Periodontists are dentistry's experts in treating periodontal disease. They receive up to three additional years of specialized training in periodontal disease treatment in both non-surgical treatments and periodontal plastic surgery procedures. Periodontists are also experts in replacing missing teeth with dental implants.

• Non-Surgical Treatments
• Gum Graft Surgery
• Laser Treatment
• Regenerative Procedures
• Dental Crown Lengthening
• Dental Implants
• Pocket Reduction Procedures
• Plastic Surgery Procedures

Untreated periodontal disease can eventually lead to tooth loss and other health problems.

PERIODONTITIS

Untreated gingivitis can advance to periodontitis. With time, plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque irritate the gums. The toxins stimulate a chronic inflammatory response in which the body in essence turns on itself, and the tissues and bone that support the teeth are broken down and destroyed. Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Often, this destructive process has very mild symptoms. Eventually, teeth can become loose and may have to be removed.
There are many forms of periodontitis. The most common ones include the following.

• Aggressive periodontitis occurs in patients who are otherwise clinically healthy. Common features include rapid attachment loss and bone destruction and familial aggregation.
• Chronic periodontitis results in inflammation within the supporting tissues of the teeth, progressive attachment and bone loss. This is the most frequently occurring form of periodontitis and is characterized by pocket formation and/or recession of the gingiva. It is prevalent in adults, but can occur at any age. Progression of attachment loss usually occurs slowly, but periods of rapid progression can occur.
• Periodontitis as a manifestation of systemic diseases often begins at a young age. Systemic conditions such as heart disease, respiratory disease, and diabetes are associated with this form of periodontitis.
• Necrotizing periodontal disease is an infection characterized by necrosis of gingival tissues, periodontal ligament and alveolar bone. These lesions are most commonly observed in individuals with systemic conditions such as HIV infection, malnutrition and immunosuppression.

The main cause of periodontal (gum) disease is plaque, but other factors affect the health of your gums.

AGE

Studies indicate that older people have the highest rates of periodontal disease. Data from the Centers for Disease Control and Prevention indicates that over 70% of Americans 65 and older have periodontitis.

SMOKING/TOBACCO USE

Tobacco use is linked with many serious illnesses such as cancer, lung disease and heart disease, as well as numerous other health problems. Tobacco users also are at increased risk for periodontal disease. Studies have shown that tobacco use may be one of the most significant risk factors in the development and progression of periodontal disease.

GENETICS

Research has indicated that some people may be genetically susceptible to gum disease. Despite aggressive oral care habits, these people may be more likely to develop periodontal disease. Identifying these people with a genetic test before they even show signs of the disease and getting them into early intervention treatment may help them keep their teeth for a lifetime.

STRESS

Stress is linked to many serious conditions such as hypertension, cancer, and numerous other health problems. Stress also is a risk factor for periodontal disease. Research demonstrates that stress can make it more difficult for the body to fight off infection, including periodontal diseases.

MEDICATIONS

Some drugs, such as oral contraceptives, anti-depressants, and certain heart medicines, can affect your oral health. Just as you notify your pharmacist and other health care providers of all medicines you are taking and any changes in your overall health, you should also inform your dental care provider.

CLENCHING OR GRINDING YOUR TEETH

Clenching or grinding your teeth can put excess force on the supporting tissues of the teeth and could speed up the rate at which these periodontal tissues are destroyed.

OTHER SYSTEMIC DISEASES

Other systemic diseases that interfere with the body's inflammatory system may worsen the condition of the gums. These include cardiovascular disease, diabetes, and rheumatoid arthritis.

POOR NUTRITION AND OBESITY

A diet low in important nutrients can compromise the body's immune system and make it harder for the body to fight off infection. Because periodontal disease begins as an infection, poor nutrition can worsen the condition of your gums. In addition, research has shown that obesity may increase the risk of periodontal disease.

GINGIVITIS

• Red, swollen or tender gums or other pain in your mouth
• Bleeding while brushing, flossing, or eating hard food
• Gums that are receding or pulling away from the teeth, causing the teeth to look longer than before
• Loose or separating teeth
• Pus between your gums and teeth
• Sores in your mouth
• Persistent bad breath
• A change in the way your teeth fit together when you bite
• A change in the fit of partial dentures

The American Academy of Periodontology's risk assessment test will help you see if you are at risk for having or developing periodontal (gum) disease. Millions of people don't know they have this serious infection that can lead to tooth loss if not treated.

