Once the correct diagnosis has been made, the overall objective of periodontal therapy is to eliminate the gum disease or, at least, to control it. There are surgical and non-surgical treatments, but both usually begin with the cleaning of your teeth by Dr. Romans, a review of your oral hygiene procedures by our staff, and the correction of your functional bite. Following those initial procedures, a decision will be made as to which method of treatment best suits your situation. The correction of your functional bite through bite adjustments is very important to your comfort and to the success of your periodontal therapy (occlusal adjustments; see page on HEADACHES,). An improper or an uneven bite will aid in the progression of your periodontal disease, will lead to the uneven wearing away of your teeth, breaking of porcelain crowns, and possible tooth fracture. This procedure will be described to you in detail prior to beginning by Dr. Romans. This is very important. SURGICAL CARE Teeth that have extensive recession of gum tissue can be treated with gum grafting procedures. This usually produces 75% to 100% coverage of the exposed root surface. It's important to realize that every area of recession does not have to be corrected by surgical grafting. This decision is made after your examination and consultation with Dr. Romans, followed by your initial cleaning procedures, oral hygiene instructions, and bite adjustments. He will give to you a detailed description of this grafting procedure. Surgery to reduce the pocket depths is our most common surgical procedure and is done to help control your disease. If pocket depths are reduced, your oral hygiene will improve. It will become easier to have your teeth cleaned professionally. The elimination or control of diseased pockets makes any needed restorative work go smoother, such as, crowns (caps), bridges, partial dentures, or the placing of dental implants (see page on DENTAL IMPLANTS). During surgery, the diseased or infected tissue is delicately removed from under the gum tissues and the root surfaces are cleaned extensively. Actually, surgery to eliminate diseased pockets is done UNDER the gum tissues. These surgical procedures are done in our office under local anesthesia while you are under the influence of a mild, oral sedative. The surgery is very tolerable. You will be able to walk in and walk out following your procedures. At no time is gum tissue surgically removed. Bone grafting is some areas to rebuild the bone that has been lost due to periodontal disease. Not all bone loss from periodontal disease is treated with bone grafting. This decision is also made by Dr. Romans after a complete review of your case, many times during the surgical procedures. Crown exposure surgery is a procedure that is done to prepare certain teeth for crowns (caps). Normally, this is reserved for teeth that have severe decay, advanced wear, or have been fractured. Before crowns cans be fitted, there must be enough tooth structure to hold the crown securely in place. The reason for surgically exposing more of the tooth is to make the crown more stable and secure. This type of surgery is used quite often to eliminate a "gummy smile," which is either a genetic problem or a condition that results from orthodontics (braces). In this situation either too much gum tissue shows or too little of the teeth show when smiling. If more of the teeth are exposed along with less gum tissue, your smile will be much improved. NON-SURGICAL PERIODONTAL THERAPY If you do not have extensive periodontal disease and you do not need large amounts of restorative dentistry, there is a chance that your case can be managed in a non-surgical manner. This will be determined by Dr. Romans after your initial examination and is accomplished through ultrasonic cleanings, regular tooth cleanings and polishing, good oral hygiene, and bite adjustments. After those are completed, you might need some minimal restorative work in the form of crowns, fillings, or bleaching (click here for more information). This non-surgical care seldom requires local anesthesia and usually can be completed in a minimal number of short appointments. Bite adjustments take two or more appointments. Dr. Romans or his staff will discuss your oral hygiene procedures at each appointment. Back to top