedures such as connective tissue or free gingival grafts. These procedures may help in regenerating the lost tissue and resolve many of the symptoms.
AM I A CANDIDATE FOR GUM GRAFTING?
The first thing our periodontist will need to do is assess the reason behind your changing gums. Not all patients are candidates for gum grafting and Dr. Abrahams needs to consider whether you have adequate surrounding bone. Other factors can influence the success of a gum graft, such as your bite, home-care, and overall well-being.
WHAT WILL GUM GRAFTING ACCOMPLISH?
Connective tissue grafting will allow Dr. Abrahams to cover the root surfaces where you have the recession. This will allow him to cover unsightly yellow roots and make teeth appear shorter. By covering the root surface, sensitivity is also greatly reduced and allows you to drink cold glass of water with little discomfort. And lastly, food impaction is minimized by covering in many of the spaces that were once open.
Free gingival grafts allow him to create a thick and strong band of gums to help prevent future recession. This is usually done if you have inadequate keratinized tissue. To explain it simply, there are two types of gum tissue: a soft loose type called mucosa and a tough pink tissue called keratinized. If around the necks of your teeth you do not have enough of the pink tough tissue, simple brushing and chewing can cause your gums to further recede. Also, if muscles in your mouth, such as frenums, pull too much in these areas with inadequate tissue it can cause recession. Dr. Abrahams may perform a simple procedure called a frenectomy to help maintain your smile.
Crown lengthening can be done for functional reasons or cosmetic. If you have concerns with a gummy smile or feel your teeth are too short you may benefit from this procedure.
Cosmetic crown lengthening is done as a team effort between Dr. Abrahams and your restorative dentist. They discuss in great detail your needs and wants for your smile to determine the best placement your gums. Patience after surgery is the key here to allow for proper healing to obtain the most optimal cosmetic result. On average we wait 4 to 6 months for healing, but in the mean time you may have temporary teeth placed to cover root surfaces.
Functional crown lengthening is common after a tooth breaks and there is not enough left to get a hold of or if you have old dental work that is irritating your gums. The purpose of this is to expose more of the tooth so that the crown has adequate surface area to attach too. Also, we need to worry about biologic width to maintain a healthy relationship between your dental work and gums
Think of your sinus as an empty space with a balloon type lining. In the past it was very difficult to place implants in the back upper area due to the sinus being very close and not enough bone to place implants. This maybe a cause of a previous extraction and the sinus drooped in or just your natural anatomy. Dr. Abrahams will do a very careful analysis on our 3D scan to determine if you can benefit from a sinus lift. Once he makes a plan, he will gently lift the balloon lining and add bone. Usually after 6 months of healing there is adequate bone present to place an implant and being the process of replacing your missing teeth
Bone grafting is needed for many reasons, such as:
- The most common type of grafting procedure is called socket/ridge preservation. After a tooth is extracted your body begins the healing process. Unfortunately during this process the bone tends to “cave in” and there is a lot of height and width lost. To prevent this, we place a bone graft at the time of extraction to act as a scaffold and preserve as much height and width as possible. Usually after 3 months of healing the bone is ready for an implant
- Ridge augmentation is a procedure that is used if you had your teeth extracted many years ago and there is not enough height or width to accommodate implants. Dr. Abrahams will place special membranes to hold bone graft material in place to allow your body to grow its own bone into the right places. Your body usually needs about 6 months to heal before implants can be placed.
- Vertical bone defects can form around teeth as a result of earlier surgery or periodontal disease. In these instances, Dr. Abrahams may choose to perform guided tissue regeneration. This procedure allows us to create a scaffold for your own bone to enter but to also help your body release proteins that can stimulate and encourage your body to regenerate other tissues for healthy teeth and gums.