Please Select... Overview Non-Surgical Services Cosmetic Procedures Surgical Services Supportive Periodontal Maintenance Dental Implants Audio/Video Sim/plant Custom Vitamin Testing Non-Surgical Services Non-Surgical Services We can use modern techniques to help rebuild lost bone support. The emphasis at Long Island Periodontal Professionals practice is conservative periodontal therapy. Many times, the early stages of periodontal disease are best treated with non-surgical periodontal therapy. Nonsurgical therapy removes plaque and calculus by controlling the growth of harmful bacteria and by treating conditions that encourage gum disease. This type of treatment may be all that's needed, especially when periodontal disease is caught early. You may also need to have certain procedures, such as replacing worn fillings that can accumulate plaque, taken care of before periodontal therapy can begin. Scaling and Root Planing Scaling and root planing removes plaque and tartar from below your gum line. This controls the growth of harmful bacteria. It also helps gums reattach firmly to the teeth. Because this procedure goes deeper than a regular cleaning, Dr. Farber and his team may use a local anesthetic. The cleaning may take two to four or more visits to complete. Even in most severe cases of periodontal disease, non-surgical periodontal therapy most often precedes surgical therapy. This is done so that the overall tissue quality is improved prior to surgery and also limits the areas of required surgery. After Your Procedure Your mouth may feel sore and tender after treatment. Keep brushing and flossing your teeth after each meal. Rinse with warm water if needed. Pain medication may be suggested if you need it. Occlusal Adjustment Occlusal Adjustment involves the reshaping or smoothing of the tooth's biting surfaces so that the bite becomes gradually more even and the pressures balanced throughout the mouth. For this procedure a handpiece or rotary drill is utilized that allows a minimal amount of tooth material to be removed. The patient is asked to bring the teeth together during normal chewing strokes. A strip of inked, thin paper is held between the teeth. When the paper is removed, pressure points are seen where the teeth came together. The darker pressure points represent areas that need reshaping. Occlusal adjustment is not painful. This treatment may involve one or more appointments depending on the severity of the problem. Most patients find that following occlusal adjustment their bite is more comfortable and their teeth have a sense of "belonging together." Night Guard Therapy Patients with a grinding or clenching habit called bruxism exert excessive stress on teeth. To alleviate these problems, a bite guard is made. This removable appliance is designed from models taken of the patient's teeth. Bite guards are usually made of hard plastic that fit over the upper or lower teeth. The bite guard is designed to be worn during periods of bruxism. For many this is during sleep. Others find it necessary at work or when they pursue concentrated tasks. For some, the wearing or a bite guard is required twenty-four hours a day. Use of the bite guard may eliminate the habit of bruxism, however most patients continue to grind or clench and must wear the bite guard for an extended period of time. Patients also often report relief from the symptoms of TM Disorders. The appliance must be checked for evidence of wear. Adjustments to the appliance are sometimes required. The Latest Products Against Periodontal Disease Researchers have developed three products that dentists can use to augment traditional periodontal therapies (such as scaling and root planing, which is the meticulous removal of plaque and tartar from the surface of the tooth and its root, producing a clean, hard, smooth surface that promotes gum reattachment). When used in conjunction with scaling and root planing, together with meticulous daily oral hygiene and quarterly professional cleanings, each of these three products enhance and promote healing of infected periodontal disease. Atridox Atridox is an antimicrobial gel that is applied to the infected gum tissue, where it flows deeply into the periodontal pocket, conforming to its shape as it quickly solidifies to a waxlike substance. It releases the broad-spectrum antibiotic doxycycline into the infected pocket over a seven-day period. During this time, the doxycycline attacks the bacteria causing the periodontal infection, dramatically reducing their numbers. Atridox, which was FDA-approved in September of 1999, is used primarily on those who suffer from chronic adult periodontitis (long-term, advanced periodontal disease), with gum bleeding and periodontal pockets deeper than 5 millimeters. No anesthesia is required when Atridox is placed within the pocket, and the way plug is absorbed by the body, so it doesn't need to be removed by a dentist. Scaling and root planing treatment is not necessary with each application of Atridox, but are still vital components in the treatment of periodontal disease, and meticulous daily oral hygiene and regular visits also accompany its use. Atridox should not be used by pregnant women or by those who are sensitive to antibiotics in the tetracycline class. Periostat Periostat, approved by the FDA in October of 1998, is billed as "the first pill to fight gum disease". It is a weakened form of the antibiotic doxycycline hyclate, and is prescribed by dentists to be taken twice a day for a period of several months. Periostat works not by attacking bacteria, but by counteracting the enzyme that is produced by the body in reaction to the bacterial infection of periodontal disease. This enzyme, collagenase, breaks down the gums, ligaments and bone that hold the teeth in place; consequently, teeth can become loose, or even be lost entirely. By inhibiting the production of this tissue-destroying enzyme, Periostat slows or even stops the enzyme's destructive activity. Used in conjunction with scaling and root planing, Periostat has been proven to improve gum reattachment and slow the loss of bone and gum disease. While use of periostat has shown no significant side effect, it