Understanding Periodontal Disease

With puberty comes a surge in sex hormones, which can make gums more susceptible to irritation from plaque and food remnants. This sensitivity can manifest as swollen, reddened, and tender gums.

In the days leading up to menstruation, some women might notice symptoms akin to those during puberty. This can include gum bleeding, pronounced redness in the gaps between teeth and gums, or even sores on the inner cheek. Generally, these symptoms recede as the menstrual period commences.

Pregnancy introduces changes to dental health, too. Between the second and eighth month of pregnancy, you might observe swollen, bleeding gums, or redness and tenderness. Occasionally, large, non-cancerous, and typically painless lumps can form in reaction to irritants. Though these often vanish post-delivery, some might require professional intervention. Prioritizing periodontal health during pregnancy is essential, as any form of infection, including those of the gums, can jeopardize the well-being of the baby. For an in-depth understanding, refer to the “Pregnancy and Periodontal Disease” segment under our “Mouth-Body Connection” section.

Oral contraceptives, which utilize synthetic hormones, can lead to symptoms like gum swelling, bleeding, and tenderness. It’s vital to inform your healthcare provider about any medication you’re on, oral contraceptives included. This precaution ensures that potential drug interactions, like the one between antibiotics and contraceptives which can reduce contraceptive efficacy, are avoided.

Menopause and the post-menopausal phase can bring about noticeable changes in your oral environment. Symptoms might encompass gum discomfort, a burning sensation, altered taste perceptions like salty or sour, and xerostomia (dry mouth). Regular oral care and professional cleanings can help mitigate these symptoms. For dry mouth, there are saliva substitutes available to offer relief.

This regular care program is designed to prevent new diseases in the gums and the bone that supports your teeth. By combining diligent home oral care with routine maintenance appointments with your dentist and Dr. Feldner, you stand a strong chance of retaining your natural teeth for life.

Your susceptibility to gum disease necessitates continuous vigilance. Bacterial plaque, the primary cause of gum disease, is a colorless film that constantly forms on your teeth, releasing toxins that can harm your gums and teeth. Regular home cleaning helps minimize calculus (hardened plaque) formation, but professional intervention is necessary to manage plaque that evades daily brushing and flossing. Regular check-ups and professional cleanings are essential to catch hidden problems and remove hardened plaque, keeping your teeth and gums in optimal health.

The severity of your initial periodontal disease will guide the frequency of your maintenance care. Dr. Feldner, in collaboration with your general dentist, will determine the most effective schedule for your supportive periodontal care.

Your Periodontal Maintenance Visit May Include:

• Reviewing changes in your health history.
• Examining mouth tissues for abnormal signs.
• Measuring pocket depths around your teeth.
• Evaluating and advising on your oral hygiene practices.
• Removing bacterial plaque and tartar.
• Conducting x-ray evaluations to monitor your teeth and the supporting bone.
• Checking for tooth decay and other dental issues.
• Assessing your bite alignment.
• Applying or prescribing medications for tooth sensitivity or other oral issues.

1. Plaque Removal: Despite diligent at-home oral care, removing all tartar (calculus) and plaque, especially beneath the gum line, can be challenging. Tartar and plaque accumulation can lead to significant periodontal issues. A dentist or hygienist, equipped with specialized tools and trained expertise, is essential to identify and remove harmful buildups that might escape routine cleaning.
2. Enhanced Smile Aesthetics: Prophylaxis is highly effective in eliminating stains and discoloration, dramatically improving the appearance of your smile. Yellowed or stained teeth can substantially detract from the overall look of a smile, and professional cleaning can address these cosmetic concerns.
3. Fresher Breath: Persistent bad breath, or halitosis, often indicates advancing periodontal disease. This can be caused by decomposing food particles under the gum line and potential infection. Regular removal of plaque, tartar, and bacteria by professional cleaning can significantly improve breath and decrease the risk of infection.

Before proceeding with scaling and root planing, Dr. Feldner conducts a comprehensive examination of the mouth, which might include x-rays and a visual inspection. Based on the gums’ condition, the extent of tartar accumulation, pocket depth, and the progression of periodontitis, Dr. Feldner will determine the necessity of these procedures. Local anesthesia may be administered in certain cases to ensure patient comfort.

