Family & Cosmetic Dental Care in a Relaxed Environment.

Exceptional Dentistry Las Vegas and Henderson NV Since 1999.

Dental Implants, Teeth Whitening, Porcelain Veneers, &
Botox Cosmetic.

Call Today For Consultation!

Email Us
Directions



Scaling and root planing is one of the most conservative and effective procedures to treat periodontal disease before it progresses. Scaling is the removal of calculus (commonly called tartar) and plaque that attach to the tooth surfaces. Scaling and root planing cleans between the gums and the teeth along the roots. Scaling and root planing specifically targets the areas below the gum line (along the root).

Scaling and root planing are sometimes referred to as a deep dental cleaning. Scaling involves removal of built up plaque at the gum line using either manual hand instruments or an ultrasonic cleaning tool (the vibrations break up the tartar and plaque). During root planing, your dentist or hygienist will be gently cleaning the roots of your teeth, and removing any rough spots along the roots and teeth. These rough spots tend to be a trap for bacteria and plaque. Plaque is far more likely to stick to rough surfaces. As the bacteria builds up in the form of plaque it creates a sticky surface for even more bacteria to accumulate. The root surface is made smooth in a process called root planing. Root planing removes any remaining tartar and smooths

Root Planing and scaling

Scaling and Root Planing

irregular areas of the root surface. This procedure is usually performed using local anesthesia, because the roots of teeth are unprotected by enamel and are very sensitive. Your dentist will use a local anesthetic to numb your mouth before starting the procedure. Local anesthetic should prevent you from feeling discomfort during the root planing and scaling. Instead, you’ll just feel the pressure of the instruments in your mouth.

It usually takes more than one visit to complete scaling and root planing. Since all of that deep cleaning can leave your teeth pretty sensitive, the dentist or hygienist will only do one part your mouth at a time. The number of treatments can depend on how severe your periodontal disease is and your personal oral hygiene habits. It generally takes 2 visits to complete the scaling and root planing procedure. You will schedule your follow up appointments about 1 week apart from each other. It will also be recommended that you schedule more frequent cleanings (every 3-4 months) after scaling and root planing to help prevent the return of gum disease.

Why is Scaling and Root Planing necessary?

Scaling and root planing actually helps gums heal. The gum tissues will have an easier time reattaching themselves to a smoother root surface than a rough one. The smoother surface also helps keep dental plaque from attacking the tooth’s root surface. This makes it far easier to maintain the gum tissue following treatment. Scaling and root planing has been shown to help prevent periodontal disease from spreading and it can also reverse the signs of ginigvitis (the earliest form of periodontal disease).

Following Scaling and Root Planing Treatment

Once the scaling and root planing is completed, oral hygiene preventive care is necessary to keep gums healthy. Periodontal disease can not be cured but it can be held at bay with proper oral hygiene techniques and practices. Brushing and flossing will help fight the dental plaque that is constantly forming around teeth. Antibacterial rinses, such as Peridex, and stannous fluoride rinses help keep bad bacteria at bay. Tartar dissolving products such as Periogen will help keep teeth cleaner between cleanings and allow for greater healing to occur. Regular dental examinations and visits to your hygienist are required to clean areas we are unable to.

Risks of Scaling and Root Planing

Scaling and root planing can introduce harmful bacteria into the bloodstream through the process. Gum tissue can also be at risk of infection. You may need to take antibiotics before and after surgery if you have a condition that puts you at high risk for a severe infection or if infections are particularly dangerous for you. You may need to take antibiotics for the following reasons:

-Have certain heart problems that place you at increased to get a heart infection called endocarditis.

-Have a weakened immune system.

-Had recent major surgeries or have man made body parts, such as an artificial hip or heart valve.

A simple, conservative procedure like scaling and root planing can reduce periodontal disease’s effects and restore the gum tissue to a healthy state. Without proper treatment, periodontal disease will progress. It will progress past the gingivitis stage into periodontitis. Periodontitis is not reversible like gingivitis. Remember: Once gum tissue is lost, it doesn’t grow back. The earlier you treat gum disease, the better chance you have for recovery. To promote healing, stop all use of tobacco. Smoking or using spit tobacco reduces your ability to fight infection of your gums and delays healing. The earlier you start treating gum disease, the better your chances of being able to take care of the problem without surgery and the lower your risk of losing any teeth. So make an appointment to see your dentist today and put an end to your periodontal disease.

 

Avulsed Tooth is the complete displacement of a tooth from its socket in alveolar bone from trauma.

Dentists generally refer to a tooth that has been knocked out as an avulsed tooth. The accidental loss of a tooth through trauma ( avulsed tooth ) is considered a very serious dental emergency for a permanent tooth (occurs in about 1/10th of the population). For an avulsed primary tooth re-implantation is generally not successful, and is usually left alone. For a permanent tooth if you act quickly enough there is a chance the avulsed tooth can be saved and maintained for many years. Even the best techniques and intentions do not always lead to a successful outcome for an avulsed tooth.

