Periodontal disease is often behind why patients avoid cosmetic dentistry – even when they need it. Also known as gum disease, periodontal disease affects people’s gums. It is preventable; however, when in an advanced state, it may require surgery. Montgomery Dental Care first looks to conservative periodontal therapy. Gum disease can have serious consequences for your mouth’s appearance and health if treatment is delayed.
With innovative dental techniques, we can achieve periodontal health for many patients in a simple, non-invasive and affordable manner. Achieving a balanced smile through periodontal cosmetic dentistry may or may not involve oral surgery. This article will explain your options. We’ll begin by answering basic questions.
Periodontitis is a serious gum infection that damages gums and can harm your jawbone. Known as periodontal disease, it is an infection of the tissues that hold your teeth in place. This gum disease is common but fairly preventable for people who take their oral health seriously. Most often, the cause is poor oral hygiene. Periodontitis can lead to tooth loss as well, it’s a risk factor for heart and lung diseases.
Cosmetic periodontal surgery will involve adjusting the gum tissue height to a more ideal position. One will need to either add gum tissue via a technique called a subepithelial tissue graft. Or by carefully removing excess gum tissue. Both techniques are very predictable and can set the stage for a much more aesthetically pleasing smile.
Non-surgical perio treatment refers to non-invasive methods used to address gum problems. When diagnosed in the early stages of periodontal disease, non-surgical periodontal therapy is often effective. This involves your dental office removing bacterial plaque and tartar buildup. When presenting at and below the gum line, extra time may be needed. Your daily oral hygiene and a strong partnership with your dentist are your best preventive measures.
Treating periodontal disease is challenging due to how extremely diverse the periodontal microflora is.
Yes, cosmetic dentistry is typically the part of your dental plan that restores your visual appearance after the periodontal disease is addressed. Once your gums are fully recovered and no signs of gum disease are detected, you may be the perfect candidate for cosmetic procedures.
Oral surgery or periodontal surgery refers to any surgical procedure performed on your teeth, gums, or other oral structures. This includes extractions, implants, gum grafts, gingivectomy, etc..
Dr. Montgomery is a dentist who has extensive specialized training and experience in complex dental issues. We’ll cover non-surgical treatment choices first.
Traditional, routine oral cleanings, and polishes only impact plaque above the gum line. While that is an essential first line of defense, these procedures aren’t sufficiently effective to truly treat gum disease.
“Scaling” is a necessary first step in the treatment process; it prepares the way for a deeper clean.
By nature, periodontal infections are usually silent and can escape detection for many years. Since it doesn’t trigger a significant pain symptom, only regular visits to your dentist or periodontist detect it. You will want to stay more on top of this if other health problems are present, like heart problems or diabetes.
Periodontal “gum” disease is typically a chronic infection caused by bacteria that manage to get under the gum line. Hidden away, it can destroy the gum and, eventually, the bone that supports your teeth. This bacterium can firmly attach itself to your tooth roots where you cannot see it occurring. At this point of progression, regular dental cleanings may be inadequate to resolve the infection. In these instances, root planing commonly referred to as “deep cleanings,” becomes necessary.
If the non-surgical therapy effectively eliminates the gum disease, the only further requirement will be scheduled periodic maintenance. Typically, that involves an oral exam every 3-4 months.
Localized placement of medications below the gum line may combat “gum” disease if in the earliest stage.
The hope is to kill any persisting unhealthy bacteria following a dental cleaning, scaling, or root planing procedure. Research has shown that patients with advanced periodontal disease may also benefit from some use of these antimicrobial medications. It’s not an effective standalone treatment nor is it intended for long-term control of advanced periodontal disease.
In recent years the introduction and use of laser therapy have an increased role in the treatment of periodontal and implant disease. Its success depends on the skill of the dentist or periodontist. This modality can be highly effective and less invasive than “traditional” periodontal treatment methods.
Multiple wavelength lasers are available for this procedure; you’ll want someone with proven experience. Although laser-trained periodontists may utilize “traditional” treatments, in addition to being more effective and less invasive, the laser approach often provides regeneration of bone tissue around the diseased teeth and implants.
The laser gum treatment targets the “bad or pathogenic” bacteria, reduces inflammation, and preserves the good tissue that you need for the regeneration of healthy gum tissue and new bone.
If you notice dark spots appearing on your gums, it may be due to periodontal disease, poor oral health, or the use of tobacco. Gum whitening, also called gum bleaching, is a cosmetic dental procedure that typically corrects those spots. You also gain a brighter smile. It only requires a shorter dentist’s office visit.
However, if you’ve already been diagnosed with periodontal disease, your disease needs to be addressed first. Then gum whitening can follow.
Basically, dental inlays are fills in cavities and hollows in a tooth in the areas between the cusps. An onlay additionally fills in cavities in those spaces, but also works for larger areas, including the cusps. While similar to crowns, the difference is they do not cover the entire tooth surface.
It is best if you have a specialist to determine which treatment approach will help your specific condition. Once the stage of your periodontal disease is diagnosed, you may need a cosmetic procedure that aligns more closely with surgery. So, let’s answer the question this surfaces.
Cosmetic or plastic periodontal surgery provides the dental patient with a more beautiful smile by correcting one or multiple issues. The most common are an uneven gum line, issues with missing teeth, and restorative procedures like crowns and bridges.
If needed, these dental procedures aim to restore and revitalize your smile. Here are some procedures performed by cosmetic dentists that you may want to consider.