If left untreated, this inflammation can cause the gums and supporting bone structure to deteriorate. This can lead to gum recession or even tooth loss. In addition, research has shown that gum disease may be associated with other diseases, such as diabetes and heart disease.

Luckily, periodontal disease can be preventable. Adding these habits to your daily routine can help.

Luckily, periodontal disease can be preventable. Adding these habits to your daily routine can help.

Brush your teeth.

Brushing after meals helps remove food debris and plaque trapped between your teeth and gums. Don't forget to include your tongue, bacteria loves to hide there.

Floss

Flossing at least once a day helps remove food particles and plaque between teeth and along the gum line that your toothbrush can't quite reach.

Swish with mouthwash

Using a mouthwash can help reduce plaque and can remove remaining food particles that brushing and flossing missed.

Know your risk

Age, smoking, diet and genetics can all increase your risk for periodontal disease. If you are at increased risk, be sure to talk with your dental professional

See a periodontist

Get an annual comprehensive periodontal evaluation (CPE) from a dental professional. A CPE looks at your teeth, plaque level, gums, bite, bone structure and other risk factors for periodontal disease. Identifying symptoms of gum disease early is key to protecting your teeth and gums.

Research has shown that periodontal disease is associated with several other diseases. For a long time it was thought that bacteria was the factor that linked periodontal disease to other disease in the body; however, more recent research demonstrates that inflammation may be responsible for the association. Therefore, treating inflammation may not only help manage periodontal diseases but may also help with the management of other chronic inflammatory conditions

DIABETES

Diabetic patients are more likely to develop periodontal disease, which in turn can increase blood sugar and diabetic complications.

People with diabetes are more likely to have periodontal disease than people without diabetes, probably because people with diabetes are more susceptible to contracting infections. In fact, periodontal disease is often considered a complication of diabetes. Those people who don't have their diabetes under control are especially at risk.

Research has suggested that the relationship between diabetes and periodontal disease goes both ways - periodontal disease may make it more difficult for people who have diabetes to control their blood sugar.

Severe periodontal disease can increase blood sugar, contributing to increased periods of time when the body functions with a high blood sugar. This puts people with diabetes at increased risk for diabetic complications.

HEART DISEASE

STROKE

Additional studies have pointed to a relationship between periodontal disease and stroke. In one study that looked at the causal relationship of oral infection as a risk factor for stroke, people diagnosed with acute cerebrovascular ischemia were found more likely to have an oral infection when compared to those in the control group.

OSTEOPOROSIS

Researchers have suggested that a link between osteoporosis and bone loss in the jaw. Studies suggest that osteoporosis may lead to tooth loss because the density of the bone that supports the teeth may be decreased, which means the teeth no longer have a solid foundation.

RESPIRATORY DISEASE

Research has found that bacteria that grow in the oral cavity can be aspirated into the lungs to cause respiratory diseases such as pneumonia, especially in people with periodontal disease.

CANCER

Researchers found that men with gum disease were 49% more likely to develop kidney cancer, 54% more likely to develop pancreatic cancer, and 30% morelikely to develop blood cancers.

A woman's periodontal health may be impacted by a variety of factors.

PUBERTY

People with diabetes are more likely to have periodontal disease than people without diabetes, probably because people with diabetes are more susceptible to contracting infections. In fact, periodontal disease is often considered a complication of diabetes. Those people who don't have their diabetes under control are especially at risk.

MENSTRUATION

Occasionally, some women experience menstruation gingivitis. Women with this condition may experience bleeding gums, bright red and swollen gums and sores on the inside of the cheek. Menstruation gingivitis typically occurs right before a woman's period and clears up once her period has started.

PREGNANCY

Some studies have suggested the possibility of an additional risk factor – periodontal disease. Pregnant women who have periodontal disease may be more likely to have a baby that is born too early and too small. However, more research is needed to confirm how periodontal disease may affect pregnancy outcomes.

