PERIODONTAL PROCEDURES

What is a Periodontist?

A periodontist is a dentist like Dr. Boquel who has successfully completed 2 years of periodontal training - after receiving a Doctorate of Dental Studies degree - and has been awarded a diploma in Periodontics. While general dentists often treat the mildest cases of periodontal disease, most patients with moderate to advanced gum disease are referred to periodontists. A periodontist can carry out complex periodontal treatment and surgeries to prevent the progression of periodontal disease and also preserve tooth structure. Additionally, periodontists like Dr. Boquel may specialize in the placement of dental implants and cosmetic gum restoration.

Further, a very few periodontists earn the prestigious title of "Diplomate of the American Board of Periodontology" by continuing their studies and successfully passing a rigorous written and oral examination administered by a number of other Board certified Diplomates.  We are proud that Dr. Boquel is a Diplomate certified in Periodontology and Dental Implant Surgery.
Dental Check Up - Periodontics in Gaithersburg and Washington DC

DID YOU KNOW...

That American periodontists study for an additional two years after graduating from dental school? Furthermore, a periodontist must not only complete a dental residency, but also a periodontal residency before becoming eligible for national or state licensure and Board certification. All periodontists must pass the National Board of Dental Examinations.

FREQUENTLY ASKED QUESTIONS

Do I need to visit a periodontist?

You may need to visit a periodontist if you have gum disease or other periodontal complications that are untreatable by your general dentist. Visit your dentist immediately if you are experiencing red or swollen gums, or if you have pockets that have formed between your gums and teeth. This could be a sign of periodontal disease or periodontitis, for which your dentist may refer you to a periodontist for treatment.

What should I expect during a periodontal visit?

Your first periodontal visit will require a complete dental and medical background review, as well as information about your current symptoms and medications. You'll undergo an examination, during which time your periodontist will inspect your gums and teeth for signs of disease. Your periodontist will then discuss your diagnosis and your options for treatment if necessary.

Will I need to follow undergo treatment after my initial visit?

There are many reasons for undergoing periodontal treatment – most commonly for the treatment of gum disease. Both surgical and non-surgical treatments are available, but only your periodontist can tell you which type is right for you.

Types of Periodontal Disease

Periodontal disease is one of the most common diseases in America, affecting nearly 65 million adults over age 30. There are two types of periodontal disease – gingivitis and periodontitis. Each refers to an accumulation of bacteria along the gum line, though one is more severe than the other.

Gingivitis – the least invasive form of periodontal disease; features minimal symptoms, such as reddening, swelling and easy bleeding along the gum line.

Periodontitis – the most serious form of periodontal disease; causes the gums to recede and pull away from the teeth.
Teeth Brushing - Periodontics in Gaithersburg and Washington DC

DID YOU KNOW...

that in addition to being one of the most prevalent diseases in America, periodontal disease is also one of the most preventable? Proper brushing and flossing techniques can help prevent the accumulation of tartar, which harbor harmful bacteria along the gum line. According to the American Academy of Periodontology, certain lifestyle habits and systemic conditions like smoking and diabetes can also contribute to the development of periodontal disease. Talk to your periodontist or dentist about the changes you can make to reduce your chances of developing gingivitis or periodontitis.

FREQUENTLY ASKED QUESTIONS

Should I seek treatment for periodontal disease?

If you are experiencing any of the signs or symptoms of periodontal disease, seek treatment as soon as possible. Found in its earliest stages, periodontal disease is more easily treated. Left untreated, periodontal disease is likely to progress, requiring more invasive treatments and potentially causing total tooth loss.

What should I expect during periodontal disease treatment?

        Your treatment experience will vary according to the stage of your disease. If gingivitis is the problem, you'll need a thorough professional cleaning and perhaps a topical antibiotic. On the other hand, a diagnosis of periodontitis may require surgery, as well as bone or tissue grafting. Talk with your periodontist about the treatment options best for you.      

Will I need to follow any special instructions following periodontal disease treatment?

        Yes. Your post-treatment care guidelines will vary according to the type of treatment you have and may include an at-home antibiotic and special instructions for keeping the treatment site clean in the days following your procedure. You will be advised to maintain your treatment results by attending periodic dental cleanings and exams in the future – perhaps more frequently than the standard twice-yearly recommendation. You'll also be encouraged to begin flossing and using a mouth rinse daily once you have recovered from your periodontal treatment.     

