Details Gwynedd Dental Associate periodontal, endodontic and orthodontic services.
Caring for you and your smile
At Gwynedd Dental, we specialize in the prevention, diagnosis, and treatment of periodontal disease, and in the placement of dental implants. We provide the following periodontal services:
> Scaling and Root Planing
> Periodontal Disease Treatment using Arestin
> Gingival Grafting
> Crown Lengthening
> Implant Placement
◾ Scaling and Root Planing
What Is Scaling and Root Planing?
Scaling and root planning or (Deep Cleaning) is the most common and conservative form of treatment for active periodontal disease. (Gum Disease)
Scaling, is the removal of calculus, or calcified hardened plaque, from the tooth and root surface. It is more commonly known to the general public as tartar. With active periodontal disease it is very common for calculus to have built up below the gumline. That’s why this process especially targets the areas below the gum.
Plaque is a sticky substance and is more likely to stick to rough surfaces. For this reason, the root surface is made smooth by a process called root planing. Root planing removes any remaining calculus and smooth’s irregular areas of the root surface. This makes it harder for bacteria to reattach, giving the patient better healing results.
Why Do I Need This Procedure Done?
Periodontal disease is a progressive disease. That means that the longer it is left untreated the worse it will get and the more it will spread. An active periodontal infection can even be passed from person to person through the saliva.
Periodontal disease is caused by an overabundance of bacteria in the mouth, this usually happens when a patient does not floss or get regular professional dental cleanings. There are also many factors that may determine how quickly someone may develop the disease. For example if a patient smokes, has a systemic disease, or there is a family history of gum disease, they may develop periodontitis much quicker than someone without these factors.
The disease process starts out as Gingivitis. Gingivitis is a mild form of gum disease that can be reversed with daily brushing, flossing, and regular professional cleanings. This form of gum disease does not include any loss of bone and tissue that hold teeth in place. When gingivitis is left untreated, it will eventually advance into “periodontitis” or gum disease.
There is a tiny area where the gum and tooth meet called a pocket. When there is an active periodontal infection, the gums will begin to pull away from the teeth resulting in the pockets becoming deep. The more advanced the disease becomes, the deeper the pockets. Your dental professional used a specialized instrument to measure the depth of these pockets. Varying stages of inflammation will also accompany an active periodontal infection. The body’s natural response to any infection is for the immune system to attempt to heal itself. The body will send out cells to fight the bacteria and plaque as it spreads and grows below the gum line. The combination of the bacterial toxins and the body’s natural response creates inflammation. This results in bleeding gums and the break down of bone and connective tissue that hold teeth in place. If not treated, the bone, gums, and tissue that support the teeth are eventually destroyed. Once this type of destruction is done it is permanent and irreversible. If the disease reaches an advanced form the teeth may even become loose and have to be removed.
Scaling and root planing is performed to remove all of the plaque and calculus so the gums can begin to heal, reattach to the tooth structure, and reduce pocket depths. For early stages of the disease, this treatment, with good home care, may be all that is needed to get the condition under control. With more advanced gum disease, scaling and root planing may be the first step in treatment before possible surgical remedies are considered. The sooner a periodontal infection can be diagnosed and treated the better.
How Is It Done?
For some patients, scaling and root planing can cause discomfort. A local anesthetic, like Novocaine, may be used to numb the portion of your mouth that is being worked on. If caught early enough, a topical anesthetic may be applied or no anesthetic at all may be needed.
The actual process is done with a combination of an ultrasonic water scaler and hand instruments. The ultrasonic scaler vibrates at a high frequency knocking off the bigger pieces of tartar while using water to irrigate and flush debris out from around the teeth. Hand instruments are not powered. They have sharp cutting edges that your hygienist uses to chip, scale, and smooth away the smaller pieces of plaque and calculus. These instruments come in various shapes and sizes. Different instruments are used for different teeth, and even for different surfaces of the same tooth.
Typically, ultrasonic instruments are used first to remove large deposits of plaque and calculus from the crowns and roots of the teeth. Hand instruments called scalers and curettes are then used to remove any remaining material and make sure the tooth surface is clean and smooth. When cleaning out the deep pockets the hygienist will work below the gum line. The hygienist cannot see the plaque or calculus. They will rely on the sense of touch to feel for roughness on the root surface. All of our hygienists are skilled and experienced in this process.