All infections are cause for concern among pregnant women because they pose a risk to the health of the baby. The Academy recommends that women considering pregnancy have a periodontal evaluation.

MENOPAUSE AND POST-MENOPAUSE

Women who are menopausal or post-menopausal may experience changes in their mouths. They may notice discomfort in the mouth, including dry mouth, pain and burning sensations in the gum tissue and altered taste, especially salty, peppery or sour.

In addition, menopausal gingivostomatitis affects a small percentage of women. Gums that look dry or shiny, bleed easily and range from abnormally pale to deep red mark this condition. Most women find that estrogen supplements help to relieve these symptoms.

TYPES OF PERIODONTAL DISEASES IN CHILDREN

Chronic gingivitis is common in children. It usually causes gum tissue to swell, turn red and bleed easily. Gingivitis is both preventable and treatable with a regular routine of brushing, flossing and professional dental care. However, left untreated, it can eventually advance to more serious forms of periodontal disease.

Aggressive periodontitis can affect young people who are otherwise healthy. Localized aggressive periodontitis is found in teenagers and young adults and mainly affects the first molars and incisors. It is characterized by the severe loss of alveolar bone, and ironically, patients generally form very little dental plaque or calculus.

Generalized aggressive periodontitis may begin around puberty and involve the entire mouth. It is marked by inflammation of the gums and heavy accumulations of plaque and calculus. Eventually it can cause the teeth to become loose.

All infections are cause for concern among pregnant women because they pose a risk to the health of the baby. The Academy recommends that women considering pregnancy have a periodontal evaluation.

SIGNS OF PERIODONTAL DISEASE

Bleeding Bleeding gums during tooth brushing, flossing or any other time	Puffiness Swollen and bright red gums	Recession Gums that have receded away from the teeth, sometimes exposing the roots

Bad breath
Constant bad breath that does not clear up with brushing and flossing

IMPORTANCE OF GOOD DENTAL HYGIENE IN ADOLESCENCE

Hormonal changes related to puberty can put teens at greater risk for getting periodontal disease. During puberty, an increased level of hormones, such as progesterone and possibly estrogen, cause increased blood circulation to the gums. This may cause an increase in the gum's sensitivity and lead to a greater reaction to any irritation, including food particles and plaque. During this time, the gums may become swollen, turn red and feel tender

As a teen progresses through puberty, the tendency for the gums to swell in response to irritants will lessen. However, during puberty, it is very important to follow a good at-home dental hygiene regimen, including regular brushing and flossing, and regular dental care. In some cases, a dental professional may recommend periodontal therapy to help prevent damage to the tissues and bone surrounding the teeth.

ADVICE FOR PARENTS

Early diagnosis is important for successful treatment of periodontal diseases. Therefore, it is important that children receive a comprehensive periodontal examination as part of their routine dental visits. Be aware that if your child has an advanced form of periodontal disease, this may be an early sign of systemic disease. A general medical evaluation should be considered for children who exhibit severe periodontitis, especially if it appears resistant to therapy.

The most important preventive step against periodontal disease is to establish good oral health habits with your child. There are basic preventive steps to help your child maintain good oral health:

• Establish good dental hygiene habits early. When your child is 12 months old, you can begin using toothpaste when brushing his or her teeth. When the gaps between your child's teeth close, it's important to start flossing.
• Serve as a good role model by practicing good dental hygiene habits yourself.
• Schedule regular dental visits for family checkups, periodontal evaluations and cleanings.
• Check your child's mouth for the signs of periodontal disease, including bleeding gums, swollen and bright red gums, gums that are receding away from the teeth and bad breath.

Could you be one of the millions of people who have gum disease and don't know it?

Take the risk assessment test now

The American Academy of Periodontology's risk assessment test will help you see if you are at risk for having or developing periodontal (gum) disease. Recent research from the Centers for Diseaese Control indicates that 64 million adults have some form of periodontal disease. Many of them do not know it!

Once your answers are submitted, a proprietary calculation determines whether you are at low, medium or high risk and generates a report of your results. This Periodontal Disease Risk Score and the information contained in your report should not be construed as dental advice or as a substitute for a comprehensive evaluation and diagnosis by a qualified practitioner. Rather, this report is intended to help educate patients about common risk factors related to periodontal diseases and to assist in the decision of when referral to a periodontist would be advisable.