Scaling: Scaling involves removing plaque and calculus from tooth surfaces, with a focus on the area beneath the gum line along the root. This is achieved using a specialized ultrasonic scaling tool, often coupled with an irrigation process that delivers antimicrobial agents below the gums to reduce oral bacteria.

Root Planing: The process of root planing smooths the tooth’s root by removing cementum and surface dentin tainted with microorganisms, toxins, and tartar. Smoothing the root surface encourages healing and reduces future bacterial colonization.

Post-scaling and planing, Dr. Feldner may recommend antibiotics or antimicrobial irrigation to control bacteria growth leading to periodontitis. In certain situations, antibiotic fibers are placed in the periodontal pockets to manage infection and promote healing. When deep pockets exist between teeth and gums, making plaque and tartar removal challenging, surgery might be necessary to regain periodontal health.

Scaling and root planing offer several benefits, crucial for periodontal health:

1. Disease Prevention: Research indicates that bacteria from periodontal infections can spread through the bloodstream, potentially affecting other body parts, and contributing to heart and respiratory diseases. Scaling and root planing effectively remove these harmful bacteria.
2. Tooth Loss Prevention: Deep gum pockets, exceeding 3mm, heighten the risk of periodontal disease. As these pockets deepen, they harbor more bacteria, leading to tissue destruction and eventual tooth loss.
3. Aesthetic and Hygiene Improvement: Besides enhancing the mouth’s appearance and reducing bad breath caused by food particles and bacteria, scaling and root planing also remove superficial tooth stains, contributing to a cleaner and more aesthetically pleasing smile.

Scaling and root planing are instrumental in maintaining oral health, preventing disease, and ensuring the longevity of your teeth, while also contributing to your overall well-being.

Crown lengthening not only contributes to a more aesthetically pleasing smile but also plays a significant role in improving oral health and ensuring the longevity of dental restorations. Dr. Feldner’s expertise in this procedure ensures that you receive the best care for a healthier, more confident smile.

With the precision of the laser to remove only diseased tissue, LANAP™ offers a restoration to oral health with minimal post-operative pain and fewer risks than conventional surgical methods. This treatment is complemented by a comprehensive homecare regimen to ensure optimal recovery and long-term gum health.

Following LANAP™ treatment, you may be prescribed anti-microbial rinses and antibiotics. It’s important to follow these directions closely:

• Limit physical activity for several hours post-surgery.
• Experience typically minimal discomfort, with Advil or Motrin recommended for the first 24 hours.
• Adhere to a liquid diet for the first day, followed by a soft diet for the next 3-7 days, avoiding spicy and hard foods.
• Avoid chewing in the treated areas for at least one week.
• Expect changes in tissue color, which is a normal response to laser therapy.
• Gently rinse with Peridex or Periogard as directed, supplementing with warm saltwater rinses in between.
• Maintain oral hygiene in untreated areas, avoiding the surgery site initially.
• Avoid applying pressure with the tongue or cheek to the treated area.

Please call our office at Periodontics & Dental Implants Phone Number 308-237-0100 if you experience:

• Prolonged or severe pain
• Excessive or continuous bleeding
• Elevated or persistent fever

It’s not uncommon, during the healing process, which can last up to a year, to experience soreness or sensitivity as bone and ligaments around the teeth strengthen. This is generally a positive sign of healing but may indicate the need for a bite adjustment.
For any concerns or questions regarding your LANAP™ treatment, please don’t hesitate to reach out to us. Our commitment is to ensure your comfort and confidence throughout your periodontal healing journey.

Bite adjustment involves a variety of strategies tailored to individual needs, which may include:

1. Reshaping Biting Surfaces: This involves modifying the surfaces of the teeth to reduce excessive pressure points. The goal is to distribute biting forces evenly across all teeth, alleviating stress on individual teeth.
2. Bite Splint Therapy: A custom-fitted plastic bite guard may be used to prevent the teeth from coming into contact. This guard can be worn during the day or night, or both, to protect the teeth and TMJ from excessive wear.
3. Orthodontic Treatment: Braces may be employed to realign teeth that have become misaligned or have drifted from their proper positions.
4. Replacing Old Restorations: Old, worn-out, or damaged fillings can be replaced to improve bite function and prevent further tooth damage.
5. Reconstructive Procedures: For teeth that are severely worn, or damaged, reconstructive treatments may be necessary to restore both function and aesthetics.

