Howard L. Graef, DDS
General Dentistry
Clawson, MI
248 589-2021

Services

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Periodontal Treatment

What is Periodontal Disease?

Periodontal diseases are infections of the gums that gradually destroy the support of your natural teeth. Dental plaque is the primary cause of gum disease in genetically-susceptible individuals. Bacteria found in plaque produce toxins or poisons that irritate the gums. They may cause them to turn red, swell, and bleed easily. If this irritation is prolonged, the gums separate from the teeth causing pockets (spaces) to form. Plaque can also harden into a rough, porous substance known as calculus (or tartar). This can occur both above and below the gum line. As periodontal diseases progress, the supporting gum tissue and bone that holds teeth in place deteriorate. If left untreated, this leads to tooth loss. However, don’t be fooled. With periodontal disease, bleeding, redness, and swelling do not have to be present. Further, pain is usually not associated with periodontal disease. This disease damages the teeth, gum, and jawbone of more than 80 percent of Americans by age 45.

Periodontal disease vs healthy gums

Periodontal Care

Periodontal treatment is necessary when various conditions affect the health of your gums and the regions of your jawbone that hold your teeth in place. Retaining your teeth is directly dependent on proper periodontal care and maintenance. Healthy gums enhance the appearance of your teeth, like a frame around a beautiful painting. When your gums become unhealthy, they can either recede or become swollen and red. In later stages, the supporting bone is destroyed and your teeth will shift, loosen, or fall out. These changes not only affect your ability to chew and speak. They also spoil your smile.

Other important factors affecting the health of your gums include:

  • Tobacco usage
  • Diabetes
  • Stress
  • Clenching and grinding teeth
  • Medication
  • Poor nutrition

Preventing Gum Disease

Adults over the age of 35 lose more teeth to gum diseases than from cavities. Three out of four adults are affected at some time in their life. The best way to prevent cavities and Periodontal Diseases is by daily thorough tooth brushing and flossing techniques and regular professional examinations and cleanings. Unfortunately, even with the most diligent home dental care, people still can develop some form of periodontal disease. Once this disease starts, professional intervention is necessary to prevent its progress.

Periodontal Treatment Methods

Dr. Graef’s practice provides a variety of surgical services. We pride ourselves on the fact that we are very conservative in our treatment recommendations and limit surgery to the areas where it is absolutely necessary.

Many times, the early stages of periodontal disease are best treated with non-surgical periodontal therapy. Even in severe cases, non-surgical periodontal therapy often precedes surgical therapy. This is done to improve the overall tissue quality prior to surgery and also to help limit the areas requiring surgery.

Scaling & Root Planing

The initial stage of treatment is usually a thorough cleaning that may include scaling to remove plaque and tartar deposits beneath the gum line.

The tooth roots may also be planed to smooth the root surface allowing the gum tissue to heal and reattach to the tooth. In some cases, the occlusion (bite) may require adjustment.

Antibiotics or irrigation with anti-microbials (chemical agents or mouth rinses) may be recommended to help control the growth of bacteria that create toxins and cause periodontitis. In some cases, Dr. Graef may place antibiotic fibers in the periodontal pockets after scaling and planing. This may be done to control infection and to encourage normal healing.

When deep pockets between teeth and gums are present, it is difficult for Dr. Graef to thoroughly remove plaque and tartar. Patients can seldom, if ever, keep these pockets clean and free of plaque. Consequently, surgery may be needed to restore periodontal health.

Scaling and Root Planing Overview

For a brief narrated overview of scaling and root planing, please click the image below. It will launch our flash educational MiniModule in a separate window that may answer some of your questions about scaling and root planing.

Sacling and Planing Overview

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Periodontal Scaling to remove plaque below the gum line
Root planing to smooth root surfaces and allow gum tissue to heal

Scaling & Root Planing

Bite Adjustment

A bite is considered to be healthy when all or most of the teeth are present and not destroyed by normal daily usage.

It is destructive when teeth show wear, looseness or when TMJ (jaw joint) damage is seen. Bite therapy helps restore a bite that can function without damage and destruction. The therapy may include:

  • Reshaping the biting surfaces of the teeth and eliminating spots of excessive pressures where the teeth are brought into contact. This is done by carefully dividing bite pressures evenly across all of the teeth.
  • Bite splint therapy using a custom-fitted and adjusted plastic bite guard to keep the teeth apart, day, night, or both.
  • Braces to reposition mal-aligned or drifted teeth.
  • Replacement of old, worn out, or damaged fillings.
  • Reconstruction of badly worn and damaged teeth.