Periodontal Treatment

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Some diseases sneak up on you. With glaucoma or heart disease, for instance, often the person doesn’t know he or she has a problem until damage is already done…or worse.
Gum disease, also known as periodontal disease isn’t like that. Gum disease gives you clues from the beginning. That’s a good thing because gum disease is reversible until the latest stages of full-blown periodontitis. That’s where Dr. Frey and his team come in. When we see early signs of problems, we can show you what’s happening, help stem the tide with procedures such as gum planing, and keep your gum disease from moving on to tooth loss and jawbone erosion.
Here’s what you need to know about gum disease.

What Is Gum Disease?

Gum disease has different stages. It’s not as if you wake up one day and your gums have pulled away from your teeth and your teeth are falling out. It generally begins with poor home dental hygiene and a lack of regular professional cleanings and exams with Dr. Frey or another provider. When you don’t keep your teeth clean plaque builds up. Plaque is the sticky film that forms on your teeth throughout the day. When you brush and floss you remove the plaque, only for it to begin forming again. This is why you need to brush twice daily, to keep plaque at bay. But when it builds up on your teeth it causes your gums to become inflamed. They become red and bleed easily when you’re brushing. At this point, your gums are simply irritated and they’re holding your teeth firmly in place. This is known as gingivitis.

Gum Disease

Nothing is serious yet. You can step up your hygiene and all will be well. But if you let gingivitis progress, the plaque begins to build and move under your gums. This makes the gums begin to pull away from the teeth and form pockets. Now you’re entering full-blown gum disease, clinically known as periodontitis. As bacteria build up in these pockets, it starts to break down the bone and connective tissue that hold your teeth in place. Pockets deepen and more gum tissue and bone are destroyed. Your teeth begin to loosen and fall out. The end of gum disease is a mouth without any teeth.

What Are The Different Types Of Periodontal Disease?

This depends on if you consider gingivitis to be gum disease or a precursor. You can break gum disease into different types depending on how it has progressed.

Gingivitis — This is early gum disease. Basically it simply means that plaque is beginning to irritate the gums, making them red and prone to bleeding. All gum disease starts with gingivitis.
Chronic Periodontitis — Gums have pulled away from the teeth and formed pockets where bacteria are accumulating. Now the bacteria will begin attacking the bone and tissues attaching the teeth to the jawbone.
Periodontal Abscess — When a pocket forms and becomes infected, an abscess can develop. This will lead to quick destruction of the attaching tissues of the teeth in the area. The teeth are likely to loosen and begin to fall out.
Perio-endo Lesion — This occurs when the infection begins in the tooth root. When decay enters a tooth, if not removed, it can eventually impact the pulp and the nerves and blood vessels within the pulp. This infection moves from the tooth into the surrounding gums. Now a problem that was just in a single tooth can spread to all of your gums and teeth.
Gingival Recession — This isn’t always due to plaque buildup. Overly aggressive tooth brushing can also cause this recession. The gums recede, exposing the tooth root that is normally covered by the gums.
Causes of Gum Disease

What Causes Gum Disease?

Plaque is really the main cause. This innocent film on your teeth is easy to brush and floss away, but if left on the teeth it begins the progression from gingivitis onward. Poor oral hygiene and lack of professional care is basically behind almost all gum disease.

Signs of Gum Disease

Signs Of Gum Disease

As mentioned above, this isn’t a yesterday your teeth were healthy, today you have gum disease kind of thing. There are signs. These are symptoms of different degrees/stages of gum disease:

● Gums that bleed when brushing your teeth
● Red, swollen, tender gums
● Persistent bad breath
● Bad taste in the mouth
● Receding gums
● Deep pockets between the teeth and the gums
● Loose or shifting teeth
● Changes in bite

How Is Periodontal Disease Diagnosed?

The key to heading off all of this is diligence. If you brush twice daily and floss once, that’s a start. Then you need to come in for your twice-yearly professional cleanings and exams with Dr. Frey. He will spot the beginnings of gum disease and we can turn things around.
Periodontal Disease Diagnosis
This is what Dr. Frey checks when a patient comes in with later stage gum disease:

Gum Condition —He checks the firmness of the gums. He looks for swelling or bleeding. He’ll measure the pockets where the gums are pulling away from the teeth.
Movement — If the patient has a history of x-rays, he’ll look for movement in bite alignment. Gum disease loosens the teeth.
Jawbone Mass — He’ll check for jawbone deterioration.

How Is Gum Disease Treated?

What Dr. Frey will need to do depends on how far along your gum disease has progressed. In every case, the first step is to stop things where they are and keep the gum disease from progressing. First, the infection needs to be removed and the tooth roots prepared to begin the process of getting the gums to reattach.
Treatments can be both surgical and non-surgical. Dr. Frey performs many of these procedures, but for more advanced cases, he’ll need to enlist the services of a periodontist.

Treatments can involve:

● Root Scaling and Planing— This is basically removing plaque from below the gumline. Done under local anesthesia, Dr. Frey uses a diode laser for this task called gum scaling. He then makes the surface smooth so that the gums can reattach. This is called gum scaling.