Sometimes, scaling and root planing can be completed in one visit. This usually is possible if you have the earliest stage of gum disease and it has not spread to the entire mouth. However, if you have generalized periodontitis, two visits are usually needed to complete the service. The hygienist will typically do one half of your mouth (two quadrants) at each visit.
For one to three days after the treatment, you may have some slight soreness and bleeding. Sensitive to hot and cold temperatures may also occur. This is normal and over-the-counter pain relievers are sufficient to help. Also, a warm salt-water rinse is therapeutic. You may also be asked to temporarily use a prescription antiseptic mouth rinse or have localized antibiotics placed under the gums in more advanced cases.
Your dental hygienist will review your home care and dental appointment schedule with you when the procedure is complete. It is crucial for the patient to understand that once the scaling and root planing is complete they need to be seen more frequently. The patient will be scheduled for alternating periodontal maintenance cleanings in between their regular six month cleanings. This, along with a good home care routine, will prevent the infection from returning and keep the tissues and bone stable. The disease process will begin again if regular brushing, flossing, and professional cleaning routines are not followed.
◾ Arestin (Antibiotic Periodontal Disease Treatment)
What Is Arestin?
Arestin is an antibiotic that is placed below the gumline to treat periodontal disease. The medicine comes as a pressed powder in a small carpel. The powder contains microspheres or tiny particles that are smaller than grains of sand. These microspheres are filled with the antibiotic minocycline hydrochloride and release slowly over time, to kill the present bacteria and keep killing new bacteria that may form deep in an infected periodontal gum pocket.
Why Do I Need Arestin?
If you have periodontal gum disease, scaling and root planning or (deep cleaning) may be needed to help improve the health of your teeth and gums. While this process removes a great deal of the bacteria that causes the infection, the procedure cannot remove all of the bacteria hiding in a deep periodontal pocket. For this reason, we may recommend antibiotic ARESTIN treatment in conjunction with the cleaning process to kill any remaining pathogens. It is decided on a case-by-case basis if you are a good candidate for this treatment. Many factors, including the stage and progression of the disease, are taken into consideration. In many cases, the placement of Arestin will allow the gum tissues to heal and reattach better and faster than deep cleaning alone. Arestin may also be recommended as a regular therapeutic treatment for areas with chronic inflammation issues.
How Is Arestin Administered?
Arestin is placed into the infected area after your deep cleaning or periodontal maintenance is completed. The medicine is placed under the gum with a blunt tip applicator and is completely painless. No needle is required and it takes only seconds to place. The Arestin will continue its release for up to 21 days and will dissolve on its own. No removal is required.
Is ARESTIN Different From Taking Antibiotic Pills?
ARESTIN is different from an antibiotic you take as a pill. The medicine is placed right only where it's needed. That means it is concentrated to the specific area of infection. A pill that travels through your entire body to reach the infected area cannot give you the same level of antibiotic concentration in your gums. Also, minocycline is specifically designed to kill the bacteria that cause periodontal disease. Most oral pill antibiotics are designed to kill a wide spectrum of bacteria and do not target the specific types of bacteria found in the infected area like Arestin.
Will My Insurance Pay For My Arestin Treatment?
Arestin in many cases may not be covered by your dental insurance. However we do participate in the Arestin Rx Access plan. That means we may be able to get you coverage through your medical insurance. We also have several payment options available.
◾ Gingival Grafting
A gingival graft is a minor surgical periodontal procedure. The goal of the surgery is to cover an area of exposed tooth root surface and stabilize the affected area.
Why Do I Need a Gingival Graft?
Gum grafting is typically needed when a patient has an area with excessive gum recession. This means the tissue that surrounds the teeth pulls away from a tooth, exposing more of the tooth and the tooth's root. There are many reasons a patient may develop gum recession. Common causes are teeth grinding, brushing too hard, and gum disease. In other cases, improperly placed oral jewelry, like a lip or tongue ring, and certain orthodontic treatments, may cause gum recession as well.
When the gum tissue begins to recess, it will often be accompanied by damage to the supporting bone. The gums are what protect and nourish the underlying bone. Without the gum tissue the bone cannot survive. This is why in severe cases of gum recession the teeth may become mobile or even lost.
