Dr. Friedman is an In-Network provider for multiple insurance plans. She offers the following procedures:
When periodontal pockets do not heal after scaling and root planing, surgery may be needed to better remove inflamed tissues and reduce the damage to the bone that has formed around the teeth. As the pockets enlarge, they provide a greater place for bacteria to live and attack the bone and tissue.
Surgery allows the periodontist to access hard-to-reach areas under the gum and along the roots where tartar and plaques have accumulated. Eliminating the bacterial stronghold and regenerating bone and tissue help to reduce pockets and repair damage caused by the progressing disease.
During the procedure, the periodondist turns back the gum tissue and removes tartar and smoothes the roots so that gum tissue can reattach. The gums are sutured back into place or into a new position to make gum tissue snug around the tooth.
Your periodontist may recommend additional procedures to regenerate lost bone and tissue. Bone surgery, including bone grafts, is used to rebuild or reshape bone destroyed by periodontal disease. Membranes (filters), bone grafts or tissue-stimulating proteins may be used to encourage your body’s natural ability to regenerate bone and tissue.
(Information obtained from the American Academy of Periodontology)
Procedures that regenerate lost bone and tissue supporting your teeth can reverse some of the damage caused by periodontal disease.
Your periodontist may recommend a regenerative procedure when the bone supporting your teeth has been destroyed due to periodontal disease. These procedures can reverse some of the damage by regenerating lost bone and tissue.
The loss of one or more permanent teeth, due to trauma, decay or periodontal disease, is increasingly common. Dental implants offer a permanent solution.
What are dental implants? They replace missing teeth. They consist of three parts: the dental implant, an abutment and the crown over the abutment.
The dental implant is made out of titanium and zirconium. These metals are very strong and they are compatible with the body’s bone. After placing an implant in the bone, you usually must wait a couple of months before the implant is ready to have a crown put on it.
An abutment is secured into the implant and it extends above the gum. The crown placed over the abutment.
Why would I need a dental implant? It’s important for your health to replace missing teeth. Leaving spaces between teeth can lead to drifting of other teeth. This can cause problems with your ability to clean food from between your teeth and negatively impact your gums.
Who is a good candidate for dental implants? As long as there is enough bone available to support the implant, and no disease is present that will deteriorate the bone over a period of time, most people are candidates for dental implants. Unlike some other tooth replacement procedures, there is no minimum or maximum age. There are some serious health issues that may disqualify you from being considered for dental implants.
Sinus Lift Surgery
A key to implant success is the quantity and quality of the bone where the implant is to be placed. The upper back jaw has traditionally been one of the most difficult areas to successfully place dental implants due to insufficient bone quantity and quality and the close proximity to the sinus. If you’ve lost bone in that area due to reasons such as periodontal disease or tooth loss, you may be left without enough bone to place implants.
Sinus lift surgery can help correct this problem by raising the sinus floor and developing bone for the placement of dental implants. Several techniques can be used to raise the sinus and allow for new bone to form. In one common technique, an incision is made to expose the bone. Then a small circle is cut into the bone. This bony piece is lifted into the sinus cavity, much like a trap door, and the space underneath is filled with bone graft material, which can regenerate lost bone and tissue.
Finally, the incision is closed and healing is allowed to take place. Depending on your individual needs, the bone usually will be allowed to develop for about four to six months before implants can be placed. After the implants are placed, an additional healing period is required.
Undergoing sinus lift surgery has been shown to greatly increase your chances for successful implants that can last for years to come. Many patients experience minimal discomfort during this procedure.
Deformities in the upper or lower jaw can leave you with inadequate bone in which to place dental implants. This defect may have been caused by periodontal disease, wearing dentures, developmental defects, injury or trauma.
To correct the problem, the gum is lifted away from the ridge to expose the bony defect. The defect is then filled with bone or bone substitute to build up the ridge. Dr. Friedman can tell you about your options for graft materials, which can help to regenerate lost bone and tissue.
Finally, the incision is closed and healing is allowed to take place. Depending on your individual needs, the bone usually will be allowed to develop for about four to six months before implants can be placed. In some cases, the implant can be placed at the same time the ridge is modified.
Ridge modification has been shown to greatly improve appearance and increase your chances for successful implants that can last for years to come. Ridge modification can enhance your restorative success both aesthetically and functionally.
Crown lengthening (or crown exposure) may be required when your tooth needs a new crown or other restoration. The edge of the fracture or the cavity may be deep below the gum tissue and not accessible. It may also be too close to the bone under the gums.
Crown lengthening involves adjusting the levels of the gum tissue and bone around the tooth. This will allow a new restoration to be placed on healthy tooth structure, ensuring a proper fit to the tooth. Crown lengthening should also provide enough tooth structure so the new restoration will not come loose in the future. This allows you to clean the margin of the restoration when you brush and floss to prevent decay and gum disease.
Esthetic Crown Lengthening
Although your teeth may appear short when you smile, the teeth may actually be the proper length but they are covered with too much gum tissue. We can correct this by performing the periodontal plastic surgery procedure known as esthetic crown lengthening.
During this procedure, excess gum and bone tissue is reshaped to expose more of the natural tooth. This procedure will reveal a more balanced ratio of tooth structure to gum tissue giving your smile a harmonious appearance.
Soft tissue grafting “Gum Grafting”
Sometimes gum recession causes the tooth root to become exposed, which can make your teeth look long. The recession may cause the teeth to be sensitive. Soft tissue grafts and other root coverage procedures are designed to cover exposed roots, to reduce further gum recession and to protect vulnerable roots from decay and eventual loss.
A thin piece of tissue is taken from the roof of the mouth, or from other lab-prepared human donor sources, to provide a stable band of attached gingiva around the tooth. The gum graft is placed in such a way as to cover the exposed portion of the root to bring the gumline more even with the adjacent teeth. The gum graft will thicken the amount of gum tissue around the neck of the tooth. It should help decrease sensitivity and prevent further recession in that area.
Non-Surgical Periodontal Therapy
Scaling and Root Planing
A periodontal pocket is when the attachment between the gum tissue and the bone and root of the tooth is severed due to periodontal disease. The procedure called scaling and root planing is a “deep cleaning” which removes the plaque and calculus build-up from the tooth to reduce the pocketing. Local anesthetic is used for patient comfort.
There are instances during the scaling and root planing procedure where we will offer you antibiotics, either by direct application in the site of infection or orally to help fend off the periodontal infection. Such techniques can increase the effectiveness of the periodontal treatment, especially in areas where an individual is experiencing severe periodontal infection.
Diabetes and Periodontal Disease
There is a two-way relationship between periodontal disease and diabetes.
For years, we’ve known that people with diabetes are more likely to have periodontal disease than people without diabetes. Recently, research has emerged suggesting that the relationship goes both ways—periodontal disease may make it more difficult for people who have diabetes to control their blood sugar. While more is needed, what we do know is that severe periodontal disease can increase blood sugar, contributing to increased periods of time when your body functions with a high blood sugar. As a diabetic, this puts you at increased risk for diabetic complications.
Treating periodontal disease may help you control your diabetes. If you are among the 29 million individuals in the U.S. who live with diabetes, you should see a periodontist for an evaluation.
(Information obtained from the American Academy of Periodontology)
Dr. Friedman uses digital x-rays. Digital radiography uses an estimated 40-90 percent less radiation than conventional film x-rays.