Research has indicated that some people may be genetically susceptible to gum disease. Despite aggressive oral care habits, these people may be more likely to develop periodontal disease. Identifying these people with a genetic test before they even show signs of the disease and getting them into early intervention treatment may help them keep their teeth for a lifetime.

Peri-implant diseases are inflammatory conditions affecting the soft and hard gum tissues around dental implants. Similar to a natural tooth, bacteria can build up on the base of the implant, below the gum line. Over time, the bacteria irritate the gum tissue, causing it to become inflamed, damaging the tissue and if not caught early, causing the bone structure below the implant to deteriorate.

Peri-implant diseases are classified into two categories.

Signs of peri-implant diseases are similar to symptoms of gum disease: red or tender gums around the implants, or bleeding when brushing. And just like your natural teeth, implants require regular tooth brushing and flossing and regular check-ups from a dental professional. Other risks factors for developing peri-implant disease include previous periodontal disease diagnosis, poor plaque control, smoking, and diabetes. It is essential to routinely monitor dental implants as part of a comprehensive periodontal evaluation

The up side to dental implants is they function just like your natural tooth. The down side is, they are capable of becoming diseased just like a natural tooth. With a proper oral health routine, your dental implant can last a lifetime.

The AAP recommends an annual comprehesive periodontal evaluation, or CPE, to assess your periodontal health and identify conditions such as periodontal disease that may need additional treatment.

WHAT IS A COMPREHENSIVE PERIODONTAL EVALUATION?

In 2011, the American Academy of Periodontology published the Comprehensive Periodontal Therapy Statement, gum inflammation is found only around the soft tissues of the dental implant, with no signs of bone loss. Generally peri-implant mucositis is a precursor to peri-implantitis. Evidence suggests that peri-implant mucositis may be successfully treated and is reversible if caught early

A Comprehensive Periodontal Evaluation, or CPE, is a way to assess your periodontal health by examining:

• Your teeth
• Your plaque
• Your gums
• Your bite
• Your bone structure
• Your risk factors

When your dental professional, such as a periodontist, general dentist, or dental hygienist, performs this evaluation, they will look at these six areas to determine the state of your periodontal health.

WHY DO I NEED A COMPREHENSIVE PERIODONTAL EVALUATION?

Recent research has indicated that the prevalence of periodontal disease in the U.S. may be significantly higher than originally estimated. This means that all adults should thoroughly assess the state of their periodontal health to receive accurate information about the health of their mouths.

By assessing your oral health on an annual basis, you and your dental professional will know how healthy your mouth is, and will be better able to notice any conditions, such as periodontal disease, that may need additional treatment.

Research has also shown, and experts agree, that there is an association between periodontal disease and other chronic inflammatory conditions, such as diabetes, cardiovascular disease, and respiratory diseases. Therefore, it is very important to treat the inflammation that causes periodontal disease as soon as possible to ensure that your entire body stays healthy.

Periodontists are dentistry's experts in treating periodontal disease. They receive up to three additional years of specialized training in periodontal disease treatment in both non-surgical treatments and periodontal plastic surgery procedures. Periodontists are also experts in replacing missing teeth with dental implants.

• Non-Surgical Treatments
• Gum Graft Surgery
• Laser Treatment
• Regenerative Procedures
• Dental Crown Lengthening
• Dental Implants
• Pocket Reduction Procedures
• Plastic Surgery Procedures

AAP treatment guidelines stress that periodontal health should be achieved in the least invasive and most cost-effective manner. This is often accomplished through non-surgical periodontal treatment.

Non-surgical periodontal treatment does have its limitations. When it does not achieve periodontal health, surgery may be indicated to restore periodontal health.

SCALING AND ROOT PLANING

Scaling and root planing is a careful cleaning of the root surfaces to remove plaque and calculus [tartar] from deep periodontal pockets and to smooth the tooth root to remove bacterial toxins. Scaling and root planing is often followed by adjunctive therapy such as local delivery antimicrobials and host modulation, as needed on a case-by-case basis

Most periodontists would agree that after scaling and root planing, many patients do not require any further active treatment. However, the majority of patients will require ongoing maintenance therapy to sustain health.