The usual cause of an avulsed tooth is a  force sufficient to break the bond between the tooth and the connection (periodontal ligament ) to the bone. An avulsed tooth has no oxygen or blood flow and will die quickly if not re implanted. The primary goal of quick reimplementation is to maintain the periodontal ligament, so that the tooth is not rejected. The avulsed tooth will always need to be splinted to the other teeth, and usually, but not always, require a root canal. The speed in which the tooth is re implanted, the cleanliness of it, and how hydrated or wet it has been all play key roles in whether or not re-implantation of the avulsed tooth will be successful.

Instructions for an Avulsed Tooth

If a tooth has avulsed due to trauma it must be re implanted in its socket within 60 minutes (or sooner if possible) of the accident for the best chance of a positive result (i.e. tooth remains in position). It is important to keep the root surface of the avulsed tooth moist. This is the reason for the need for speed when re implanting the tooth.

An avulsed tooth, whose structure is maintained without any major fracture, must be re-implanted in its socket within an hour after the accident for best chances for it to remain in position. The best option is to attempt re-implantation within the first few minutes at the site where the accident occurred. The avulsed tooth should be attempted to be cleaned and placed back into the socket ( hole in jaw ) by an adult. This can be either the person who lost his or her tooth or by an adult if a child has suffered the trauma. If the avulsed tooth goes back into its socket where it was originally then it would be considered to be a successful re-implantation.

smileIf the avulsed tooth is dirty, it is vitally important that it is cleaned, the best way is with the patient’s own saliva by putting it in their mouth. Once the avulsed tooth is cleaned in this manner the patient should spit out any blood and dirt in mouth. While spitting, you probably will remove the blood clot forming in the avulsed tooth socket. This will allow an easier re-implantation of the avulsed tooth into the socket. the tooth can also be rinsed with cold water or milk. When the avulsed tooth is as clean as you can get it, it should be placed back in the socket as soon as possible. The quicker it is done, the better the chance for success. There are also “tooth saver” kits made to hold and keep the avulsed tooth wet for transport to a dentist.

If the avulsed tooth cannot be repositioned in its socket for any reason, then it should be brought to the dentist as soon as possible. There are a few ways to accomplish this:

1) The avulsed tooth should be rinsed and cleaned as explained above. The person who had the accident must then keep the avulsed tooth in their mouth. They should keep the avulsed tooth under the tongue or between the cheek and back teeth or lip and front teeth. If the trauma happened to a young child the previous advice should be disregarded as they can swallow the tooth. In such a case, the avulsed tooth should be rinsed and placed in milk, or in water with salt. Go to your dentist as soon as possible.

2) After cleaning with saliva, the avulsed tooth can be put in a solution of water and salt. A half a teaspoon of salt should be mixed in a cup of water. It is best to use bottled water if it is  available, but tap water can also be used in a pinch.

3) The avulsed tooth can also be placed in fresh room temperature milk. The patient and avulsed tooth in solution should be brought to the dentist as soon as possibleSave-a-tooth avulsed tooth kit

4) There is a commercial product available for the storage of an avulsed tooth. It is called Save-A-Tooth. This is a small container containing fluid to help preserve the avulsed tooth  for easy transport and re-implantation.

Exceptions to the Rule

The instructions above are recommended for adult teeth only. If a primary tooth (also called baby tooth) has avulsed following an accident, the re-implantation will not really work.

-If the adult avulsed tooth is broken or has visible fractures following the trauma, and or its root remained in the socket, the re-implantation will not be successful. This is because the tooth will not reattach to its root, and a fractured tooth will continue to break down.

Prognosis of Avulsed Tooth following Re-Implantation

It should be remembered that even if you follow all of these recommendations precisely, the tooth in question may eventually need to be extracted. If the instructions are followed correctly, chances are better that the tooth may remain in position.  An immediate splinting to the other teeth is optimal to take stress off the tooth and allow for healing. It may eventually need root canal treatment and possibly a crown to restore the avulsed tooth to its full form and function.

The re implanted  tooth can also seem to be fine for a few months or even a few years before it eventually becomes a problem.

At the Dentist Office

Putting the avulsed tooth back in its socket sometimes can be quite easy. And sometimes it can be very complicated, such as when the tooth or bone is fractured or broken. Your dentist may use water to flush debris from the socket. Then they will attempt to slide the avulsed tooth back into place. As mentioned earlier, it is most important to re implant the tooth as soon as possible. Ideally, this should occur within the hour of the accident.

The best course to take will depend upon how long the tooth was out of the mouth and amount of trauma. In either case, the dentist will splint the avulsed tooth to the teeth on either side with a soft wire and/or a resin material. This will be used to maintain the tooth in place for days-weeks.

If the bone around the tooth was not fractured, the root usually will reattach firmly to the bone in about three to four weeks. More extensive damage to the area may need 6-8 weeks of healing time.

Your dentist should examine the tooth again in three to six months to ensure the tooth is doing fine with no evidence of infection occurring. If there are no signs of infection, the next visit will be at your yearly dental examination. The dentist will then continue to monitor the tooth for the next 2-3 years to ensure that the tooth re implanted successfully.

