My gums are receding and my teeth appear “long.” Can this be fixed?

If left untreated, gum recession can lead to tooth loss. Gum recession can be a sign of serious bone recession. Soft tissue grafts can fix this condition and also prevent further recession or bone loss. In the procedure, gum tissue can be taken from your palate or another donor source. This tissue is then placed over the exposed roots, which helps to even out the gum line and reduce sensitivity to hot and cold temperatures.


I have a “gummy” smile. What can be done to correct this?

A procedure called esthetic crown enhancement can correct “gummy” smiles. “Gummy” smiles make teeth appear too short because either the gum and/or supporting bone did not passively repositon lower around the tooth after its eruption into the mouth. With esthetic crown enhacement, the gums and supporting tissues are reshaped/repositioned to expose the natural length & form of the tooth.


What is maintenance therapy?

Maintenance therapy is used to help prevent further infection from occurring in patients who have already received periodontal treatment. Dr. Frankel will tailor a program to fit your needs, which will include periodontal checkups, plaque and tartar removal and sometimes polishing your teeth or checking your bite. The frequency of visits varies from case to case from every few weeks to four times per year.


In advance cases, that have not reached stability, we suggest that you continue to see us for all maintenance visits. Once we are certain that you have reached a steady state of health, we will ask you to see both your general dentist and us, on an alternating basis, to best preserve an optimal result. Research has proven to us that this is the best treatment for our patients.


If I have periodontal disease, do I need surgery? What are my options?

Whether you need surgery or not will depend on how advanced your periodontal disease is. There are non-surgical treatments, such as root scaling and planing available, for those with mild gum disease. If you are in the advanced stages of gum disease, you may benefit from having surgery. With the latest technology and advanced techniques available today, many surgical procedures can be performed in an office setting with little discomfort.


Are dental implants the best restoration option?

Your periodontist, Dr. Frankel, can determine if dental implants are the best restoration option for your individual case. Dental implants have a natural look and feel and can help prevent shifting of surrounding teeth. Implants are often preferred to bridges and dentures because they are more secure. The average life span of a bridge has been shown to be between 7 to 10 years. Dental implants have been shown to last much longer than a bridge and in many instances will last a life time.


Are there ways to prevent periodontal disease?

A good oral hygiene regimen is imperative in preventing periodontal disease. Proper brushing and flossing, in conjunction with regular dental visits for professional cleaning twice a year, will help keep your smile healthy for life. If you have periodontal disease that is treated, research clearly demonstrates that professional cleanings should be performed every 3 months to maintain disease stability.


My gums bleed when I brush my teeth. Is this normal?

Healthy gums should not bleed when you brush your teeth. This is one of the early signs of gum disease. You should schedule an appointment with your periodontist for a complete periodontal screening.


Is periodontal disease contagious?

Although it is not an airborne disease, research has indicated that the bacteria that causes gum disease can be passed through saliva. Therefore, families and couples who may be in close contact with a person with gum disease are also at risk. We recommend being screened for periodontal disease regularly if you are potentially at risk, particularly if you have a family history of periodontal disease or tooth loss.


What is periodontal disease, and am I at risk of developing it?

The term “periodontal” simply means “around the tooth.” Periodontal disease affects the gums and bones supporting the teeth. Also known as gum disease, periodontal disease or “gum disease” often is attributed to the bacteria in dental plaque, which causes the gums to become inflamed and infected. Other factors, such as smoking or tobacco use, poor nutrition, stress or pregnancy, may put you at risk of developing gum disease.


What is a periodontist? Do I need to see one?

A periodontist specializes in the diagnosis, treatment and prevention of periodontal disease, as well as dental implant placement. Periodontists have completed 4 years of dental school and have received an additional 3 years of training to obtain the necessary education to perform procedures in periodontics. Your general dentist may refer you to a periodontist if you exhibit the symptoms of gum disease or need a dental implant; however, you may schedule an appointment on your own if you have concerns about your oral health.


How are these treatments performed?

