CRISPY

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Periodontics

Periodontology or Periodontics is the specialty of dentistry that studies supporting structures of teeth, diseases, and conditions that affect them. The supporting tissues are known as the periodontium, which includes the gingiva (gums), alveolar bone, cementum, and the periodontal ligament. A professional who practises this speciality field of dentistry is known as a periodontist. Periodontal diseases take on many different forms but are usually a result of a coalescence of bacterial plaque biofilm accumulation of the gingiva and teeth, combined with host immuno-inflammatory mechanisms and other risk factors which lead to destruction of the supporting bone around natural teeth. Untreated, these diseases lead to alveolar bone loss and tooth loss and, to date, continue to be the leading cause of tooth loss in adults.


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Case 1 (15 Months)
Root Coverage Procedure

Root Coverage Procedure to reduce sensitivity and increase aesthetics - Published in Straumann Emdogain Esthetic Book - Case 6 (2011) (pictures are copyrighted)



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Case 2 (15 Months)
Root Coverage Procedure

Root Coverage Procedure to reduce sensitivity and increase aesthetics - Published in Straumann Emdogain Esthetic Book - Case 6 (2011) (pictures are copyrighted)



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Esthetic
Crown-lengthening
Procedure

(pictures are copyrighted)


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Treating
Periodontal disease

Root Coverage Procedure to reduce sensitivity and increase aesthetics - Published in Straumann Emdogain Esthetic Book - Case 6 (2011) (pictures are copyrighted)

Q&A

Who is a periodontist?

A periodontist is a dentist who specializes in the prevention, diagnosis and treatment of periodontal disease and in the placement of dental implants. Periodontists are also dentistry’s experts in the treatment of oral inflammation. They receive extensive training in these areas, including three additional years of education beyond dental school. Periodontists are familiar with the latest techniques for diagnosing and treating periodontal disease. In addition, they can perform cosmetic periodontal procedures to help you achieve the smile you desire. Often, dentists refer their patients to a periodontist when periodontal disease is present. However, you don't need a referral to see a periodontist. In fact, there are occasions when you may choose to go directly to a periodontist or to refer a family member of friend to your own periodontist. If you value your oral as well as overall health, anytime is a good time to see a periodontist for a periodontal evaluation. Sometimes the only way to detect periodontal disease is through a periodontal evaluation. A periodontal evaluation is especially important if you exhibit any symptoms of periodontal disease.


Gum disease symptoms
Gum disease is often silent, meaning symptoms may not appear until an advanced stage of the disease. However, warning signs of gum disease include the following:

• Red, swollen or tender gums or other pain in your mouth
• Bleeding while brushing, flossing, or eating hard food
• Receding gums causing the teeth to look longer than before
• Loose or separating teeth
• Pus between your gums and teeth
• Sores in your mouth
• Persistent bad breath
• A change in the way your teeth fit together when you bite
• A change in the fit of partial dentures


What are the causes of gum disease?
Periodontal (gum) diseases, including gingivitis and periodontitis, are serious infections that, left untreated, can lead to tooth loss. Periodontal disease can affect one tooth or many teeth. The main cause of periodontal disease is bacterial plaque, a sticky, colorless film that constantly forms on your teeth. However, factors like the following also affect the health of your gums.

Smoking/Tobacco Use
As you probably already know, tobacco use is linked with many serious illnesses such as cancer, lung disease and heart disease, as well as numerous other health problems. What you may not know is that tobacco users also are at increased risk for periodontal disease. In fact, recent studies have shown that tobacco use may be one of the most significant risk factors in the development and progression of periodontal disease.

Genetics
Research proves that up to 30% of the population may be genetically susceptible to gum disease. Despite aggressive oral care habits, these people may be six times more likely to develop periodontal disease. Identifying these people with a genetic test before they even show signs of the disease and getting them into early interventive treatment may help them keep their teeth for a lifetime.

Puberty, Pregnancy and Menopause in Women
A woman's health needs are unique. Though brushing and flossing daily, a healthy diet, and regular exercise are important for oral health throughout life, there are certain times in a woman's life when extra care is needed—times when you mature and change such as puberty or menopause, and times when you have special health needs, such as menstruation or pregnancy. During these particular times, a woman's body experiences hormonal changes that can affect many of the tissues in your body, including the gums. Your gums can become sensitive, and at times react strongly to the hormonal fluctuations. This may make you more susceptible to gum disease. Additionally, recent studies suggest that pregnant women with gum disease are seven times more likely to deliver preterm, low birth weight babies.

Stress
As you probably already know, stress is linked to many serious conditions such as hypertension, cancer, and numerous other health problems. What you may not know is that stress also is a risk factor for periodontal disease. Research demonstrates that stress can make it more difficult for the body to fight off infection, including periodontal diseases.

Medications
Some drugs, such as oral contraceptives, anti-depressants, and certain heart medicines, can affect your oral health. Just as you notify your pharmacist and other health care providers of all medicines you are taking and any changes in your overall health, you should also inform your dental care provider.

Clenching or Grinding Your Teeth
Has anyone ever told you that you grind your teeth at night? Is your jaw sore from clenching your teeth when you're taking a test or solving a problem at work? Clenching or grinding your teeth can put excess force on the supporting tissues of the teeth and could speed up the rate at which these periodontal tissues are destroyed.


