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Periodontal Treatment Options

Scaling & Root Planing | Arestin | Surgical | Cosmetic |
Benefits of Periodontal Treatment
Periodontal treatment is an investment in your health. Treating periodontal problems will help you achieve a healthy mouth and help prevent tooth loss. In fact, with prompt treatment, proper home care, and regular dental visits, a great majority of patients can keep their teeth for a lifetime.
What is the treatment for Periodontal Diseases?
After evaluating your periodontal health, Dr. Bernard will work with you to determine the treatment options that best meet your needs.

If periodontal disease is your problem, the treatment can vary widely depending on how far the diseases have progressed. If caught in the early stages, simple procedure are done that will remove the plaque and calculus from below the gum line and disrupt the infection-causing bacteria. If these diseases have advanced to the point where the periodontal pockets are deep and the supporting bone is lost, further treatment might be necessary.
Scaling and Root Planing (Deep Cleaning)
Scaling and root planing or what some people call a "Deep Cleaning" is a step above regular cleaning that you might receive at your general dentist's office and a step below laser or surgical procedure. It is a non-surgical technique that removes plaque and calculus below the gum line.

Tooth root surfaces are cleaned and smoothed with specially designed instruments. This procedure will generally arrest periodontal infection that is limited to the gum tissues and not yet advanced into the bone.
Arestin Treatment
Arestin is a conservative, non-surgical way to treat pockets of infection caused by periodontal disease. It is used either in conjunction with scaling and root planing, or may be used if scaling does not effectively eliminate the bacteria.

Arestin is a commonly used antibiotic, minocycline, in high concentration, which is placed directly into the pockets. It is slowly released over a period of 7 days, and effectively eliminates the bacteria deep in the pockets, and even within the gum tissue itself.

This mode of direct therapy is much more effective than taking the medication by mouth. We use Arestin treatment both in the initial phase of treatment, and also during maintenance, if pockets recur.

Research shows significant reduction in pocket depths, as well as reduction in disease activity, and we are very excited by the clinical results we see in our practice!
Surgical Treatments
There are a variety of surgical treatments that can be used to resolve your particular needs. If surgery is required, rest assured that Dr. Bernard and his entire team will make certain that you are always comfortable not only during the surgical procedure but postoperatively as well.

Surgery to Eliminate Bone Infections and to Regenerate Lost Bone
If your periodontal disease has progressed into the bone around your teeth, it is likely that a surgical procedure will be necessary to eliminate the infection. In the past, these procedures sometimes removed gum tissues and resulted in longer teeth. Today, newer procedures are used that are not only more effective but also more aesthetic. These minor surgical procedures eliminate the infection that has invaded the bone and often, the lost bone can be regenerated through a variety of bone grafting techniques. Dr. Bernard will carefully review your options and answer any questions you might have.
Cosmetic Periodontal Procedures
Start smiling! If you are not happy with your smile, there are cosmetic periodontal and dental procedures available to help you achieve the look you desire. Cosmetic procedures are one of Dr. Bernard's special interests. if you have a cosmetic concern you are at the right place - ask for a smile consultation. Together, you and Dr. Bernard can talk about your gum line, the amount of tooth you would like to show in your smile and any other cosmetic concerns you might have. Our office offers a full range of treatments to help you achieve the look you want.

Gummy Smile - after Gummy Smile - before Gummy Smile or uneven gum line
If you feel your teeth are too short and you show too much gum when you smile or that your gum line is uneven, Dr. Bernard may have the cosmetic treatment that will solve your problem.

Your teeth are probably not "too short." More than likely they are the prefect length, but you simply have too much gum tissue covering your teeth and hiding your smile.

Cosmetic procedures can sculpt your gum line, often with use of our dental laser, by removing excess gum tissue and giving you the proper contour of your gums and teeth with just the right length. Many times this is all that needs to be done, but if restorations are needed, this procedure sets the stage, allowing your new veneers or crowns to have the correct length and shape giving you a beautiful new smile.

