Call: (949) 640-1122
1401 Avocado Ave, Suite 404 • Newport Beach, CA 92660
Newport Center Dental Group
Periodontics & Dental Implants
Periodontics involves the treatment of problems with the soft tissues of the mouth and the underlying bone which supports the teeth. The focus includes both non-surgical and surgical management of periodontal disease, and the placement of dental implants.
A Periodontist is mainly concerned with:
- Preventing the onset of gum disease (periodontal disease)
- Diagnosing conditions affecting the gums and bone, and
- Treating gingivitis, periodontitis, and bone loss
Periodontal disease is a progressive condition, and is the leading cause of tooth loss among adults in the developed world.
A periodontist is able to treat slight, mild, moderate, and advanced gum disease by first addressing the bacterial infection that is causing the problem, providing periodontal treatment, then providing information and education on good oral hygiene and the effective cleaning of the teeth.
Periodontal disease begins when the toxins found in bacterial plaque that are present on a person’s teeth start to attack the soft or gingival tissue surrounding the teeth. This bacteria embeds in the gum and rapidly breeds, causing a low-grade bacterial infection. As the infection progresses, it starts to burrow deeper into the tissue causing inflammation or irritation between the teeth and gums. The response of the body is to destroy the infected tissue, which is why the gums appear to recede. As the supporting tissue is destroyed, “pockets” form around the teeth, and if no treatment is sought, the hard tissue which makes up the supporting bone also begins to be destroyed. Over time, these pockets become deeper, providing a larger space for bacteria to live, and making it difficult to reach and to control with routine oral hygiene. As bacteria develop around the teeth and deep under the gumline, it proliferates within the gum tissue, causing further loss of the supporting bone, and ultimately causing unstable teeth and tooth loss.
If you experience any of the following signs and symptoms, it is important that you schedule an appointment with your dentist or with a Periodontist without delay:
- Bleeding while eating or brushing – Unexplained bleeding while consuming food or during the course of daily cleaning is one of the most common signs of periodontal infection.
- Bad breath – Continued halitosis (bad breath) which persists even when a rigorous oral hygiene program is in place, can be indicative of periodontitis, gingivitis or the beginnings of an infection in the gum tissues.
- Loose teeth and gum recession – Longer looking teeth can signal recession of the gums and bone loss due to periodontal disease. As this disease progresses and attacks the jawbone, (the anchor holding the teeth in place) the teeth may become loose or be lost all together.
- Related health conditions – Heart disease, diabetes, and other conditions are thought to be correlated with periodontitis and periodontal infections. The bacterial infection can spread through the blood stream and affect other parts of the body.
Diagnosis & Treatment
Before initiating any dental treatment, the periodontist must extensively examine the gums, bone and general condition of the teeth. When gingivitis or periodontal disease is officially diagnosed, the periodontist has a number of surgical and non surgical options available to treat the underlying infection, halt the recession of the soft tissue, and restructure or replace teeth which may be missing.
Gingivitis/Slight Periodontal Disease – When the gum pockets exceed 4-5mm in depth, the periodontist, dentist or hygienist may perform scaling and root planing to remove debris and build-up from the pockets and allow them to heal. Education and advice will be provided on an effective cleaning regimen thereafter.
Moderate Periodontal Disease – If the gum pockets reach 4-6mm in depth a more extensive scaling and root planning cleaning might be required. This cleaning is usually performed under local anesthetic.
Advanced Periodontal Disease – Gum pockets in excess of 6-7mm are usually accompanied by bone loss and gum recession. Scaling and root planning will nearly always be performed as the initial nonsurgical treatment. In addition to those nonsurgical treatments, the periodontist may recommend surgical treatment to reduce pocket depth.
Tooth Loss – Where one or several teeth are missing due to periodontal disease, dental implants are an effective option. If the bone is strong enough to provide a suitable anchor for the prosthetic tooth, the implant can be placed. However, if the bone is severely eroded, bone grafts may be performed by the periodontist to provide a suitable support for the new tooth/teeth.
