Periodontal Procedures

Dr. Daley provides procedures for all periodontal diseases, from LANAP laser to non-surgical treatment.

LANAP Laser Therapy


LANAP (Laser Assisted New Attachment Procedure) is used to treat periodontal disease and save many teeth that were previously considered hopeless. It uses the world’s first digital dental laser–the PerioLase ® MVP-7 , which was specifically designed for treating periodontal disease. The PerioLase ® laser is used as part of Laser Periodontal Therapy™, to remove harmful bacteria and diseased tissue from the gum pocket by passing a laser light between gum and tooth. Patients don’t hear or feel it – except for a little warmth. LANAP promises the patient a pain-free method to zap away disease. The procedure’s method of eliminating germs from the gums is very similar to lifting ink from a paper. First, the laser uses heat to strip away the diseased gum. The laser only seeks out infected tissue, which is darker in color than healthy tissue, leaving healthy tissue in place. Then, the dentist uses the laser a second time to heat the area until a clot is formed, protecting the newly-lasered tissue by sealing it. This allows the body to heal naturally so that the gum pockets improve and the teeth become more stable.

Patient Benefits

  • Dramatically less traumatic yet highly effective alternative to cut and sew gum surgery.
  • No cutting of the gum tissue with a scalpel and no stitches means easy recovery with minimal bleeding.
  • Preserves gum tissue instead of cutting it away.
  • Reduces root exposure and sensitivity.
  • Reduces infection.
  • Reasonable expense.

Plastic Surgery

Periodontal procedures are available to lay the groundwork for restorative and cosmetic dentistry and/or improve the esthetics of your gum line.

You may have asked your periodontist about procedures to improve a “gummy” smile because your teeth appear short. Your teeth may actually be the proper length, but they’re covered with too much gum tissue. To correct this, your periodontist performs crown lengthening.

During this procedure, excess gum and bone tissue is reshaped to expose more of the natural tooth. This can be done to one tooth, to even your gum line, or to several teeth to expose a natural, broad smile.

Your dentist or periodontist may also recommend crown lengthening to make a restorative or cosmetic dental procedure possible. Perhaps your tooth is decayed, broken below the gum line, or has insufficient tooth structure for a restoration, such as a crown or bridge. Crown lengthening adjusts the gum and bone levels to expose more of the tooth so it can be restored.

What are the benefits of this procedure?
Whether you have crown lengthening to improve function or esthetics, patients often receive the benefits of both. A beautiful new smile and improved periodontal health – your keys to smiling, eating and speaking with comfort and confidence.

Pocket Depth Reduction

Figure 2

Figure 1

The main cause of periodontal disease is bacteria in the form of a sticky, colorless plaque that constantly forms on your teeth. However, many factors can cause periodontal disease or influence its progression.

Your bone and gum tissue should fit snugly around your teeth like a turtleneck around your neck. When you have periodontal disease, this supporting tissue and bone is destroyed, forming “pockets” around the teeth.

Over time, these pockets become deeper, providing 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. Eventually, too much bone is lost, and the teeth need to be extracted.

Your periodontist has measured the depth of your pocket(s) (see figures 1 and 2). A pocket reduction procedure has been recommended because you have pockets that are too deep to clean with daily at-home oral hygiene and a professional care routine.

During this procedure, your periodontist folds back the gum tissue and removes the disease-causing bacteria before securing the tissue into place. In some cases, irregular surfaces of the damaged bone are smoothed to limit areas where disease-causing bacteria can hide. This allows the gum tissue to better reattach to healthy bone.

What are the benefits of this procedure?
Reducing pocket depth and eliminating existing bacteria are important to prevent damage caused by the progression of periodontal disease and to 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 for you to reduce them. Reduced pockets and a combination of daily oral hygiene and professional maintenance care increase your chances of keeping your natural teeth – and decrease your chances of serious health problems associated with periodontal disease.

Non-Surgical Therapy

Many times, the early stages of periodontal disease are best treated with non-surgical periodontal therapy. This usually consists of good oral hygiene training, scaling and root planning and antibiotic therapy. Scaling and root planning is done under local anesthesia and involves the use of special instruments which go beneath the gum line to effectively remove calculus, debris and diseased root surface. These procedures are performed by our hygiene team of dental professionals. 4 to 6 weeks or later, the areas are reevaluated for changes such as decreased bleeding, tissue swelling, probing scores and has there been any reattachement of the tissues to the tooth. In some cases, the occlusion (bite) may require adjustment.