TRAY DELIVERY SYSTEMS

A tray delivery system consists of a custom-fit tray made from impressions of the patient's mouth. Patients use the tray at home to deliver medications that have been prescribed by their dentist. Tray delivery systems were cleared by the Food and Drug Administration (FDA) since they are similar to fluoride trays traditionally used to prevent tooth decay. However, the FDA clearance process did not determine that any specific medication delivered via tray delivery systems has been proven to be a safe or effective way to treat gum disease. Additionally, numerous clinical studies have suggested that topically applied medicines do not reach the source of periodontal infections. When determining the best course of treatment for your specific case, be sure to discuss the pros and cons of all available treatment options with your dental professional.

Exposed tooth roots are the result of gum recession. Gum graft surgery will repair the defect and help to prevent additional recession and bone loss.

Gum grafts can be used to cover roots or develop gum tissue where absent due to excessive gingival recession. During gum graft surgery, 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 GUM GRAFT SURGERY?

A gum 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. Whether you have a gum graft 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.

Limited research suggests that the use of lasers as an adjunct to scaling and root planing (SRP) may improve the effectiveness of this procedure. SRP is a non-surgical therapy used to treat periodontal diseases. In addition, when the lasers are used properly during periodontal therapy there can be less bleeding, swelling and discomfort to the patient during surgery.

CAN THE USE OF LASERS IN PERIODONTAL THERAPY HARM PATIENTS?

Yes and no. Each laser has different wavelengths and power levels that can be used safely during different periodontal procedures. However, damage to periodontal tissues can result if an inappropriate wavelength and/or power level is used during a periodontal procedure.

DOES THE RESEARCH ON LASERS SUPPORT THEIR USE IN PERIODONTICS AT THIS TIME?

At this time, there is insufficient evidence to suggest that any specific laser wavelength is superior to the traditional treatment methods of the common periodontal diseases, such as periodontitis.

CAN I TRUST THE CLAIMS IN AN AD FOR PERIODONTAL THERAPY PERFORMED WITH A LASER?

It is important to beware of advertising that sounds too good to be true because it very well may be. A dental professional can help you separate fact from hype.

WILL MY INSURANCE CARRIER COVER THE USE OF A LASER IN PERIODONTAL THERAPY?

Insurance carriers reimburse for the procedure being performed rather than the device used to perform it. Therefore, whether your periodontist uses traditional tools for treatment or lasers, your reimbursement will be the same for that specific procedure. Before having surgery, always consult with your insurance carrier to determine what procedures are covered in your plan.

Procedures that regenerate lost bone and tissue supporting your teeth can reverse some of the damage caused by periodontal disease.

Your periodontist may recommend a regenerative procedure when the bone supporting your teeth has been destroyed due to periodontal disease. 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.

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 other health problems associated with periodontal disease.

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 lengths, but they're covered with too much gum tissue. To correct this, your periodontist performs a dental crown lengthening procedure.

During the dental crown lengthening 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 dental 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 level to expose more of the tooth so it can be restored.

A dental implant is an artificial tooth root that is placed into your jaw to hold a replacement tooth or bridge. Dental implants may be an option for people who have lost a tooth or teeth due to periodontal disease, an injury, or some other reason.

TYPES OF DENTAL IMPLANTS

• Endosteal (in the bone): This is the most commonly used type of implant. The various types include screws, cylinders or blades surgically placed into the jawbone. Each implant holds one or more prosthetic teeth. This type of implant is generally used as an alternative for patients with bridges or removable dentures.
• Subperiosteal (on the bone): These are placed on top of the jaw with the metal framework's posts protruding through the gum to hold the prosthesis. These types of implants are used for patients who are unable to wear conventional dentures and who have minimal bone height.
  

  Before dental implant	After dental implant

ARE YOU A CANDIDATE FOR DENTAL IMPLANTS?

The ideal candidate for a dental implant is in good general and oral health. Adequate bone in your jaw is needed to support the implant, and the best candidates have healthy gum tissues that are free of periodontal disease.

