Periodontal Procedures in Billings, MT

Non-Surgical Periodontal Therapy

Non-surgical therapy removes plaque and calculus by controlling the growth of harmful bacteria and by treating conditions that encourage gum disease. This type of treatment may be all that's needed, especially when periodontal disease is caught early. You may also need to have certain procedures, such as replacing worn fillings or crowns with overhanging margins that can accumulate plaque, taken care of before periodontal therapy can begin.

Scaling and Root Planing:

Scaling is a type of cleaning that removes plaque and calculus from the teeth at and slightly below the gumline. Root planing smoothes root surfaces, so the supportive tissues can better reattach to the tooth surface. Often, this will be done with local anesthesia so you can relax and feel nothing as we rehabilitate your gums.

Antibiotics:

Periodontal disease is a bacterial disease and the key to controlling or eliminating it is the effective reduction or elimination of the harmful bacteria. An adjunctive option to scaling and root planing may be provided in either pill form or applied directly to the infected area (gum pocket) in the form of antibiotic powder. An antibacterial mouth rinse also may be prescribed to help control the harmful effects of and reduce bacterial plaque.

Occlusal Adjustment:

An improper bite or a traumatic occlusion may increase bone destruction attached to such offending teeth. We may either choose to adjust your bite so that your teeth meet properly and function better or construct a custom bite guard or splint- a removable device that fits over upper or lower teeth - to protect teeth surfaces and relax tense jaw muscles.

Surgical Periodontal Therapy

Crown Lengthening:

Crown lengthening is a periodontal procedure that reshapes the gum and supporting tissues to expose more of the tooth. This procedure can be used for aesthetic reasons to repair teeth that appear too short or "gummy smiles" and uneven gum lines.

It is also commonly performed on patients to repair a tooth that is fractured or decayed below the gum line. By reshaping the gum and supporting tissue, the fractured or decayed area becomes more accessible and gives us the needed space to establish the restoration.

With crown lengthening, patients reap the benefits of both enhanced function and aesthetics. Their overall periodontal health improves along with letting the natural beauty of their smile shine through.

Bone Grafting:

Much in the same way that gum tissue can be restored with soft tissue grafts, the same can be said for those patients who suffer from bone loss due to periodontitis. Bone in the jaw is kept strong and healthy when a healthy tooth is in its socket. However, when bone loss occurs, the tooth has less support, can become loose and eventually be lost.

Guided Tissue Regeneration (GTR) attempts to regenerate lost periodontal structures, such as bone, ligaments and connective tissue attachments, that support the teeth. Biocompatible membranes are used conjunctively with bone grafts for the regeneration to be successful.

If a tooth is lost, a patient may seek dental implants to restore his/her smile. However, even dental implants need a healthy jawbone before they can be placed. Guided Bone Regeneration (GBR) or Ridge Augmentation restores the bone before the placement of implants. Biocompatible membranes and bone grafts keep the tissue out, thus allowing the bone to grow.

The recent advances in technology have led to a higher success rate with this procedure, leading to bone formation and resolving the defect.

Emdogain:

Emdogain is a grafting product that promotes the regeneration of hard and soft tissues lost through periodontal disease. Emdogain's main ingredient is amelogenin, a protein that aids in the creation of teeth and supporting structures but produced only when our teeth are developing.

Emdogain is applied to the root surface. By doing so, the body thinks it is forming a natural tooth attachment, much like when your teeth first developed. Thus, the development of a natural tooth attachment and bone starts over.

Gum Grafting:

Aggressive tooth brushing, orthodontics, or periodontal disease can lead to gum recession, which ultimately results in exposed tooth roots. When tooth roots are exposed, teeth appear too long and can become sensitive to hot and cold liquids and foods. Also, the exposed roots are in danger of decay.

Soft tissue grafts are available to repair this problem as well as prevent further recession, bone loss or decay. The procedure covers the roots where excessive gum recession is present. Gum tissue is taken from your palate or from another donor source to cover the exposed root, thus, evening your gum line and reducing sensitivity levels.

Wisdom Teeth Extractions:

Wisdom teeth are the last teeth to erupt within the mouth. When they align properly, and gum tissue is healthy, wisdom teeth do not have to be removed. Unfortunately, this does not generally happen because of crowding and malposition of the erupting wisdom teeth.

The extraction of wisdom teeth is necessary when they are prevented from properly erupting within the mouth. They may grow sideways, partially emerge from the gum, and even remain trapped beneath the gum and bone. Impacted teeth can take many positions in the bone as they attempt to find a pathway that will allow them to erupt successfully.

These poorly positioned impacted teeth can cause many problems. When they are partially erupted, the opening around the tooth allows bacteria to grow and will eventually cause an infection. The result: swelling, stiffness, pain and illness.

The pressure from the erupting wisdom tooth may move other teeth and disrupt the orthodontic (positioned achieved by your orthodontist) or natural alignment of teeth. Although rare, the most serious problems occur when tumors or cysts form around the impacted wisdom tooth, resulting in the destruction of the jawbone and healthy teeth. Removal of the offending impacted tooth or teeth usually resolves these problems.

Early removal is recommended to avoid such future problems and to decrease the surgical risk involved with the procedure. Every year of your life, your bone gets more dense raising the technical aspects of the surgery and increasing the chances of having delayed healing or bone support defects post healing.

Wisdom teeth are a valuable asset to the mouth when they are healthy and properly positioned. Often, however, problems develop that require their removal. When the jaw isn't large enough to accommodate wisdom teeth, they can become impacted (unable to come in or misaligned). Wisdom teeth may grow sideways, emerge only part way from the gum or remain trapped beneath the gum and bone.

Extraction of wisdom teeth is generally recommended when:

Wisdom teeth only partially erupt. This leaves an opening for bacteria to enter around the tooth and cause an infection. Pain, swelling, jaw stiffness and general illness can result.
There is a chance that poorly aligned wisdom teeth will damage adjacent teeth.
A cyst (fluid-filled sac) forms, destroying surrounding structures such as bone or tooth roots.

If you are having a problem when you come to see us, we will talk about the health and positioning of your wisdom teeth. We may make a recommendation for removal if deemed necessary.