Surgical treatments:

● Flap Surgery/Pocket Reduction Surgery— In this procedure, the gums are lifted back and tartar is removed. Dr. Frey uses the diode laser to clean periodontal pockets, vaporizing infected tissue and disinfecting the area to activate tissue regrowth. The laser energy penetrates the soft tissues while instantly sealing blood vessels and nerve endings.
● Bone Grafts— Bone grafts are used on areas of the jawbone that have deteriorated. The grafts are placed and bone mass regrows, stabilizing the teeth.
● Soft Tissue Grafts— Tissue is usually taken from the roof of the mouth and stitched onto areas where the gums have receded or thinned.
Bone Surgery— In moderate to advanced jawbone loss, surgery is done to decrease craters that have formed.

Is Gum Disease Treatment Permanent?

Gum disease is preventable, but you must practice good dental hygiene to do so. If you’ve had any level of gum disease, hopefully you’ll improve your hygiene and keep your twice-yearly professional visits. But if you go back to your old ways, gum disease can return.
Gum Disease Treatment

Can Gum Disease Be Reversed?

Gum disease can almost always be reversed. It’s a matter of reducing the pockets, removing the infection, restoring the bone (if necessary), and getting the gums to reattach to the teeth. Of course, how far the gum disease has progressed can dictate if reversal is possible. For instance, if a person has allowed the disease to progress to the point where all of his or her teeth are affected and cannot be saved, extraction may be necessary and the teeth replaced by dentures or dental implants.

Periodontal Disease And Dental Implants

The goal in treating gum disease is to keep your natural teeth. But if you’re at an advanced stage you may have already had some tooth loss. Dr. Frey believes dental implants are far and away the best solution for replacing missing teeth. A dental implant is named for the titanium “implant” that is screwed down into the hole occupied by the former tooth root. The jawbone then grows around the implant, making it a part of the jaw. A post is attached to the implant and an artificial tooth is attached to the post.

To place an implant successfully into the jawbone, there must be sufficient jawbone mass to hold the implant. Otherwise, the implant may fail and not take hold. That’s where the bone grafting mentioned above may be necessary, to rebuild jawbone mass before an implant can be placed.

If the patient is missing multiple teeth, Dr. Frey may use dental implants to anchor a bridge or a partial arch of false teeth. He could even use the All-on-4 system using four implants to anchor an entire upper or lower set of false teeth.

Bottom line — implants don’t halt or cure gum disease; they can simply be used to replace missing teeth that are a result of gum disease.

Schedule A Consultation

If you are concerned about your periodontal health, or worried you may be at risk for developing gum disease, Dr. Frey can help you. Contact our Beverly Hills office today by calling (310) 276-4537 to schedule your consultation.

Frequently Asked Questions

Do braces last longer than Invisalign?

For most patients, Invisalign takes about 12 to 18 months. However, those with very mild cases often see results within the first 6 months, while those with more severe cases may need up to 24 months. Traditional braces usually take about 12 to 18 months, with some patients needing up to 24 months. Very rarely does it take less time to treat malocclusion with traditional braces.

Is Invisalign covered by insurance?

Some dental insurance providers will cover dental insurance, while others will not. Our office staff will be happy to contact your provider to determine coverage. We strive to help you get the most out of your benefits.

What teeth are not suitable for Invisalign?

Invisalign clear aligners are not suitable for baby teeth or for teeth that are severely rotated or with large gaps between them.

Is it OK to get Invisalign from a dentist?

Yes, you can get Invisalign treatment through a general dentist. However, it is important to make sure that they are an Invisalign provider. This is because this treatment option requires specialized treatment to ensure the best results.

Is Invisalign still braces?

Yes, Invisalign clear aligners are considered a type of orthodontic treatment. However, this option is much more comfortable, convenient, and aesthetically pleasing than traditional metal braces.

How many times a day can I remove Invisalign?

Invisalign aligners can be removed as many times as necessary- but the time should not exceed 4 hours. While the aligners need to be removed when eating/drinking or when brushing/flossing, the longer they are worn, the more effective they will be.

Who is a bad candidate for Invisalign?

Patients who still have baby teeth or who have teeth with wide gaps between them or teeth that are severely rotated should not consider Invisalign treatment. It is possible to use Invisalign after other methods for more precise movements.

What is the success rate of Invisalign?

The success of Invisalign depends on several factors including the type and severity of the malocclusion, as well as the compliance of the patient. Most patients have been satisfied with their results.

How long do you need to wear Invisalign?

Invisalign clear aligners should be worn for 20 to 22 hours a day. Each set should be worn for 1 to 3 weeks. This will be outlined in your treatment plan, depending on the type and severity of your malocclusion.

Why is Invisalign so expensive?

One of the primary reasons that orthodontic treatment in general is expensive is because of the additional training the dentist needs. Invisalign is slightly more expensive due to the many benefits it brings.

Is Invisalign costlier than braces?

One of the biggest concerns that patients have is Invisalign cost. However, the average cost is comparable to that of traditional braces. Unfortunately, while many dental insurance providers will cover a portion of treatment, many others still classify this as a cosmetic procedure and will not cover any portion of it.

If you do not have insurance or if your provider does not cover treatment, we offer some financing options as well.

How much does Invisalign cost in California?

The cost of Invisalign treatment varies depending on several factors including the type and severity of your malocclusion the location of the clinic and the experience/expertise of the dentist. The average cost in California ranges from around $4,500 to $9,000, which is slightly higher than the national average.

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