A gingival graft is designed to address these concerns effectively. In this procedure, a thin piece of tissue is harvested from the roof of the mouth or shifted from adjacent areas to form a stable band of attached gingiva around the tooth. This graft can also be positioned to cover the exposed root, depending on the specific needs.

For those seeking alternatives, the Pinhole Surgical Technique™ offers another option for addressing gum recession without traditional grafting.

By choosing to undergo a gum grafting procedure, you are taking a significant step towards restoring the health and aesthetics of your gums, ensuring the longevity and comfort of your smile.

The Chao Pinhole® Surgical Technique offers numerous advantages:

• Reduced discomfort post-treatment
• Quicker recovery compared to traditional grafting.
• Elimination of the need for sutures
• No requirement for scalpels or other invasive surgical tools
• Avoids the need to harvest donor tissue from the patient’s palate.
• Delivers natural-looking, long-lasting results.

The Pinhole Surgical Technique stands out as a state-of-the-art solution for treating gum recession, prioritizing patient comfort and aesthetic outcomes. This procedure underscores our commitment to providing advanced, patient-centered care for lasting dental wellness.

The key function of the membrane is to shield the slower-growing bone from the quicker-growing soft tissue. This separation allows the bone to regenerate and rebuild itself over time.

By opting for guided bone and tissue regeneration, patients can take advantage of a sophisticated approach to periodontal care, paving the way for improved dental health and the potential for future dental restorations.

1. Crown Lengthening: Contrary to appearance, your teeth may be of normal length, hidden beneath excess gum tissue. Crown lengthening is a periodontal plastic surgery procedure that reshapes excess gum and bone tissue to reveal more of your natural tooth. This can be performed on a single tooth or multiple teeth to create an even gum line and unveil a more attractive smile.
2. Gum Grafting: This procedure involves soft tissue grafts to cover exposed tooth roots, reducing gum recession and protecting the roots from decay and potential tooth loss. Gum grafting also addresses aesthetic concerns related to visible roots.
3. Bone Grafting: Following tooth loss, jawbone recession can lead to unnatural indentations in your gums and jaw, contributing to an aged appearance. Bone grafting post-tooth loss helps preserve the socket/ridge, minimizing the collapse of gums and bone. This results in less shrinkage, providing a more aesthetic base for tooth replacement options like implant crowns or fixed bridges.

Dr. Feldner provides the most effective and advanced treatment options for each patient. During your consultation, he will discuss the full range of grafting options, including the innovative use of bone morphogenetic protein, to determine the best course of action for your specific needs. This commitment to employing cutting-edge techniques like BMP is part of our ongoing effort to ensure optimal patient care and successful outcomes in bone regeneration procedures.

Cosmetic periodontal surgery not only enhances your smile’s appearance but also plays a crucial role in improving oral health, ensuring that your teeth and gums remain healthy and visually appealing for years to come. Dr. Feldner’s expertise in these procedures ensures that you receive tailored care that aligns with your unique aesthetic goals.

The screening process is entirely painless. Dr. Feldner will examine your mouth for any abnormalities and palpate the face, glands, and neck for unusual bumps. Advanced tools like lasers might be used to reveal pathological changes beneath the surface, identifying spots and lesions invisible to the naked eye.

Key indicators that Dr. Feldner will look for include:

• Red patches and sores, especially on the floor of the mouth or the front of the tongue
• Persistent bleeding sores
• Leukoplakia, characterized by white or gray lesions.
• Soreness, lumps, or a general thickening of tissue in the mouth or throat

Regular oral cancer screenings are a critical component of your dental health regimen. These exams not only facilitate the early detection of cancerous changes but also offer peace of mind and a proactive approach to maintaining your overall oral health.