Periodontics is the specialist branch of dentistry that deals with gums and the surrounding supporting structures of teeth and implants, including bone.
A Periodontist is a dentist with specialized training in caring for gums and supporting structures.
The health of the gums and bone supporting teeth and implants is vital to maintain a functional and aesthetic smile. Periodontal (or gum) disease is an inflammation and infection of the gums and supporting structures of teeth and is caused by a buildup of plaque on teeth. The plaque contains bacteria which can damage the gums and supporting structures if not removed on a regular basis.
The early stages of gum disease are called Gingivitis. This is a reversible inflammation of the gums which is ordinarily treated by the removal of plaque and calculus via good oral hygiene habits (brushing and flossing). Where the plaque is not removed regularly gingivitis can progress to a more chronic inflammation called periodontitis. Periodontitis can lead to irreversible damage to the gums and supporting structures and gums may recede from the teeth. If both the gums and bone recede, teeth can become loose and can eventually be lost. Once periodontal disease advances to more advanced stages, professional intervention is necessary to prevent its progress.
Flap Surgery –
Surgery might be necessary if inflammation and deep pockets remain following treatment with deep cleaning and medications. A dentist or periodontist may perform flap surgery to remove tartar deposits in deep pockets or to reduce the periodontal pocket and make it easier for the patient, dentist, and hygienist to keep the area clean. This common surgery involves lifting back the gums and removing the tartar. The gums are then sutured back in place so that the tissue fits snugly around the tooth again. After surgery the gums will heal and fit more tightly around the tooth. This sometimes results in the teeth appearing longer.
Bone and Tissue Grafts -
In addition to flap surgery, your periodontist or dentist may suggest procedures to help regenerate any bone or gum tissue lost to periodontitis. Bone grafting, in which natural or synthetic bone is placed in the area of bone loss, can help promote bone growth. A technique that can be used with bone grafting is called guided tissue regeneration. In this procedure, a small piece of mesh-like material is inserted between the bone and gum tissue. This keeps the gum tissue from growing into the area where the bone should be, allowing the bone and connective tissue to regrow. Growth factors – proteins that can help your body naturally regrow bone – may also be used. In cases where gum tissue has been lost, your dentist or periodontist may suggest a soft tissue graft, in which synthetic material or tissue taken from another area of your mouth is used to cover exposed tooth roots.
Since each case is different, it is not possible to predict with certainty which grafts will be successful over the long-term. Treatment results depend on many things, including how far the disease has progressed, how well the patient keeps up with oral care at home, and certain risk factors, such as smoking, which may lower the chances of success. Ask your periodontist what the level of success might be in your particular case.