We are fortunate to have Dr. Melissa Goodman, a certified periodontist (gum specialist), in our office to provide the following specialty services for our patients:

Arestin
Arestin is an antibiotic (minocycline hydrochloride) that is gently placed in a deep gum pocket to reduce the depth of the pocket in patients with adult periodontitis. It is used as an adjunct to scaling and root planing procedures. This procedure is painless and has proven results in the proper cases. In some patients, multiple applications are required.

Gum Grafts
Gum grafts can be placed where the gums have receded and exposed the roots of the teeth. Risk factors for gum recession include genetics, gum disease or trauma. Receding gums increase the likelihood of developing cavities on the tooth root which can create a tremendous amount of sensitivity. A gum graft can be rotated in from nearby tissue, obtained from the roof of your mouth, or can be made from synthetic material. Placing the graft over the tooth root will create a barrier to alleviate your problems. Dr. Goodman can help you select the option that is best for you.

Extraction with Socket Preservation / Guided Bone Regeneration (GBR)
Some teeth cannot be saved, and extraction/removal is the only option. If someone is considering having an implant placed in this site, a bone graft can be placed at the time of extraction to ensure the best foundation for the future implant. Bone grafting involves placing a material in the tooth socket that eventually becomes replaced by your own natural bone. This process takes approximately 3 months.

Implant Placement
A dental Implant is a small screw-shaped cylinder that is placed into bone. The implant acts like the root of a natural tooth because bone forms around the implant to hold it firmly in place through a process called osseointegration. Implants are used to replace one or more missing teeth, or to stabilize dentures. In cases where there are multiple missing teeth, multiple implants can be placed to allow for implant-supported bridges or dentures.

The success rate for dental implants is very high. With proper care, good dental hygiene, and a healthy lifestyle, it is rare that implants will fail.

Gingivectomy
Gingivectomy involves surgically recontouring the gums. It can be used to treat gingivitis (inflammation of the gums) or gum overgrowth from poor oral hygiene or medications. Gingivectomy can also be performed for cosmetic reasons to recontour bulging tissues.

Biopsies
The oral cancer screen is an extremely important part of your examination. When a growth or abnormality is identified, a sample of the tissue can be removed and sent to a laboratory to ensure an accurate diagnosis and treatment plan.

Crown Lengthening
Functional crown lengthening is a surgical procedure that recontours the gum and the underlying bone around a tooth. This provides your dentist with an adequate amount of healthy tooth to support a crown or filling. Without this procedure, it may not be possible to fix the tooth or do so in a healthy manner.

Esthetic Crown lengthening is a procedure to address excessive gingival display, otherwise known as a “gummy” smile. A person with a gummy smile appears to have short teeth despite actually having normally sized teeth because excess gum tissue partially covers them.

Guided Bone
Regeneration In people who have lost one or more teeth, the gum and bone begin to disappear, leaving them with an indentation/concavity. To properly have an implant placed that is both functional and aesthetic, your doctor may need to rebuild the bone and gum tissue in this area. A variety of different bone graft materials can be used to accomplish this. Dr. Goodman will review these with you.

Sinus Augmentation
Procedure (sinus lift) For a dental implant to be successful, there must be good quantity and quality of bone. When teeth in the upper jaw have been missing for many years or a significant amount of bone has been lost due to periodontal disease, there may not be adequate bone to support dental implants. After teeth in the upper back jaw have been missing for a prolonged period of time, the sinus above can expand and cause the jaw to shrink. This can result in an insufficient amount and quality of bone to adequately support dental implants. Sinus augmentation may be required to elevate the sinus floor and develop bone for ideal placement of dental implants. Sinus augmentation and implant placement can be done in one procedure or two separate procedures. Dr. Goodman will assess the thickness of bone relative to the sinus floor and discuss the treatment options with you.

Pocket Reduction Surgery 
Pocket reduction surgery (flap procedure) involves gaining access to the roots of the teeth to remove bacteria and tartar (calculus). The human mouth contains dozens of different bacteria. Bacteria in plaque (the sticky substance on teeth) produce acids that lead to demineralization of the tooth surface, and ultimately contribute to periodontal disease.

Periodontal infections cause chronic inflammation in the body that destroys bone and gum tissues once they invade the subgingival area (below the gum line). Gum pockets form and deepen between the gums and teeth as the tissue continues to be destroyed, eventually leading to teeth falling out. Pocket reduction surgery is an attempt to alleviate this destructive cycle by reducing the depth of bacteria-harbouring pockets. It has proven effective at eliminating bacteria, reducing bacterial spread, reducing inflammation, halting bone loss, saving teeth, and facilitating home care. Routine follow-up and continual care after pocket reduction procedures is vital for maintaining healthy gums and teeth.

Periodontal Regeneration
Bone loss and pocketing are symptoms of gum disease that have traditionally been treated by cleaning and removing the infected tissue to create a healthier and more maintainable environment for teeth and supporting bone structures.

Newer treatments, called periodontal regeneration, aim to diagnose disease early and reverse the effects of gum disease to grow back some of the bone that has been lost. Dr. Goodman has used Emdogain for many years to save thousands of teeth from extraction. Emdogain works by stimulating a patient’s own bone cells and allowing the tissue to biologically regenerate itself. Periodontal regeneration is a cost-effective way to help patients keep their own natural teeth.

Frenectomy
A labial frenectomy involves gently trimming the tissue that attaches the lip to the gum either in the upper or lower area of your mouth. If this attachment approaches the teeth, it can prevent the gap between the two front teeth from closing. Frenectomy is a short procedure that requires little to no recovery time.

For more information about periodontal treatment, or to book an appointment, please call our Scarborough Centenary Dental office today at 416-281-4746.