Diabetes
Diabetes is a disease that causes altered levels of sugar in the blood. Diabetes develops from either a deficiency in insulin production (a hormone that is the key component in the body's ability to use blood sugars) or the body's inability to use insulin correctly. According to the American Diabetes Association, approximately 16 million Americans have diabetes; however, more than half have not been diagnosed with this disease. If you are diabetic, you are at higher risk for developing infections, including periodontal diseases. These infections can impair the ability to process and/or utilize insulin, which may cause your diabetes to be more difficult to control and your infection to be more severe than a non-diabetic.

Poor Nutrition and Obesity 
As you may already know, a diet low in important nutrients can compromise the body's immune system and make it harder for the body to fight off infection. Because periodontal disease is a serious infection, poor nutrition can worsen the condition of your gums.

Sources– American Academy of Periodontology


Fallacies and Facts about gum diseases

Fallacy
Tooth loss is a natural part of aging.
Fact
With good oral hygiene and regular professional care, your teeth are meant to last a lifetime. However, if left untreated, periodontal (gum) disease can lead to tooth loss. It is the primary cause of tooth loss in adults 35 and over.

Fallacy
People who have gum disease are "dirty" and don't brush their teeth.
Fact
Research proves that up to 30% of the population may be genetically susceptible to gum disease. Despite aggressive oral care habits, these people may be six times more likely to develop periodontal disease. Identifying these people with a genetic test before they even show signs of the disease and getting them into early interventive treatment may help them keep their teeth for a lifetime.

Fallacy
Gum disease doesn't affect overall health.
Fact
Emerging research links periodontal disease to other health problems including heart and respiratory diseases; preterm, low birthweight babies; stroke; osteoporosis; and diabetes.

Fallacy
Gum disease is a minor infection.
Fact
The mass of tissue in the oral cavity is equivalent to the skin on your arm that extends from the wrist to the elbow. If this area was red, swollen, and infected, you would visit the doctor. Gum disease is not a small infection. Its result, tooth loss, leads to a very different lifestyle—dentures. The changes in your appearance, breath, and ability to chew food are dramatic.

Fallacy
Bleeding gums are normal.
Fact
Bleeding gums are one of nine warning signs of gum disease. Think of gum tissue as the skin on your hand. If your hands bled every time you washed them, you would know something is wrong. Other signs of gum disease include: red, swollen or tender gums; sores in your mouth; gums that have pulled away from the teeth; persistent bad breath; pus between the teeth and gums (leaving bad breath); loose or separating teeth; a change in the way the teeth fit together; and a change in the fit of partial dentures.

Fallacy
Gum disease affects all races and ethnicities equally.
Fact
While gum disease can affect anyone, certain populations are especially at risk. Research reported in the Journal of Periodontology has shown that Mexican Americans and African Americans are more likely to develop periodontitis than people of European descent. While the reason for this increased risk is not known, it may be due to the frequency of dental visits or different inflammatory responses in different ethnicities. Additionally, a study from the New York University College of Dentistry found that of all recent U.S. immigrants, those who come from Puerto Rican, Indian, or Haitian backgrounds were much more likely to have periodontitis than immigrants of other backgrounds, possibly due to variance in diet and susceptibility to the oral bacteria that causes gum disease.

Fallacy
Treatment for gum disease is painful.
Fact
New periodontal procedures including local anesthesia and over-the-counter medications, have made patients' treatment experiences pleasant and comfortable. Many patients find they are back to normal routines on the same day or by the next day.

Fallacy
Gum disease is easy to identify, even in its early stages, so my dentist would tell me if I had it.
Fact
Millions of people don't know they have this serious infection that can lead to tooth loss if not treated. You should always get involved in your dental care, so that problems are detected in the early stages. You should inform your dentist if any signs of gum disease are present; or if any changes in your overall health or medications occurred in between visits. Most importantly, you should ask your dentist about your periodontal health and what method was used to evaluate its condition. This level of participation enables you to work in a team approach with your dentist to identify subtle changes that may occur in the oral cavity.

Fallacy
Once teeth are lost, the only treatment options are crowns, bridges or dentures.
Fact

Dental implants are a permanent tooth-replacement option for teeth lost to trauma, injury or periodontal disease. Dental implants are so natural-looking, and feeling that many patients forget they ever lost a tooth.

Fallacy
Cavities are the number-one cause of tooth loss.
Fact
Periodontal disease is the number-one cause of tooth loss. According to the 1996 American Dental Association/Colgate survey, U.S. dentists say gum disease is a more pressing oral health concern than tooth decay by a 2-to-1 margin.

Fallacy
Because gum disease is a bacterial infection, antibiotics can be used to treat it.
Fact
Research demonstrates that antibiotics can be a helpful adjunct to treating periodontal disease. However, medical and dental communities are concerned about the overuse of these medications in treating infections because of the possibility of the development of antibiotic resistant strains of bacteria. This overuse would be detrimental to patients if they develop a life-threatening illness for which antibiotics would no longer be helpful.

Fallacy
Pregnant women should skip professional dental checkups.
Fact
Teeth and gums are affected during pregnancy like other tissues in the body. In order to decrease the risk of damaging the gums and tissues surrounding the teeth, pregnant women should schedule an appointment for a periodontal evaluation.