is in the tetracycline class of drugs and should be avoided by anyone sensitive to tetracycline, Pregnant women should also avoid Periostat, as tetracycline use can cause permanent tooth discoloration in the developing fetus. Periochip Periochip is a very small biodegradeable gelatin strip that fits right into periodontal pockets. Periochip is a time-released medication containing the agent chlorhexidine gluconate that kills bacteria. The chip is placed after scaling and root planing procedures. The active ingredient eliminates the bacteria in the infected pocket and speeds the healing process. Periochip dissolves in a week or so, you don't need to come back to the office to have it taken out. Periochip is safe for most adults, it should be avoided in pregnant women and those allergic to chlorhexidine. None Are a Cure... Developers of all three medications caution that none are meant to be a cure for periodontal disease. Once bone loss has occured, no medication can bring it back. However, Periostat, Atridox and Perio Chip are additional tools that dentists can use to prevent further loss of bone and connective tissue. Home Care and Periodontal Maintenance Periodontal Disease is similar to other chronic diseases such as diabetes. It requires ongoing care and monitoring to keep it under control. While brushing the outside surfaces of your teeth, position the brush at a 45-degree angle where your gums and teeth meet. Gently move the brush in a circular motion several times using small, gentle strokes. Use light pressure while putting the bristles between the teeth, but not so much pressure that you feel any discomfort. When you are done cleaning the outside surfaces of all your teeth, follow the same directions while cleaning the inside of the back teeth. To clean the inside surfaces of the upper and lower front teeth, hold the brush vertically. Make several gentle back-and-forth strokes over each tooth. Don't forget to gently brush the surrounding gum tissue. Next you will clean the biting surfaces of your teeth. To do this use short, gentle strokes. Change the position of the brush as often as necessary to reach and clean all surfaces. Try to watch yourself in the mirror to make sure you clean each surface. After you are done, rinse vigorously to remove any plaque you might have loosened while brushing. If you have any pain while brushing or have any questions about how to brush properly, please be sure to call the office. How to Floss: Periodontal disease usually appears between the teeth where your toothbrush cannnot reach. Flossing is a very effective way to remove plaque from those surfaces. However, it is important to develop the proper technique. The following instructions will help you, but remember it takes time and practice. Start with a piece of floss (waxed is easier) about 18" long. Lightly wrap most of the floss around the middle finger of one hand. Wrap the rest of the floss around the middle finger of the other hand. To clean the upper teeth, hold the floss tightly between the thumb and forefinger of each hand. Gently insert the floss tightly between the teeth using a back-and-forth motion. Do not force the floss or try to snap it in to place. Bring the floss to the gumline then curve it into a C-shape against one tooth. Slide it into the space between the gum and the tooth until you feel light resistance. Move the floss up and down on the side of one tooth. Remember there are two tooth surfaces that need to be cleaned in each space. Continue to floss each side of all the upper teeth. Be careful not to cut the gum tissue between the teeth. As the floss becomes soiled, turn from one finger to the other to get a fresh section. To clean between the bottom teeth, guide the floss using the forefinger of both hands. Do not forget the back side of the last tooth on both sides, upper and lower. When you are done, rinse vigorously with water to remove plaque and food particles. Do not be alarmed if during the first week of flossing your gums bleed or are a little sore. If your gums hurt while flossing you could be doing it too hard or pinching the gum. As you floss daily and remove the plaque your gums will heal and the bleeding should stop. Periodontal maintenance procedures enable you to gain control of the disease and will increase your chances of keeping your natural teeth. It's your protection. During your periodontal maintenance visit, the following will be done: Your medical and dental histories will be updated. These factors may influence your periodontal health and treatment effectiveness. A thorough periodontal evaluation is performed including: Assessment of your probing depths (measure pockets) An oral cancer screening of your inner and outer oral tissues X-rays may be taken to evaluate your teeth and bone supporting the teeth Fluoride treatment to prevent root decay and sensitivity a review of your at-home oral hygiene routine and recommendation customized for your condition. During your maintenance visit harmful bacterial plaque and calculus are removed from above and below the gumline. If new or recurrent periodontal disease is identified, then additional periodontal treatment may be recommended. Typically, your teeth will be cleaned, scaled and polished every three months. Three month intervals help keep the plaque levels around the gums minimal and thus significantly reduces your risk of re-infection. Maintenance is the key to successful treatment. Many times these visits will be scheduled on an alternating basis with your restorative dentist. Preserving your periodontal health brings a lifetime of benefits. Keeps dental costs down by preventing future problems Research links periodontal infection to more serious health problems, such as cardiovascular disease and pre-term, low weight babies. A commitment to periodontal maintenance is a commitment to better health. >back to top Overview | Non Surgical Services | Cosmetic Procedures Surgical Services | Periodontal Maintenance | Dental Implants Audio and Video | Sim Plant | Custom Vitamin Testing © 2001 Long Island Periodontal Professionals. All rights reserved. Disclaimers apply. Send Questions or comments to info@longislandperio.com.