Periodontal Surgery

Periodontics is the dental specialty focusing exclusively in the inflammatory disease that destroys the gums and other supporting structures around the teeth. Periodontal surgery is performed by a periodontist — a dentist who specializes in the prevention, diagnosis, and treatment of periodontal, or disease, and in the placement of dental implants.

Scaling and Root Planing

Scaling and root planing — sometimes called a deep cleaning — is intended to remove etiologic agents which cause inflammation to the gingival (gum) tissue and surrounding bone. Common etiologic agents removed by this conventional periodontal therapy include dental plaque and tartar (calculus). These non-surgical procedures completely cleanse the periodontium and are an effective method for individuals suffering from gingivitis (mild gum inflammation) and moderate/severe periodontal disease.

Osseous Surgery

Osseous surgery, sometimes referred to as pocket reduction surgery or gingivectomy, refers to a number of different surgeries aimed at gaining access to the tooth roots to remove tartar and disease-causing bacteria. 

Goals of Osseous Surgery

Osseous surgery is used to reshape deformities and remove pockets in the alveolar bone surrounding the teeth. It is a common necessity in effective treatment of more advanced periodontal diseases. The ultimate goal of osseous surgery is to reduce or eliminate the periodontal pockets that cause periodontal disease. Despite the word “surgery” the procedure is reported to feel more like a thorough cleaning. The specific goals of surgery include:

  • Reducing Bacterial Spread:
    Bacteria from the mouth can spread throughout the body and cause other life-threatening conditions such as heart disease and respiratory disease. Removing deep tartar and thereby bacteria can help reduce the risk of bacteria spreading.

  • Preventing Bone Loss:
    The immune system’s inflammatory response prompted by periodontal bacteria can lead to bone loss in the jaw region, and cause teeth to fall out. Osseous surgery seeks to stop periodontal disease before it progresses to this level.

  • Enhancing the Smile:
    Mouths plagued with periodontal disease are often unsightly. Brown gums, rotting teeth, and ridge indentations can leave a person feeling depressed and too self-conscious to smile. Fortunately, osseous surgery can help reduce bacteria and disease and thereby restore your mouth to its former radiance, while restoring confidence at the same time.

  • Facilitating Home Care:
    As the gum pocket deepens, it can become nearly impossible to brush and floss adequately. Osseous surgery reduces pocket size, making it easier to brush and floss, and thereby prevent further periodontal disease.

What does the procedure involve?

A local anesthetic will be used to numb the area prior to surgery. First, the doctor will cut around each tooth of the affected area to release the gum tissue from the bone. This allows access to the bone and roots of the teeth. After the roots have been thoroughly cleaned through scaling, a drill and hand tools will be used to reshape the bone around the teeth. Bone is removed in some areas to restore the normal rise and fall of the bone, but at a lower level. Bone grafting may also be necessary to fill in large defects.

Next, the gums will be placed back over the remaining bone and suture them in place. The site will also be covered with a bandage (periodontal pack) or dressing. Pain medicine and mouth rinses containing chlorhexidine are generally prescribed following the surgery.

Do not be alarmed if bleeding and swelling occur after the surgery. This can be controlled easily by placing an ice pack on the outside of the affected area. In cases where the bleeding and swelling is in excess, it is advised that you call to notify our office. Several follow up visits may be necessary and you must fulfill a meticulous maintenance program especially during the initial phases of healing to avoid post-operative infection.

Gum Grafting

A gum graft is a collective name for surgical periodontal procedures that aim to cover an exposed tooth root surface with grafted oral tissue. Exposed roots are usually the result of gingival recession due to periodontal disease.

Soft Tissue Grafting

Soft tissue grafting is often necessary to combat gum recession. Periodontal disease, trauma, aging, over-brushing and poor tooth positioning are the leading causes of gum recession. The main goal of soft tissue grafting is to either cover the exposed root or to thicken the existing gum tissue in order to halt further tissue loss.

Bone Grafting

Bone grafting is often closely associated with dental restorations. In the majority of cases, the success of a restoration procedure can hinge on the height, depth, and width of the jawbone at the implant site. When the jawbone has receded or sustained significant damage, the implant(s) cannot be supported on this unstable foundation and bone grafting is usually recommended for the ensuing restoration.

Laser-Assisted Periodontal Surgery

The use of laser in periodontal treatment is a recent development. By utilizing the body’s own natural ability to “heal itself,” a periodontist utilizes multiple lasers, often without a scalpel and sutures, to remove infection from your body and create an environment for regeneration of the tissues around your teeth (gum, bone, cementum, ligament) that are lost due to periodontal disease.

Laser Procedures

  • Periodontal Disease

  • Tissue Grafting

  • Biostimulation

  • Cosmetic Procedures – gum recontouring

  • Crown Lengthening

  • Oral Biopsy

  • Frenectomy

How does it work?

The laser therapy works by targeting only diseased gum, which it discerns by the color. Diseased gums are darker than healthy gums. The laser is then used to agitate the healthy tissue, encouraging it to reattach to the bone. Because of the regrowth of this connective tissue, there is also a much lower chance of gum disease returning than with traditional surgery.

Due to the ability of the laser to target and remove only diseased tissue, a periodontist is able to help restore you to health with no post-operative pain and fewer side effects and risks than traditional surgery. This is in conjunction with a detailed dental hygiene and home care program.

Benefits

  • Comfort:
    With laser treatment, there is reduced or no bleeding, minimized swelling, no charring, and no drill noise or vibration. The stress and anxiety often associated with dental work is therefore eliminated when you experience quick, effective, and essentially pain-free laser procedures. Also, postoperative sensitivity is greatly limited by laser dentistry, and recovery time is much quicker than with traditional methods. In fact, due to the less-invasive nature of the laser technique, the mouth begins to heal immediately after work is completed!

  • Reduced Risk of Infection:
    The laser’s high-energy light beam acts as a sterilizer on the area it is working, thereby reducing the risk of bacterial infections and relapses. 

  • Anesthesia Limited or Eliminated:
    Because laser dentistry is virtually painless, no longer will you suffer with fear of injections and numbness. Often, only a light anesthetic spray is required. Laser treatment eliminates the complications and cost associated with anesthesia.

Pinhole Surgical Technique PST™

The Pinhole Surgical Technique PST™, offered exclusively with Dr. Steve Wolf, is a procedure in which specialized instruments are used to make a small hole in your gum and add collagen material which stabilizes the area of gum recession. This new method is simple, suture-free and minimally invasive. PST™ was developed and patented by John Chao, D.D.S. It has been featured in the International Journal of Periodontics, one of the most prestigious dentistry journals in the world.

Genetic Tests

Salivary DNA testing can determine the cause of periodontal infection. The report will tell you the type and concentration of disease-causing bacteria, the bacterial information necessary to help classify high-risk versus low-risk cases.

Conscious Sedation

Conscious sedation helps reduce anxiety, discomfort, and pain during certain procedures. This is accomplished with medications and (sometimes) local anesthesia to induce relaxation.

Conscious sedation is commonly used in dentistry for people who feel anxious or panicked during complex procedures. In the past, conscious sedation has been called twilight sleep, happy gas and laughing gas.

Under conscious sedation, you are mostly awake for the procedure. It may be administered by inhaling gas through a mask (nitrous oxide) or by taking a pill. The effects of conscious sedation may be minimal or moderate:

  • Minimal effects feel like you’re relaxed but fully conscious and responsive

  • Moderate effects feel like you’re sleepy and may lose consciousness, but you’re still somewhat responsive

If you are interested in conscious sedation for your next dental procedure, please ask your provider at your next visit.