Osseous surgery, also known as pocket depth reduction, is a surgical procedure intended to restore your gums to a healthier, more natural state. If your periodontist has recommended osseous surgery, it is because you have pockets that are too deep to clean with daily at-home oral hygiene and a professional care routine. Your bone and gum tissue should fit snugly around your teeth, creating a protective cover from bacteria. If you have periodontal disease, the supporting tissue and bone are destroyed, and this forms pockets around the teeth. Over time, these pockets become deeper and provide a larger space for bacteria to live. As bacteria develop around the teeth, they can accumulate and advance under the gum tissue. These deep pockets collect even more bacteria, resulting in further bone and tissue loss. To reduce the need for extractions, osseous surgery may be recommended.

Reducing pocket depth and eliminating existing bacteria are important in preventing damage caused by the progression of periodontal disease and in helping you maintain a healthy smile. Eliminating bacteria alone may not be sufficient to prevent disease recurrence. Deeper pockets are more difficult for you and your dental care professional to clean, so it's important to make them as small as possible. Small pockets and a combination of daily oral hygiene and professional maintenance care increase your chances of keeping your natural teeth as well as decrease the chance of serious health problems associated with periodontal disease.

HOW IS OSSEOUS SURGERY PERFORMED?

During this procedure, our periodontist will fold back the gum tissue and remove the disease-causing bacteria before securing the tissue back into place. If the underlying bone has been damaged, the irregular surface will be smoothed out to limit areas where disease-causing bacteria can hide. This will also allow your gum tissue to reattach to healthy bone more effectively.

You may experience some swelling after the surgery, so applying an ice pack to the outside of your face over the treated area can help with any discomfort. In some cases, antibiotics are given before, during, and after the treatment in order to prevent any infections. After a week or two, you'll come back to our office so that your periodontist can check the surgical area and ensure your mouth is healing properly.

When you come to our office for your grafting procedure, a local anesthetic will be given to numb the areas involved. You may also receive medicine to help you relax. We want your experience in our office to be as comfortable as possible, so let us know if there is anything you need during your procedure.

Depending on your specific needs, your periodontist will perform one of three different types of gum tissue grafts. Many factors will contribute to your chosen grafting technique. Your periodontist can tell you which method will work best for you, your health, and your smile.

CONNECTIVE TISSUE GRAFTS

The most common method to treat root exposure, connective tissue grafting involves your periodontist laying a flap of skin on the roof of your mouth (or palate) and removing tissue from under the flap, called sub-epithelial connective tissue. This tissue is then stitched to the gum tissue surrounding the exposed root. After the connective tissue, or graft, has been removed from under the flap, the flap is then stitched back down.

ALLOGRAFT TISSUE GRAFTS

Using an allograft(tissue from a tissue bank). It is similar to the traditional connective tissue with the big difference being that there is no tissue from the palate (roof of the mouth) used. This usually results in less post operative discomfort.

FREE GINGIVAL GRAFTS

Similar to a connective tissue grafting, a free gingival graft involves the use of tissue from the roof of the mouth. A small amount of tissue is removed directly from the roof of the mouth and then attached to the gum area being treated. This technique is a "barrier-type" graft which may or may not result in root coverage.

PEDICLE GRAFTS

In this procedure, instead of taking tissue from the palate, it is grafted from gum around or near the tooth needing repair. The flap, called a pedicle, is only partially resected so that one edge remains attached. The gum is then slid to the adjacent tooth to cover the exposed root and sewn into place. This procedure can only be done if you have adequate gum tissue near the tooth needing additional gum tissue.

Scaling and root planing is one of the most effective, non-surgical ways to treat gum disease before it becomes severe. Scaling and root planing cleans between the gums and the teeth down to the roots.

