Our Services
What is periodontal disease?
The initial consultation
Conservative management
Periodontal surgery
Implant surgery
Aesthetic crown lengthening surgery
Connective tissue grafting
What is periodontal disease?
Periodontal disease comprises of a group of diseases affecting the supporting structures of the teeth (periodontium). The most common forms of periodontal disease are caused by bacteria (dental plaque) which reside on the tooth surface, and when left to mature are able to cause an infection of the gums. The end result of this infection is loss of the bone which supports the tooth, which can eventually lead to tooth mobility and tooth loss. The loss of bone support with periodontal disease is in most cases irreversible.
Susceptibility to disease and rate of progression to disease are related to bacterial pathogenicity, individual host responses to the periodontal pathogens, as well as inherent or acquired modifying factors (related to genetic susceptibility and environmental factors). Smoking is by far the biggest preventable risk factor for periodontal disease.
The initial consultation
The initial appointment with the periodontist involves a thorough examination and assessment of the gums. This assessment is made through the measurement of the gum pockets (periodontal probing) which will reflect the gum health.
Clinical measurements of gum health will be compared with any radiographic data available, and will enable a diagnosis of your gum condition to be made. A treatment plan will be suggested and discussed with you. As periodontal disease is a chronic condition, commonly no treatment is performed during the consultation appointment.
Conservative management
The main goal of treatment for periodontal disease is to achieve and maintain a healthy functioning dentition for the patient. Given that bacteria are the primary cause of periodontal disease, current periodontal therapy revolves around the physical removal of bacteria and bacterial retentive factors, and the prevention the reformation of bacterial plaque. Advances in our understanding of the pathogenesis of periodontal disease has not changed this basic tenet.
The initial phase of therapy is often termed cause-related therapy, as the bacterial plaque and plaque retentive factors are targeted in this phase of treatment. The objectives of cause-related therapy are to control supragingival plaque levels (to prevent caries and gingivitis) and to arrest periodontal disease and prevent its progression. The following procedures are generally employed to accomplish this:
- education of the patient to understand the disease process and motivate them to combat the disease
- providing oral hygiene instruction so that the patient can develop an effective self-performed plaque control regime
- the removal of plaque and calculus deposits on teeth through scaling and root debridement procedures
- and the removal of plaque retentive features such as overhanging restorations and ill-fitting crowns
The process of scaling and root debridement (deep clean) is most often performed with the use of hand instruments and ultra-sonic scalers. Depending on the level of severity and treatment needs, this treatment may be performed over one or multiple visits with or without local anesthetic. Severe cases generally require up to four one-hour visits of cleaning. The adjunctive use of antimicrobials is generally not required.
A periodontal review is generally performed three months after the completion of initial phase therapy. This review involves retaking the measurements of the gum pockets and comparing these measures with the initial charting to assess the healing response to the initial treatment. In most situations, this visit will also involve a light clean as well. Your periodontist will then discuss with you your future treatment needs. Periodontal disease is a chronic condition (similar to diabetes mellitus), and hence requires a life long commitment to excellent plaque control and periodic professional maintenance (as is appropriate to your case). The long-term management of periodontal disease always requires regular cleaning with a dental professional in order to prevent recurrence of disease.
Periodontal surgery
Non-surgical therapy is sufficient for most patients, and with ongoing maintenance treatment, they may achieve long term periodontal health. However non-surgical therapy does have its limitations, and sites that remain inflamed and bleeding after the initial phase may require periodontal surgery. Periodontal surgical procedures include: pocket depth reduction procedures; regenerative procedures; crown lengthening; and soft tissue grafts.
The advantage of surgical procedures is that it allows for the improved assessment of root surfaces, and the restoration of periodontal anatomy damaged by periodontal diseases and thus facilitates oral hygiene practices. The decision to perform periodontal surgery is generally discussed with you at the first review appointment (three months after the completion of initial-phase therapy).
Implant surgery
Dental implants have become the treatment of choice for the replacement of missing teeth in many situations. Dental implants can be used to support single teeth, multiple teeth (bridgework) or even full arch situations (denture or bridge). Dental implants involve the placement of an implant fixture (a medical grade titanium implant) in the jawbone, following which a tooth (crown) can be placed onto the implant. In this situation, the implant serves as the foundation of the new tooth. In most situations, the surgery for placing a single tooth implant will take less than 90 minutes. As the dental implant relies upon bone for anchorage, where the volume of bone is insufficient, bone grafting procedures may be required.
At Perio Partners, our practitioners are highly trained in the surgical placement of dental implants. We use only the most reputable implant systems and are dedicated to the follow up and long-term care of implants.
Aesthetic crown lengthening surgery
Aesthetic crown lengthening surgery can be performed to improve the appearance of a "gummy smile". This procedure involves recontouring of the gums and underlying bone in order to lengthen the teeth and provide for a more natural appearance.
Connective tissue grafting
Connective tissue grafting procedures can be performed to "grow back" some of the gum which has been lost. It works best where the gum has receded in localised areas, and becomes less suitable where multiple (>3) teeth are involved.
Our Location:
250 Faraday Street(Corner of Faraday and Cardigan St)
Carlton, Victoria 3053
