Tooth scaling removes plaque, tartar and hard, crusty calculus deposits, which are loaded with bacteria.
Sub-gingival tooth scaling is necessary when plaque and tartar are detected below the gum line.
Sometimes after a tooth scaling, the roots of a tooth must be planed in order to create a smooth surface for the gum tissue to re-attach to. In addition to the planing, your dentist may also prescribe medication in order to control infection and pain.
When a tooth is lost, both bone and gum tissue compete for the defect space. The gum tissue generates quicker than bone, thus assuming the space. With a membrane placement we can keep the gum tissue from the space, while the bone regenerates. Bone regeneration is often used to rebuild the supporting structures around the teeth which have been destroyed by periodontal disease. Bone surgery may be used to rebuild or reshape bone. Grafts of the patient's bone or artificial bone may be used, as well as special membranes.
Decay can frequently be found below the gum line. In order to gain access to the decay, it is necessary to reduce some of the bone surrounding the area of decay so the gum tissue can be positioned either higher up or lower down on the tooth making access to repair decay feasible. In other circumstances, the tooth may fracture below the gum line. Often the tooth requires a crown (cap) to cover over the fracture line. In order for the crown to fit over the fracture line, it is necessary to raise or lower the gum and reshape the bone accordingly so that the fracture line now becomes visible above the gum. The tooth is now ready for a crown (cap). When smiling, ideally there should be a display of upper teeth and a slight amount of gum displayed as well. In many circumstances there is an excessive amount of gum displayed (this is known as a gummy smile). In order to reduce the gum display so that there can be an ideal amount of tooth and gum showing, it is necessary to move both the gum and bone higher up on the teeth. The bone is gently sculpted to create room for the gum tissue to be ideally positioned. Hence the correct proportions of the teeth and gum are now visible.
When smiling, ideally there should be a display of upper teeth and a slight amount of gum displayed as well. In many circumstances there is an excessive amount of gum displayed (this is known as a gummy smile). In order to reduce the gum display so that there can be an ideal amount of tooth and gum showing it is necessary to move both the gum and bone higher up on the teeth. The bone is gently sculpted to create room for the gum tissue to be ideally positioned. Hence the correct proportions of the teeth and gum are now visible.
When deep pockets between teeth and gums (6 millimeters or deeper) are present, it is difficult for a dentist to thoroughly remove the plaque and tartar. Flap surgery is a procedure where the gum flap is lifted away from the tooth. Diseased tissue and sometimes bone is removed. The rough surfaces of the tooth are then smoothed by root planing. The area is medicated and the gum flap is replaced and sutured allowing the bone and gum tissue to heal. One of the goals of flap surgery is to reduce the depth of the periodontal pockets to make them easier to keep clean.
If a patient has an excess amount of tissue that connects the lower and upper lips to the jaw and gum line, a frenectomy procedure is performed to remove the excess tissue.
A frequent periodontal condition is known as gum recession. This means the existing gum tissue has receded up or down the root of the tooth exposing various amounts of the root. Root exposure can create root sensitivity especially to hot and cold, an increased potential for root decay, and/or esthetic concerns. Gum grafting procedures are the treatment of choice to prevent the recession from continuing further. There are many different types of recession and hence many different types of gum grafting. Some are aimed at covering the root of the tooth and other procedures are focused on providing an excellent new zone of gum tissue to halt the recession.