Periodontal plastic surgery can be performed on an outpatient basis with local anesthesia and some form of sedation. Improved techniques have greatly advanced grafting procedures. The results of these advances have been shorter healing times, absence of scarring, and an esthetic result. You will need to make some changes to your eating habits during the first 2 weeks by eating softer foods. Other possible medications and instructions will be discussed at your consultation appointment. Patients often receive the benefits of both: a beautiful new smile and improved oral health.


What is the appropriate treatment sequence for these procedures?

Preprosthetic communication between your dentist and periodontist is essential to arrive at a treatment plan that meets your needs and expectations.


Usually, periodontal procedures are completed prior to restorative work. Sometimes, you may be in transition from the start of your restorative care and its completion. This may mean you are in temporaries, which will not be replaced by the final restorations until your periodontal therapy is complete.


Why do I need a ridge augmentation?

Sometimes when you lose one or more teeth, you can get an indention in your gums and jawbone where the tooth used to be. This happens because the jawbone recedes when it no longer is holding a tooth in place. Not only is this indentation unnatural looking, it also causes the replacement tooth to look too long compared to the adjacent teeth. This may even affect the way you speak if it involves a front tooth.


A periodontist can fill in this “defect” with a procedure called a ridge augmentation, recapturing the natural contour of your gums and jaw. A new tooth can then be created by your dentist that is natural looking, easy-to-clean, and beautiful.


This patient had a large defect where a tooth was removed. Hard and soft tissue grafting were used to eliminate this defect:

What are the benefits of crown lengthening?

Whether you have crown lengthening to improve function or esthetics, patients often receive the benefits of both: a beautiful new smile and improved periodontal health – your keys to smiling, eating and speaking with comfort and confidence.


This patient required a crown to protect a cracked tooth. However, the tooth was too short for the crown to fit. A crown lengthening allowed more tooth structure to be made available for the crown:

Decay was inaccessible on the back of these front teeth. Crown lengthening provided room for new restorations:


Why do I need crown lengthening?

Periodontal procedures are available to lay the groundwork for restorative and cosmetic dentistry and/or to improve the esthetics of your gum line. Do you feel your teeth look too short and your smile is too gummy or your gums cover too much of some teeth while leaving the others the right length? Your teeth may actually be the proper lengths, but they’re covered with too much gum tissue. To correct this, your periodontist performs crown lengthening. This can be done to one tooth, to even your gum line, or to several teeth to expose a natural, broad smile.


Your dentist or periodontist may also recommend crown lengthening to make a restorative or cosmetic dental procedure possible. Perhaps your tooth is decayed, broken below the gum line, or has insufficient tooth structure for a restoration, such as a crown or bridge.


What are the benefits of mucogingival/periodontal plastic surgery?

A soft tissue graft can reduce further recession and bone loss. In some cases, it can cover exposed roots to protect them from decay. This may reduce tooth sensitivity and improve esthetics of your smile.


Whether you have crown lengthening to improve function or esthetics, patients often receive the benefits of both: a beautiful new smile and improved periodontal health – your keys to smiling, eating and speaking with comfort and confidence.


Why do I need plastic surgery?

Periodontal procedures are available to stop further dental problems and gum recession, and/or to improve the esthetics of your gum line. Exposed tooth roots are the result of gum recession. Perhaps you wish to enhance your smile by covering one or more of these roots that make your teeth appear too long. Or, maybe you’re not bothered by the appearance of these areas, but you cringe because the exposed roots are sensitive to hot or cold foods and liquids.


Your gums may have receded for a variety of reasons, including aggressive tooth brushing or periodontal disease. You may not be in control of what caused the recession, but prior to treatment your periodontist can help you identify the factors contributing to the problem. Once these contributing factors are controlled, a soft tissue graft procedure will repair the defect and help to prevent additional recession and bone loss. Soft tissue grafts can be used to cover roots or develop gum tissue where absent due to excessive gingival recession. This can be done for one tooth or several teeth to even your gum line and reduce sensitivity.