 




The #1 goal of periodontal disease treatment is to allow for re formation of and re attachment of the periodontal tissues. The best way (and least invasive) is via regeneration or regrowth. There have been various products come to market over the years that have been considered the next immediate fix in regenerative periodontal therapy. Very few have ever seen the real world clinical results of emdogain. Emdogain is made up of various biological proteins and growth factors that have been scientifically proven (thru clinical research and trials) to regrow periodontal tissue, connective tissue, and bone. Emdogain has been shown to be quite stable and predictable for Periodontal  regeneration of lost periodontal tissues.

How Does Emdogain Work?

Emdogain achieves its clinical results by tricking the body into forming new bone, cementum, and attachment fibers. Emdogain’s secret weapon is in its enamel matrix proteins (also called amelogenins) taken from developing teeth in pigs. Luckily, humans do not recognize these proteins as foreign, as they are similarly found in all mammals. There is also a 0 (zero) chance of transmission of any disease by the proteins. During tooth development, these proteins are secreted onto the root surface that is developing preceding the formation of tooth attachment. Luckily for us, this also occurs when the proteins are placed on the root surface of a tooth that has lost bone and attachment from periodontal disease.

Periodontal regeneration

Emdogain

By reintroducing enamel matrix proteins, you are triggering a biologic response from the body to do what it did naturally during your earliest of development. Enamel matrix proteins are only in the body for a short window of time during human development.When applied to the root surface of teeth, these proteins group and form into an insoluble matrix layer that promotes the attachment of mesenchymal cells. These cells produce new matrix components and growth factors that participate in the regain of tooth attachment. Epithelial cell growth is also inhibited by emdogain. This allows for proper tissue and bone reformation to take place without interference.

Treatment

Periodontal regeneration

Radiograph showing bone level before and after emdogain.

Once your dentist has diagnosed, the presence of periodontal disease. Emdogain will be discussed as the least invasive and most effective way to restore the area back to its natural cosmetic appearance. The area in question is generally referred to as a defect. That term is used because there is a periodontal pocket present where the bone and soft tissue has moved away from attaching to the tooth. This is caused by the periodontal disease process. After the defect has been  exposed so the dentist has full visualization of the area. The area is cleaned and debrided of any inflammation and/or diseased tissue or hard tartar deposits. Emdogain is used to help the tissues repair themselves. Emdogain comes as a premixed gel in a syringe. The material is inserted into the defect area. The area is closed and patient can then go about their normal lives. Obviously, the area might be a little tender and patient should avoid flossing and chewing on that side for a few days to allow proper healing time and no disturbance of emdogain as it does its work.

Post Treatment

In the following two weeks, about 75% of the tooth surface where the defect was present will be covered withPeriodontal Regneration the newly developing tooth tissues. The attachment and supporting  structures begin to reattach to the tooth to aid in keeping the tooth stable and healthy. These new tissues will take about one year to complete the maturation process. For this reason, the area where Emodgain is used, should not be periodontally probed (by your dentist or hygienist) for a period of about 6 months. Emdogain can also be used with soft tissue defects.

Emdogain is not ideal for every defect. Your dentist 89014 will be able to describe to you if emdogain is right for your particular case.

 



A gingival graft is the name given for any of a number of surgical periodontal procedures whose goal is to cover an area of exposed tooth root surface with grafted oral tissue from another source. Other names for this procedure are gum graft or periodontal cosmetic surgery. Gum recession is a process in which the margin of gingival tissue that surrounds the teeth wears away in a direction toward the end of the root, exposing more of the tooth. This can cause damage to supporting bone. It is a common dental problem (Studies have shown about 75% of americans have some form of periodontal disease) that often goes unnoticed until it becomes more severe.

Most people are not even aware that their gum tissue has receded since it is such a slow,gradual process. However, over time, an exposed tooth root can not only look ugly, but it can also cause tooth sensitivity. Tooth loss can occur eventually if the gingival tissue is not restored. To repair the damage and prevent further dental problems, a gingival graft may be needed. There are a few goals the dentist and patient are looking for when recommending or performing this surgery. They include:

1)Prevention of further root exposure.

2)To decrease or eliminate tooth sensitivity by covering the root area that was previously uncovered.

Gingival Graft

Gingival Graft – Before and After

3)Decrease the possible incidence of root caries as the root is no longer exposed.

4)Improved aesthetics. This is especially true of teeth that are shown during smiling.

A gingival graft is very effective in solving the problem at hand but there is no guarantee that gum problems won’t develop again. However, with regular dental checkups and careful at home maintenance, serious damage requiring further surgery can be prevented. Other ways to prevent periodontal disease include:

*Brush your teeth twice a day with a fluoride toothpaste. I recommend an electric toothbrush like the Rotadent.

*Floss daily.

*Maintain the schedule recommended by your dentist in regards to hygiene appointments. Usually a 6month recall schedule is the norm but it can more often depending on your situation. Ask your dentist what the best schedule is for you.

*Eat a well balanced and healthy diet.

*Do not smoke.