Our dental professionals and board certified periodontist are here to help. The first step is to diagnose the problem. During your routine exam the hygienist and doctors will be on the lookout for areas that have started to develop gum recession. One you have been diagnosed, it is imperative to treat the actual cause of the gum recession. Once addressed and treated, we can complete your gingival graft and put you on the road to health.
Recession is a common dental problem affecting from 4% to 12% of adults. The condition most often goes unnoticed by the patient because it is a gradual process. However, over time, an exposed tooth root cannot only look ugly, but can begin to cause symptoms such as sensitivity and pain. Eventually, if gum recession is not treated, it can lead to tooth loss. To repair the damage and prevent further dental problems, a gum tissue graft may be needed.
What to Expect from Your Surgery
Depending on your own personal needs, one of two methods will be used to complete your surgery, a connective tissue graft or an a-cellular graft. A connective tissue graft takes donor tissue from the roof of the patient’s own mouth or an area near the tooth that is being repaired. An a-cellular graft uses tissue obtained from a donor bank. The doctor will determine which treatment is best for you. Once your personal treatment plan has been established, the doctor will review all the steps that will be taken before and after the surgery to make sure you are aware of all the proceedings and set your mind at ease. The doctor may also place you on an oral antibiotic for two days prior to the surgery-taking place.
The first and most important step of your procedure will be to make you feel comfortable. Topical anesthetic will be applied to the area and then series of quick injections will make the area completely numb so you don’t feel a thing. Nitrous Oxide is also available for our patients that need that little bit of extra comfort. Once your surgery is complete, the doctor and assistant will review, with you, all your home care and post-op instructions.
Once the graft is complete, there will typically be a 2 to 4 day recovery time. For a 48-hour period of time, you will be asked not to exercise or overexert yourself. You should also not eat or drink hot items, use a straw, or rinse your mouth for 48 hours. You should not eat hard foods or brush the surgery site at all for 2 weeks. In some instances you may have to wear an appliance for 2 to 3 days after the surgery, if the doctor feels the surgery site needs extra protection. You will also be placed on an anti-inflammatory medication and possible pain medication, if needed. The sutures or stitches at the surgery site will dissolve on their own in 2 to 3 weeks and do not need to be removed. Lastly, you will be asked to return in 2 weeks so the doctor can re-evaluate the results of your surgery.
◾ Crown Lengthening
What Is A Crown Lengthening?
This is a minor, common, surgical procedure that is done to expose more of the crown of a tooth so the tooth can be restored.
Why Do I Need This Procedure Done?
Sometimes, when a tooth breaks not enough of the tooth is left sticking out above the gum to support a filling or crown. This can happen when a tooth breaks off at the gumline or a large filling falls out near the gumline. In other cases, decay may have formed on the tooth or root surface that lies below the gumline. In order to place a new filling or crown, the dentist needs to expose more of the tooth. Crown lengthening is also used for cosmetic purposes when a patient has excessive gum tissue around their upper teeth. We call this a "gummy smile." While this typically has no harmful symptoms associated with it, many patients do not like the look of excessive gum tissue when smiling. Crown lengthening can resolve these issues.
What to Expect from Your Procedure
Once your personal treatment plan has been established, the doctor will review all the steps that will be taken before and after the surgery to make sure you are aware of all the proceedings and set your mind at ease. The doctor may also place you on an oral antibiotic for two days prior to the surgery taking place.
The first and most important step of your procedure will be to make you feel comfortable. Topical anesthetic will be applied to the area and then a series of quick injections will make the area completely numb so you don’t feel a thing. Nitrous Oxide is also available for our patients that need that little bit of extra comfort. Once your surgery is complete the doctor and assistant will review all your home care and post-op instructions with you.