If you are missing a tooth or teeth, or have extractions planned in the future, dental implants may be the solution you are looking for to replace the missing tooth. Actually, the term “dental implant” actually refers to at least two separate dental processes. It includes the surgical placement of a titanium cylinder into the bone (which serves as the “root” of the implant) followed by a crown that is affixed to the titanium cylinder after a period of healing. In effect it involves placement of a dental implant and then an implant supported crown. Often times a periodontist or an oral surgeon will perform the surgical placement of the titanium cylinder, and your general dentist or prosthodontist will fabricate the crown that is affixed to it.
It is important to know that in order to place a dental implant, there must be a sufficient amount of bone at the site where the implant will go. In some cases, bone grafting prior to implant placement is the only way to get enough bone in the area to be able to place a dental implant. Also it is important to have the correct type and amount of soft tissue in the area, so it may be necessary to perform soft tissue augmentation procedures in the area.
Dental implants and their restorations can be a wonderful alternative to missing teeth.
Deep Cleaning of Teeth
Scaling and Root Planing – Deep Cleaning of Teeth
Your dentist may recommend you receive a deep cleaning of your teeth. The dental term for this procedure is “scaling and root planing”. Scaling and root planing (SRP) is indicated when the pockets around your teeth are deep, and calculus (tartar) and plaque have built up causing inflammation of your gums, and possibly bone loss.
SRP attempts to remove the plaque and calculus from the roots and crown portion of your teeth. When this is accomplished the inflammation in your gums is reduced and hopefully the pockets will be reduced.
The dental professional will want to see you 3 to 4 weeks later to re-evaluate the healing process that begins once you leave the office. During that time, it is of paramount importance to practice excellent oral hygiene in order to encourage proper healing.
Hard Tissue Grafting
Bone Grafts Around Teeth
Sometimes the destruction caused by periodontal disease creates craters in the bone around your teeth (A). In some instances, a bone graft can be placed in the crater defect to regenerate the lost bone (B – 6 months after graft placed). This small surgical procedure has the ability to add several years of function to the affected tooth.
Bone Grafts Prior to Dental Implants
One of the most important aspects of treatment planning for dental implants is to evaluate how much bone is present in the area that is to receive the dental implant(s). Dentists do this by visual exam and measurements, conventional x-rays, and advanced imaging like a CT scan.
If it is decided that there is not enough bone available, you may need to have a bone graft placed.
The more common bone graft procedures are:
- Sinus Lifts
- Lateral Ridge Augmentations
- Vertical Ridge Augmentations
Each of these grafts can be performed using your own bone, bone from a safe donor source, or from a bovine source.
After you have been treated by your dentist or periodontist for periodontal disease, you should be evaluated by a dental health professional on a more frequent basis. These appointments are called Periodontal Maintenance visits, and they are different from your biannual recall appointment with your general dentist.
Periodontal Maintenance includes a thorough examination of your gums and pockets around your teeth. Also, the teeth cleaning associated with the Periodontal Maintenance appointment is a more meticulous one, as the dental health professional is trying to prevent future disease from occurring. Periodontal Maintenance is performed anywhere from two to four times per year, depending on what your periodontist, periodontal hygienist, or dentist believes is best to prevent problems from arising again.
In the past, when it became necessary to remove a tooth, there was significant risk of loss of bone at the extraction site (the tooth socket). The bone which surrounds the tooth socket can deteriorate very quickly once a tooth is removed. This can adversely affect the placement of a dental implants at the site. It can also affect the esthetic result if a bridge is placed.
Placement of a socket preserving bone graft, or alveolar ridge preservation (ARP), is a procedure to reduce bone loss after tooth extraction in order to preserve the architecture (shape) of the tooth socket and to keep the socket in its original shape. Preservation of bone volume and architecture is crucial for dental implants stability and esthetics. Therefore, Socket Preservation can create a more solid base for dental implants.
- Dan J Spears, DDS
- Martin Rovira, DMD
- Victor M. Israel, DMD (Periodontist)
- George Naidus, DDS
- Gemma Hipolito, DDS
- Kia Ebrahim, DMD
- Gary Lyon, DDS (Orthodontist)
- Roger Van Scotter, DDS (Periodontist)
|Monday||8:00 am - 6:00 pm|
|Tuesday||8:00 am - 6:00 pm|
|Wednesday||8:00 am - 6:00 pm|
|Thursday||8:00 am - 6:00 pm|
|Saturday*||8:00 am - 1:00 pm|
We'll make you smile!
Please join our dental family.