Dental implants are intimately connected with the gum tissues and underlying bone in the mouth. Since periodontists are the dental experts who specialize in precisely these areas, they are ideal members of your dental implant team. Not only do periodontists have experience working with other dental professionals, they also have the special knowledge, training and facilities that you need to have teeth that look and feel just like your own. Your dentist and periodontist will work together to make your dreams come true.

WHAT IS A DENTAL IMPLANT PROCEDURE LIKE?

This procedure is a team effort between you, your dentist and your periodontist. Your periodontist and dentist will consult with you to determine where and how your implant should be placed. Depending on your specific condition and the type of implant chosen, your periodontist will create a treatment plan tailored to meet your needs.

• Replacing a Single Tooth If you are missing a single tooth, one implant and a crown can replace it.
• Replacing Several Teeth If you are missing several teeth, implant-supported bridges can replace them.
• Replacing All of Your Teeth If you are missing all of your teeth, an implant-supported full bridge or full denture can replace them.
• Sinus Augmentation A key to implant success is the quantity and quality of the bone where the implant is to be placed. The upper back jaw has traditionally been one of the most difficult areas to successfully place dental implants due to insufficient bone quantity and quality and the close proximity to the sinus. Sinus augmentation can help correct this problem by raising the sinus floor and developing bone for the placement of dental implants.
• Sinus Augmentation A key to implant success is the quantity and quality of the bone where the implant is to be placed. The upper back jaw has traditionally been one of the most difficult areas to successfully place dental implants due to insufficient bone quantity and quality and the close proximity to the sinus. Sinus augmentation can help correct this problem by raising the sinus floor and developing bone for the placement of dental implants.
• Ridge Modification Deformities in the upper or lower jaw can leave you with inadequate bone in which to place dental implants. To correct the problem, the gum is lifted away from the ridge to expose the bony defect. The defect is then filled with bone or bone substitute to build up the ridge. Ridge modification has been shown to greatly improve appearance and increase your chances for successful implants that can last for years to come.

WHAT CAN I EXPECT AFTER RECEIVING A DENTAL IMPLANT?

This procedure is a team effort between you, your dentist and your periodontist. Your periodontist and dentist will consult with you to determine where and how your implant should be placed. Depending on your specific condition and the type of implant chosen, your periodontist will create a treatment plan tailored to meet your needs.

As you know, your own teeth require conscientious at-home oral care and regular dental visits. Dental implants are like your own teeth and will require the same care. In order to keep your implant clean and plaque-free, brushing and flossing still apply!

After treatment, your periodontist will work closely with you and your dentist to develop the best care plan for you. Periodic follow-up visits will be scheduled to monitor your implant, teeth and gums to make sure they are healthy.

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, if too much bone is lost, the teeth will need to be extracted.

Your periodontist has measured the depth of your pocket(s). A periodontal 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.

Reducing pocket depth and eliminating existing bacteria are important to prevent damage caused by the progression of periodontal disease and to help you 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 the chance of serious health problems associated with periodontal disease.

Periodontists are often considered the plastic surgeons of dentistry. If you are looking to improve your smile, a periodontist may be able to help.

GUMMY SMILE OR UNEVEN GUM LINE

Do you feel your teeth look too short and your smile is too gummy or your gums cover too much of some teeth while leaving the others the right length? If so, dental crown lengthening might be the solution for you. During this procedure, excess gum tissue is removed to expose more of the crown of the tooth. Then your gumline is sculpted to give your new smile just the right look.

LONG TEETH/EXPOSED ROOTS

Sometimes gum recession causes the tooth root to become exposed, which makes your teeth look long and can make you look older than you are. This recession can happen as a result of a variety of causes, including periodontal diseases.

Gum graft surgery and other root coverage procedures are designed to cover exposed roots, to reduce further gum recession and to protect vulnerable roots from decay.

INDENTATIONS IN THE GUMS AND JAWBONE

Tooth loss can cause an indentation in the gums and jawbone where the tooth used to be. This happens because the jawbone recedes when it no longer is holding a tooth in place. Not only is this indention unnatural looking, it also causes the replacement tooth to look too long compared to the adjacent teeth.

Ridge augmentation can fill in this defect recapturing the natural contour of the gums and jaw. A new tooth can then be created that is natural looking, easy to clean and beautiful.