Periodontics

Dr. Khokhar is a dentist who specializes in the prevention, diagnosis and treatment of periodontal disease and in the placement of dental implants. Periodontists receive extensive training in these areas, including three additional years of education beyond dental school. Periodontists are familiar with the latest techniques for diagnosing and treating periodontal disease. In addition, they can perform cosmetic periodontal procedures to help you achieve the smile you desire. Often, dentists refer their patients to a periodontist when their periodontal disease is advanced. However, you don't need a referral to see a periodontist. In fact, there are occasions when you may choose to go directly to a periodontist or to refer a family member or friend to your own periodontist.

Warning sign of gum disease:

• Persistent swollen red or bleeding gums
• Tooth sensitivity
• Bad breath
• Developing spaces between your teeth
• Gum recession
• Change in your bite
• Loose teeth

If you are experiencing any of the above symptoms you may have or might be developing periodontal disease. Periodontal disease is a chronic bacterial infection that affects the gums and supporting bone of the teeth. This is a serious infection that may lead to tooth loss if not treated. Untreated gingivitis may cause periodontitis. In time this plaque can spread and grown under the gum line. Your gums will then separate from your teeth forming pockets. As the disease progresses, the pockets get deeper and the gum tissue and bone are destroyed.

Non Surgical Treatment

We believe that periodontal health should be achieved in the least invasive and most cost-effective manner. This is often accomplished through non-surgical periodontal treatment, including scaling and root planing (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), followed by adjunctive therapy such as local delivery antimicrobials and host modulation, as needed on a case-by-case basis.

 After scaling and root planing, many patients do not require any further active treatment, including surgical therapy. However, the majority of patients will require ongoing maintenance therapy to sustain health. Non-surgical therapy does have its limitations, however, and when it does not achieve periodontal health, surgery may be indicated to restore periodontal anatomy damaged by periodontal diseases and to facilitate oral hygiene practices.

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Periodontal Surgery for Pocket Reduction

If you're diagnosed with periodontal disease, you may need periodontal surgery. Periodontal surgery is necessary when we determine that the tissue around your teeth is unhealthy and cannot be repaired with non-surgical treatment.

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.

Mild Periodontitis	Advanced Periodontitis

During your examination, the depth of your pocket(s) is measured. A pocket reduction procedure is recommended if you have pockets that are too deep to clean with daily at-home oral hygiene and a professional care routine.

During this procedure, your gum tissue is gently pushed back and the roots of your teeth are cleaned off of 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 Pocket Reduction Procedures

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.

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Crown Lengthening

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

A “gummy” smile makes teeth appear short.  The teeth may actually be the proper lengths, but they're covered with too much gum tissue. To correct this, crown lengthening can be performed with a combination of soft and hard tissue sculpting.

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.

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Soft Tissue Grafts

Soft tissue grafts are performed to stop gum recession and to improve the esthetics of your gum line. During this procedure gum tissue is taken from your palate or other donor source to cover the exposed root. A soft tissue graft reduces further recession and bone loss, which may reduce tooth sensitivity.

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Bone Grafting

Bone grafting is performed to reverse the bone loss / destruction caused by periodontal disease, trauma, or ill fitting removable dentures. It is also used to augment bone to permit implant placement, such as augmenting bone in the sinus area for implant placement, or augmenting bone to enhance the fit and comfort of removable prostheses, or to enhance esthetics of a missing tooth site in the smile zone. When one loses a tooth, as in an extraction, the surrounding bone collapses. To preserve this bone for future implant placement or for esthetics, a bone graft is used.

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Regenerative Procedures

You  may need a regenerative procedure when the bone supporting your teeth has been destroyed. These procedures can reverse some of the damage by regenerating lost bone and tissue.

During this procedure, gums are gently pushed back and the area is thoroughly cleaned. Membranes (filters), bone grafts or tissue- stimulating proteins can be used to encourage your body's natural ability to regenerate bone and tissue.

There are many options to enhance support for your teeth and to restore your bone to a healthy level. We will be happy to discuss your best options with you.

Regenerative Procedure Before and After

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 associated with periodontal disease.

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