Even in most severe cases of periodontal disease, non-surgical periodontal therapy most often precedes surgical therapy. This is done so that the overall tissue quality is improved prior to surgery and also limits the areas of required surgery.

When deep pockets between teeth and gums are present, it is difficult for you as a patient to thoroughly remove plaque and tarter. Patients can seldom, if ever, keep these pockets clean and free of plaque. Consequently, surgery may be needed to restore periodontal health

Antibiotics may be recommended to help control the growth of bacteria that create toxins and cause periodontitis. In some cases, our doctors may place antibiotics locally in the periodontal pockets after scaling. This may be done to control infection and to encourage normal healing.

Soft Tissue Graft

Periodontal procedures are available to stop further dental problems and gum recession, and/or to improve the esthetics of your gum line.

Exposed tooth roots are the result of gum recession. Perhaps you wish to enhance your smile by covering one or more of these roots that make your teeth appear too long. Or, maybe you’re not bothered by the appearance of these areas, but you cringe because the exposed roots are sensitive to hot or cold foods and liquids.

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 will help you identify the factors contributing to the problem. Once these contributing factors are controlled, a soft tissue graft procedure will repair the defect and help to prevent additional recession and bone loss.

Soft tissue grafts can be used to cover roots or develop gum tissue which is absent due to excessive gingival recession. During this procedure, your periodontist takes gum tissue from your palate or another donor source to cover the exposed root. This can be done for one tooth or several teeth to even your gum line and reduce sensitivity.

What are the benefits of this procedure?
A soft tissue graft can reduce further recession and bone loss. In some cases, it can cover exposed roots to protect them from decay; this may reduce tooth sensitivity and improve esthetics of your smile. A beautiful new smile and improved periodontal health – your keys to smiling, eating and speaking with comfort and confidence.

Regeneration

The main cause of periodontal disease is bacteria in the form of a sticky, colorless plaque that constantly forms on your teeth. However, many factors can cause periodontal disease or influence its progression.
Your bone and gum tissue should fit snugly around your teeth like a turtleneck around your neck. When you have periodontal disease, this supporting tissue and bone is destroyed and pockets develop. Eventually, too much bone is lost, and the teeth need to be extracted.

Your periodontist has recommended a regenerative procedure because the bone supporting your teeth has been destroyed (see figure 1 at right). These procedures can reverse some of the damage by regenerating lost bone and tissue.

During this procedure, your periodontist folds back the gum tissue and removes the disease-causing bacteria. Membranes (filters), bone grafts or tissue-stimulating proteins can be used to encourage your body’s natural ability to regenerate bone and tissue.

As you can see, there are many options to enhance support for your teeth and to restore your bone to a healthy level (see figure 2 at right). Your periodontist will discuss your best options with you.

What are the benefits of this procedure?
Eliminating existing bacteria and regenerating bone and tissue helps to reduce pocket depth and repair damage caused by the progression of periodontal disease. With a combination of daily oral hygiene and professional maintenance care, you’ll increase the chances of keeping your natural teeth – and decrease the chances of serious health problems (see main brochure) associated with periodontal disease.

Crown Lengthening

Periodontal procedures are available to lay the groundwork for restorative and cosmetic dentistry and/or to improve the health and esthetics of your smile.
Crown lengthening is a surgical procedure that recontours the gum tissue and often the underlying bone surrounding one or more teeth so that an adequate amount of healthy tooth is exposed.

Crown lengthening is often used as part of a treatment plan for a tooth that is to be fitted with a crown. This procedure provides the necessary space between the supporting bone and crown, preventing the new crown from damaging gum tissues and bone.

Your dentist or periodontist may also recommend crown lengthening in order to make a restorative procedure possible. If a tooth is badly worn, decayed or fractured below the gum line, crown lengthening adjusts the gum and bone levels to gain access to more of the tooth so it can be restored.

What are the benefits of this procedure?
Functional crown lengthening is an important part of an integrated effort to optimize your health, appearance, comfort and function. A beautiful new smile and improved periodontal health are your keys to smiling, eating and speaking with comfort and confidence.