Once the procedure is complete, there will typically be a 2 to 4 day recovery time. Ice packs can be applied for 15 minute on/off increments for swelling as long as it persists. For a 48-hour period of time, you will be asked not to exercise or over exert yourself. You should also not eat or drink hot items, use a straw, rinse your mouth, or smoke for 48 hours. When you begin rinsing again, after 48 hours, gently use salt water rinses daily until the tissues have healed. Generally this is about two weeks or until your post-op checkup appointment. You should also not eat hard foods or brush the surgery site at all for 2 weeks. After the surgery, you will be placed on an anti-inflammatory medication and possible pain medications, if needed, as some discomfort can be expected. Medications should be taken with food to avoid nausea. Soft bland foods are the best choice for two weeks. For example: Eggs, Pasta, Pudding, Jell-O. If excessive bleeding occurs, take a moistened plain tea bag and place it at the bleeding site. Apply gentle pressure on the tea bag with your fingers. If you are not able to stop the bleeding you should contact us on the after-hours emergency line. The sutures or stitches at the surgery site will dissolve on their own in 2 to 3 weeks and do not need to be removed. Lastly, you will be asked to return in 2 weeks so the doctor can re-evaluate the results of your surgery.
At Gwynedd Dental we provide Root Canal Therapy to treat Endodontic issues regarding the tooth root, nerve, and surrounding tissues.
◾ Root Canal Therapy
WHAT IS A ROOT CANAL?
Root canal therapy or endodontic treatment is most commonly known as a “ Root Canal”. This procedure is designed to correct and treat an infection or inflammation of the dental pulp. The pulp is the soft tissue inside the center of the tooth and roots. This is also where the nerves and blood vessels are contained that keeps the tooth vital or “ alive”. When a root canal is preformed the first step is to remove the pulp along with bacteria, the decayed nerve tissue and related debris from the tooth and its roots. Then the interior of the tooth is prepared and sealed. A rubber compound called gutta percha is placed into the tooth's root canal and a permanent crown is placed over the tooth to strengthen it.
WHAT CAUSES A TOOTH TO NEED A ROOT CANAL?
Inflammation or infection of the pulp can have a variety of causes. The most common are deep decay, repeated dental procedures on the same tooth, faulty dental restorations, or a cracks in the tooth. In addition, trauma to a tooth may cause pulp damage even if the tooth has no visible chips or cracks.
DOES HAVING A TOOTHACHE = ROOT CANAL?
It’s a common thought that a patient will have a toothache if they are in need of a root canal. This is actually wrong. It is when pulp inflammation or infection is left untreated that a tooth may begin to have pain and possibly form an abscess. In fact, if a tooth is then left untreated even further the toothache may eventually go away. This is because the tooth has become non vital or a “ dead tooth”. The nerves inside the pulp have died and the tooth is now a brittle shell that will often begin to crumble. Every case is different and a toothache or absence there of may indicate a variety of different issues. The easiest and most efficient way to avoid a root canal is to visit us for your bi -yearly check ups. Any type of decay or infection caught early is much easier to treat for the doctor and patient.
WILL HAVING A ROOT CANAL HURT?
Contrary to jokes about the matter, modern root canal treatment is very similar to having a routine filling, and usually can be completed in one appointment, depending on the condition of your tooth. You can expect a comfortable experience during and after your appointment. On occasion a mild pain reliever like IB Profin or Motrin may be suggested after the procedure. In addition if an active abscess is present the tooth is considered “ hot” and may not respond to anesthesia or Novocain. In this case the doctor may prescribe you antibiotics for several days before the procedure to temporarily eradicate the infection. This will make the infection subside enough so that the anesthesia may take effect for your comfort during the root canal procedure.
WHY DO I NEED TO HAVE A CROWN PUT OVER MY TOOTH AFTER A ROOT CANAL?
Once a root canal is complete the nerves and blood vessels inside the tooth are permanently removed. This means the tooth is now non-vital or “dead”. No nutrients, blood or oxygen are able to feed to that particular tooth anymore. This causes the tooth to become brittle. A crown is placed to strengthen the tooth.
At Gwynedd Dental we care about your smile and we can prevent and correct irregularities of the teeth with our Clear Correct Braces which require No Wire and No Brackets.
◾ Clear Correct No Wire No Bracket Braces
No Bracket, No Wire Orthodontic System. Looking for an alternative to metal braces? ClearCorrect is the clear and simple choice. We can straighten your teeth using a series of clear, custom, removable aligners. Each aligner moves your teeth, just a little bit at a time, until the teeth straighten.
921 N. Bethlehem Pike
Spring House, PA 19477
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