Signs & Symptoms of Periodontal Disease

Periodontal disease – also known as gingivitis and periodontitis – is most easily identified by the visible symptoms it causes as it progresses. In its beginning stages, periodontal disease often causes no symptoms at all, making it difficult for the average person to notice. With time, bacteria begin causing inflammation in the gums, which may result in reddening or gums that are tender, swollen and easily bleed. As bacteria continue to proliferate, the teeth may begin to appear longer due to a receding gum line. Eventually, pockets may begin to form between the gums and teeth, which can lead to loosened teeth or total tooth loss. Other symptoms of periodontal disease may include chronic bad breath and mouth sores.

DID YOU KNOW?

Periodontal disease is a serious oral health problem that affects nearly half of American adults. It is easily treated in its earliest stages, although many people do not know they have it until symptoms appear – often not until it has progressed to moderate or severe stages that require more complex treatments. The most effective way of finding and preventing periodontal disease is by adopting good oral hygiene and attending periodic dental cleanings and exams.

FREQUENTLY ASKED QUESTIONS

How do I know if I have periodontal disease?

Only a dentist can diagnose periodontal disease. If you are suffering with any of the symptoms listed above, schedule a dental exam immediately to find out if you need Gaithersburg and Washington, DC periodontal treatment. If you are symptom-free, you still need to visit your dentist twice yearly for an exam.

What will happen if I am diagnosed with periodontal disease?

You may be referred to a Gaithersburg and Washington, DC periodontist who can evaluate the severity of your condition and formulate a treatment plan that is best for you. Treatments vary according to the type of periodontal disease you have and how far it has progressed, although the goal of any Gaithersburg and Washington, DC periodontist is to provide the most effective and conservative treatment possible.

How can I prevent periodontal disease from returning in the future?

Once you have had periodontal disease, you are more likely to develop the condition again. However, you can help prevent recurrences by brushing and flossing after every meal and snack, avoiding tobacco products, adopting a healthy and nutritious diet, and attending frequent dental exams and cleanings as recommended by your dentist.

Gum Surgery

Periodontists treat their patients with the most conservative measures possible, but sometimes surgery is necessary to facilitate oral health and aesthetics. Some of the reasons your periodontist may recommend gum surgery include:

To restore gum tissues lost to periodontal disease. Also known as guided tissue regeneration, this procedure is often combined with bone grafting to help support the teeth.

To cosmetically improve your gum line. Known as muco-gingival surgery, this procedure grafts soft oral tissues into the gum line to fill in areas that have become recessed. The gum grafts conceal exposed tooth roots to allow for a more aesthetically pleasing appearance.

To prepare your teeth for dental restorations. The purpose of this type of gum surgery is to reveal more of the tooth's root, effectively lengthening the crown of the tooth. Crown lengthening is reserved for patients who have decay below the gum line or have inadequate tooth structure to support a dental restoration.

DID YOU KNOW…

that your jaw bone and gums should naturally hug the roots of each tooth, encircling the base of the crown to hold it in place? But when gum disease is allowed to progress, the gums can recede and begin to create ‘pockets' around the teeth that will only become deeper with time. As bacteria proliferate in these pockets, patients experience further bone and tissue loss. Gum surgery is often the most conservative solution for patients with advanced gum disease – otherwise leaving the option of eventually having the teeth extracted.

FREQUENTLY ASKED QUESTIONS

Am I a candidate for gum surgery?

        Gum surgery may be right for you if you need crown lengthening for a restoration, you want to cosmetically enhance your gum line, or you have 3mm or greater pockets around your teeth due to periodontal disease. To find out more about gum surgery and your options for treatment, schedule an appointment with a periodontist.     

What should I expect during gum surgery?

        Gum surgery is an in-office procedure performed under local anesthesia. Most patients feel no discomfort during the procedure, and report little if any sensitivity afterward.      

Will I need to follow any special instructions following my gum surgery?