Gingivectomy is a more formal name for gum contouring. This is a cosmetic dental procedure where the dentist seeks to create an even gum line. Some people’s gum lines are uneven, causing teeth to appear too small or too long. Full-mouth oral gum reshaping improves your gums’ proportions to better fit your teeth.
When this cosmetic technique is used, the dentist scales back your gums to display more of your teeth’s surface. Another reason why gingivectomies are beneficial is to reduce further damage from gum disease.
Gingivectomy is a surgery performed in our dental office. All aspects of the surgery will be discussed with you prior to the procedure. Your feeling comfortable and confident in your dental treatment plan is important. Orthodontic treatment as a possible etiology for gingival recession.
Commonly, gum disease leads to tooth loss. If left until advanced, you may lose more than one tooth. Take action before several teeth are affected. Dental implants are an ideal option when replacing missing teeth lets you regain an esthetically pleasing smile. After being permanently embedded into your jawbone, they look and feel like your natural teeth and fit seamlessly into everyday life.
If untreated for too long, it increases the risk of periodontal disease destroying some jawbones. This means that surgery may only be possible if combined with additional procedures. You can rest assured that Dr. Marc L. Montgomery will discuss your best options with you.
Periodontal disease can lead to your gums receding or pulling away from one or more teeth. In severe cases of Periodontal disease, the root may be exposed and vulnerable. When gum recession occurs to this extent of impacting tooth roots, your dentist may bring up gum graft surgery. Gum grafting stops further decay from adding additional damage to your teeth. This procedure involves selecting a small piece of your surrounding gum tissue, commonly from the roof of your mouth, and attaching it where your gums are receding.
At times more than one gum graft is necessary. This oral surgery is also known as laser cosmetic gum recontouring or may involve a gingival graft. Gum graft surgery is considered a good cosmetic fix for receding gums.
Pinhole surgical technique (PST) is similar to gum grafting with the advantage of being less invasive. It is a practical application to assist in protecting your teeth while providing cosmetic benefits. It can be compared to orthoscopic/laparoscopic surgery; however, this minimally invasive procedure corrects gum recession by crafting a small hole in your gum line.
During a PST procedure, your dentist strategically creates a “pinhole” above your infected gum area. This involves “teasing” or encouraging the gums to draw downward, covering the affected area. An expert will know the correct instrument to use. Dental patients like it because it is less invasive, involves less recovery time, no scalpels or grafts, and the results are immediately attractive. We carefully consider your overall health, smile design goals, and which technique is likely to give you the best long-term outcome.
The cosmetic surgical procedure of using crowns and fixed bridges in another option. If a tooth is removed, typically the gum surrounding the bone collapses and forms an indentation which impacts the patient’s smile. Dental crowns or crown lengthening can look like your former natural tooth.
Porcelain crowns provide a very natural-looking smile. They are used when simply filling in a tooth is no longer the best option. If decay is severe, your dentist may recommend using a porcelain crown. They also provide solutions for severely damaged teeth or teeth that have already had multiple fillings.
Ridge augmentation may be recommended to correct uneven gum margins due to a lost tooth. It is recommended to undergo this surgical procedure before new tooth replacements are made. If you have gum tissue issues, you want any replacement teeth to look attractive and natural. Bone loss and slipping tooth alignment can be prevented when a tooth is removed or lost.
Surgery may be needed to remove calcium deposits in root canals or to treat damaged root surfaces or the surrounding bone of the tooth. First, your dental X-rays will assess the extent of damage. Many people simply need a non-surgical root canal. However, if the tooth has a large filling or is weakened from extensive decay, it needs protection from possible future damage. The final stage of your root canal is restoring your tooth to normal function.
It surprises many people that having a cavity filled is actually a type of dental surgery. Periodontal cosmetic dentistry can involve several dental procedures that are intended towards improving the appearance of your teeth. To gain a stunning smile design, teeth whitening, applying color-match fillings, bonding, and the usage of dental aligners (such as Invisalign), etc., may be recommended.
If a cavity is treated before it causes pain, you probably won’t need extensive treatment. Your dental exam will reveal which of the three types of cavities you have — smooth surface, pit, fissure, or root. It’s part of fine cosmetic smile design to select the best tooth-filling color.
It’s important to remember that these eary symptoms of periodontal disease may be subtle signs. Don’t wait till any one of the following becomes chronic.
As we age, the risk of getting periodontal disease increases. It is quite common among seniors.
Jocelyne Feine, DDS, MS, HDR reported through NIH that: “About 9 out of 10 adults aged 20 to 64 years have experienced tooth decay.” Additionally, the Oral Health in America – April 2022 Bulletin states that Periodontal (gum) disease impacts over 2 in 5 adults between the ages of 45 and 64 in the United States. It is associated with nearly 60 other health problems, including diabetes, heart conditions, and Alzheimer’s disease.
Due to its prevalence, we teach gum disease prevention to all of our patients. When possible, the above cosmetic procedures let us repair teeth when possible, rather than replacement teeth. Healthy teeth and beautiful smiles are dependent on healthy gums.
Get informed on action steps to prevent gum disease as a senior; download this periodontal preventative care PDF provided by NIH.
Marc L. Montgomery, DDS, has made great strides in the non-surgical management of periodontal problems. He is also a cosmetic dental expert and trains other dentists in cosmetic surgical procedures. You may be a candidate for cosmetic periodontal surgery. The surgery aims to make your gum line even and create an aesthetic balance with your teeth. If you’re interested in learning more about cosmetic periodontal surgery or any of the other procedures mentioned above, request an appointment.
Talk to the team at Montgomery Dental with any questions regarding appointments or dental care.
Thank you so much for making me smile. Whenever I’m in pictures now, I’m always smiling!