Before after Long Teeth or Exposed Roots
If one or more of your teeth are too long, exposing the root surface, there are grafting procedures Dr. Bernard can use to cover these roots. The old saying, "long in the tooth" has become synonymous with aging. And it's true, if your gums recede, exposing your roots, you do look older. Dr. Bernard can cover roots with a variety of grafting techniques.

Depressions in the Gum or Jawbone
If you lose one or more teeth, it is not uncommon to have an indentation in your gums and jawbone where the tooth used to be. This occurs because the jawbone recedes when it no longer is holding a tooth in place. Not only is this deficiency unnatural looking, it also causes the replacement teeth to look unnatural.

Dr. Bernard can resolve this unsightly problem by filling in the indentation with a procedure called "ridge augmentation," recapturing the natural contour of your gums and jaw. A new tooth can then be created that is natural looking, easy to clean and beautiful.

Shrinkage of the gum can often be prevented when a tooth needs to be removed, with a procedure called "ridge preservation." Dr. Bernard can extract the tooth, and fill in the socket with a synthetic material at the same visit.

Crown Lengthening or "Crown Exposure"
If a tooth is decayed or broken off under the gumline, it is often impossible to restore without exposing sound tooth structure. This is done with a simple surgical procedure. Your dentist will need to wait about 6 weeks after the treatment before making the permanent crown.
Preventive Maintenance - Keeping your Gums and Bone healthy
Unfortunately periodontal treatment is never complete. Once the active phase of therapy is over, and your disease is under control, the challenge then becomes maintaining health. The goal of maintenance therapy is to reduce or eliminate as many of the risk factors that caused your disease in the first place. Dr. Bernard and his team will customize a program that will effectively meet your individual needs.

Are maintenance visits worth it?
You bet! They are the cheapest insurance you can get to prevent future dental problems. Continued treatment will save you dollars, time and perhaps even discomfort in the long run.

Proper Daily Home Care
This includes effective brushing and flossing. Dr. Bernard and his team will make certain you know the best techniques especially as they relate to your unique problem.

Frequent Professional Cleaning and Evaluation
For many periodontal patients, these visits are scheduled at a three month interval, ideally alternating them with your general dentist. In this manner you will receive the expertise of both your general dentist and Dr. Bernard. The actual time period between visits will be determined by the health of your gums and bone. If you are struggling to maintain health, the interval may be shortened, and on the other hand, if you historically have done well, the interval may be lengthened. The reason behind the three month interval is that the bacteria that live in your mouth take three months to mature to the point that they produce the poisons that reinfect you. We cannot eliminate this bacteria, but the professional cleaning disrupts them, forcing the bacteria to start the growth process all over again.
Another important part of the maintenance visit is the periodontal evaluation. If you have already experienced periodontal disease, they you know that it can occur with little or no symptoms. It therefore is important to track the health of your gum and bone over time to make certain reinfection does not occur and to catch it early, if it does.

Stabilizing the Bite
When you bit, all teeth should touch evenly. If certain teeth are forced to carry more than their fair share of the load, then they can become more susceptible to re infection. This can be resolved by "buffing off high spot," a procedure called a bit adjustment. if you have a tendency to clench or grind your teeth, that, too, can put you at risk for future disease and a bite guard may be prescribed.

Bite Guards
It is not uncommon for people to clench or grind their teeth. Some people are aware of this habit, but most are not. Grinding your teeth may make a noise, but clenching, which is equally damaging, is silent. In either case, these habits can damage your jaw joint and your teeth, and make you more susceptible for gum and bone disease. Second only to smoking, clenching and grinding is a strong risk factor for periodontal disease and must be controlled if treatment is to be successful.

Fortunately, this problem can be controlled through the use of what is called a bite or night guard. This is a hard plastic retainer-like appliance that is custom made for your bite. Although most people are initially resistant to the idea of wearing the guard, not only do most patients become accustomed to it, most actually end up liking it. They find they sleep better with the guard than without it.

The bite guard evenly distributes the forces created through the clenching and/or grinding and prevents them from making your disease spread more rapidly or putting you at more risk for future problems. Feel free to talk to Dr. Bernard or any of his team regarding this strong risk factor.