        Although the surgery itself should not be uncomfortable, you may experience sore and swollen gums in the days immediately following the procedure. Use a cold pack to reduce swelling in the hours after the treatment, and consume only a soft diet for the first few days after the procedure. Pain medication as well as antibiotics may be prescribed to ensure your recovery is free of complication. Be sure to keep the surgical site clean, and schedule a time to return to your periodontist's office if you have sutures that need to be removed.     

Crown Lengthening

Crown lengthening is a very common procedure used for functional and cosmetic purposes. In restorative dentistry, crown lengthening is used to prepare the teeth for dental restorations, such as caps and crowns, which require a sufficient amount of tooth structure above the gum line in order to support new restorations. Other patients may elect to undergo crown lengthening in an attempt to cosmetically treat a ‘gummy' smile. Careful contouring can remove excess gum tissues surrounding the teeth, revealing a more aesthetically appealing smile. This procedure can often be performed with minimal intrusion at only one office visit (along with non-surgical follow up appointments to ensure proper healing and successful results).

DID YOU KNOW…

that crown lengthening is not only functionally and aesthetically efficient, but also beneficial to patient health? Gums that extend too far over a natural tooth can be more difficult to clean and keep free of pockets that harbor harmful bacteria. A lengthened crown is more hygienic and easier to clean, reducing the chances of gum disease later on. Untreated gum disease can advance, causing inflammation, bleeding, and even tooth loss. 

FREQUENTLY ASKED QUESTIONS

Am I a candidate for crown lengthening treatment?

        You may be a candidate for crown lengthening if: (1) your general dentist says your tooth structure is inadequate to support a necessary restoration; or (2) if your teeth appear short and you want to expose more of your natural teeth. Schedule a periodontal consultation to find out more about your eligibility for crown lengthening.     

What should I expect during periodontal crown lengthening procedure?

        Crown lengthening is performed in a periodontist's office under local anesthetic. During the procedure, the surgeon gently removes gum tissues and bone to expose the underlying tooth. The surgical site will be rinsed, cleansed, and sutured shut. Procedure length depends on the number of crowns being lengthened. If you are undergoing crown lengthening to prepare for a restoration, your permanent crown will not be placed for a number of  months following the procedure.     

Will I need to follow any special instructions following a crown lengthening treatment?

        Yes. You may experience some swelling and soreness in the initial days following a crown lengthening procedure. Use ice and pain relievers to minimize discomfort, and be sure to take any prescriptions as directed. Be prepared to consume a diet of soft foods in the days following your procedure based upon your own personal comfort level.     

Periodontal Scaling & Root Planing

Periodontal scaling and root planing is a procedure used to treat periodontal disease. Thought of by many as a ‘deep cleaning', this in-office procedure involves the careful removal of hardened plaque near the gum line, where harmful bacteria can grow and cause damage to both the hard and soft tissues of the mouth. The treatment starts with scaling, during which special instruments are used to scrape tartar away from the teeth and gums. Root planing follows, which is a process of smoothing the surface of the tooth's root in order to prevent bacteria from accumulating there in the future. Finally, an antibiotic may be administered to ensure that no bacteria remain at the treatment site.

DID YOU KNOW…

That you cannot brush or rinse away hardened plaque that causes periodontal disease? The only thing you can do is prevent is from accumulating by using good brushing and flossing habits. Once tartar has formed, the only way to remove it is via a professional dental or periodontal cleaning.

FREQUENTLY ASKED QUESTIONS

Do I need a periodontal scaling and root planing?

        You may need scaling and root planing if you are suffering with mild to moderate periodontal disease. Visit a periodontist for an exam if you are experiencing any of the symptoms of periodontal disease, such as inflamed or receding gums, chronic bad breath or loose teeth. If your periodontal disease is advanced, you may require additional treatment.     

What should I expect during scaling and root planing?

        If you require a scaling and root planing, you'll first be made comfortable – perhaps using a local anesthetic. You should feel little or no discomfort. Procedure lengths vary according to the extent of the disease and the areas it is located within the mouth. If your periodontal disease is widespread, you may need multiple visits.     

Will I need to follow any special post-treatment care instructions?

        Yes. You'll need to follow all instructions for antibiotic usage (if prescribed) following your treatment. You'll also be advised to avoid certain habits that can cause recurrences of periodontal disease in the future, such as smoking. Most patients experience little or no discomfort after scaling and root planing.