Scaling is basically the process of removing dental tartar from the surfaces of the teeth. Root planing is the process of smoothing out the root surfaces and removing any infected tooth structure. If you have gum disease or gum pocketing, the gum pockets around the teeth will have deepened, thereby allowing tartar deposits to form under the gum line. A careful cleaning of the root surfaces to remove plaque and calculus (tartar) from deep periodontal pockets and smoothing the tooth root to remove bacterial toxins will help ensure that your gum disease is controlled.

HELPFUL HINTS TO KEEP IN MIND

1. Scaling and root planing does not usually cause much discomfort, but you my experience some soreness afterwards, since deeper regions under the gums have been cleaned.

2. Your teeth themselves may become a bit more sensitive to temperature, and bleeding might occur for a little while after your procedure.

3. Over-the-counter painkillers, such as ibuprofen, work very well to alleviate discomfort, as do ice packs applied to the outside of the face around the treated area.

4. Brushing and flossing will have to be done more gently to avoid aggravating any bruised or tender gum areas. We'll show you the best methods for keeping your teeth clean during this time.

Scaling and root planing is a simple procedure that can work very well to stop gum disease. If you maintain good dental care after the procedure, the progression of your gum disease should stop, and your gums will heal and become firm and pink again in no time!

Clinical crown lengthening is accomplished in those situations where decay has extended below the gum line and nearing the level of the bone around teeth.  When a crown is to be placed on a tooth, it is necessary that the margin, (interface of the crown and the tooth) be greater than 2 mm from the bone supporting the tooth.  This allows for long term success of the crown and the long term health of the periodontal support tissues of the teeth.   The process for this is very similar to that process for the cosmetic crown lengthening process.

Your gums may have receded for a variety of reasons, including aggressive tooth brushing or periodontal disease. You may not be in control of what caused the recession, but prior to treatment, your periodontist can help you identify the factors contributing to the problem. Gum grafting will cover the exposed roots to protect them from decay, help reduce tooth sensitivity, and improve the aesthetics of your smile. Whether you have a gum graft to improve function or aesthetics, you'll probably receive the benefits of a beautiful new smile and improved periodontal health – your keys to smiling, eating, and speaking with comfort and confidence.

Gum recession is caused by advanced gum disease. When gingivitis goes untreated, gum disease (also called periodontitis) will cause gums to pull away from the teeth, leaving deep pockets where bacteria can grow and damage the bone that supports the teeth. Gums can also shrink back from the teeth, making the teeth look longer. Teeth may then become loose, fall out, or have to be pulled out by a dentist.

DO YOU HAVE GUM RECESSION?

Gum recession does not happen overnight. You may not even notice that your gums have receded, as it is a very slow, gradual process. However, without a gum tissue graft, recession can have a detrimental effect on the health and function of your teeth. If your dentist has diagnosed you with gingivitis or periodontal disease, it is important to notice if:

•  You have sensitivity to hot or cold temperatures, or even to sweet, spicy, or sour foods

•  Your teeth appear longer than normal

•  Spaces between your teeth seem to grow

 •  The roots of your teeth begin to show

At Family Dentistry, we use advanced techniques and high quality biocompatible materials, combined with years of education and experience, to create the best dentures and partials for you. People lose teeth because of dental traumas, advanced gum disease, large cavities, or tooth extractions. An affordable way to replace your missing teeth is to fit you for either a partial or full set of dentures.

Not only can missing teeth cause embarrassment, they can also hurt your dental wellbeing. Your bite may worsen because your remaining teeth are doing the work meant for a full set of teeth. In other words, your bite shifts and impacts how you chew and speak, and may even cause jaw joint problems. Patients who have missing teeth also have higher risks of gum disease and losing more teeth.

Depending on your teeth replacement needs, our staff can customize full dentures for your upper and lower arches, or create partial dentures to fill in gaps around your natural teeth.  You may opt to receive dental implants as the attachment points for your new dentures. Having a full set of teeth not only improves your appearance, but also improves your speech and allows you to more effectively meet your dietary needs.

Our dentures are custom-fit for you individually, they will improve speaking and chewing abilities, and prevent the aging look of sagging cheeks and lips.