PATIENTS & FAMILY

Periodontal disease (also known as periodontal infection, gum disease or pyorrhea) is an ongoing infection in the gums around your teeth. The cause of periodontal disease is infectious bacteria that gets deep into your gums and causes tissue inflammation.

This infection starts destroying the bone that supports your teeth. If left untreated, it can lead to tooth loss. Read more about Periodontal Disease.

First and foremost, if you are a smoker, quit! Studies have shown that smoking increases your risk for gum disease and tooth loss in a number of ways. Uncontrolled diabetes will also put you at significant risk for gum disease and tooth loss. Coming in for regular maintenance and taking good care of your teeth at home will aid prevention.

Gingivitis is inflammation of the gums. Your gums may be swollen, reddened, and bleed when brushed or flossed. The difference between gingivitis and periodontal disease is that no bone has been lost around the teeth yet.

Periodontal disease is controlled, not cured. Regular maintenance can ensure disease control by eliminating bacteria on a more frequent basis.

The primary job of a periodontist is to monitor the health of your gums and assess your homecare to evaluate control of gum disease. Your general dentist is essentially a specialist in detecting cavities and restoring diseased teeth. He or she will pay special attention to your restorative needs.

Yes, patients with advanced periodontal disease have been shown to have a higher risk of developing heart disease, stroke and diabetes. Research shows that treating your periodontal disease may improve diabetic glucose control.

No, periodontal disease is typically a “silent” disease in that pain is not noticed until the disease becomes advanced. Therefore, it’s crucial that radiographs and periodontal probing are completed regularly to identify the disease as early as possible. Bleeding gums, shifting teeth and bad breath are all signs.

Dental implants are the greatest innovation in the history of dentistry. A dental implant is a titanium root replacement that is placed into the bone. During the healing phase, the bone tightly “bonds” to the implant, securing it in place. Following the healing phase, your restorative dentist can place a tooth on top of the dental implant that now acts as a titanium root. In some select instances, the implant can be placed at the time of the extraction to shorten the treatment time.

A bridge is essentially two teeth that are holding an artificial tooth between them. These two teeth have crowns (caps) on them to hold the artificial tooth in place. If you get a cavity on one of them, you need to replace the whole bridge. Further, all bridgework will eventually need to be replaced. A dental implant does not require placing crowns on teeth that do not need them. If the crown on the implant needs to be replaced for some reason, you are simply replacing one, not three, as you would with a bridge.

There are several other benefits that are case specific. Ask your dentist for more information.

Yes. People with dentures experience the gradual shrinkage of the bone underneath the denture over time. Implants can serve two purposes in this situation: (1) they can secure the denture, allowing for a snug fit, or (2) they can prevent additional bone shrinkage or loss. In a sense, your teeth told the bone that it was supposed to be there. When the teeth were lost, the bone lost its purpose too. Implants can “remind” your bone that it’s supposed to be there. If you have a poorly fitting denture, you can often use an implant to recoup the function you had with your original teeth.

“Mini” dental implants are typically 1.5 to 2.5mm wide while a standard implant is about 4mm wide. Mini implants were originally designed as temporary implants to support a dental prosthesis while standard implants healed. Once the wider implants had healed, the mini implants would be removed. Recently, many dental companies have promoted the use of mini implants as a substitute for standard, wider implants. They claim that mini implants are highly successful, less invasive and more economical than traditional implants.

While there are decades of research that show that traditionally sized implants are highly successful, there is minimal research supporting the use of mini implants. As mini implants have much less surface area for bone to attach than standard implants, failure rates for mini implants are higher than traditional implants, especially in the upper jaw where bone quality is poor. Additionally, the risk of implant fracture may be increased due to reduced implant width. And, restorative parts are limited for mini implants, which may limit options when placing a tooth on a mini implant.

Dr. Gordon Christensen, a practicing prosthodontist and co-founder of Clinical Research Associates, stated: “Patients should be advised that these implants are being used throughout the world, but they have not been subjected to long-term research such as that done on standard-sized implants.”

Crown lengthening is simply making a tooth longer, so the crown will fit properly and the gums remain healthy. This may be done to enhance your smile, or to allow a dentist to restore a tooth that has broken off or has a very deep cavity.

Alternating your hygiene visits between your general dentist and AZPerio is a critical part of the investment you made in your oral health.  If there is a discrepancy, and our fees are higher (in some cases, the general dentist’s fees are higher than AZPerio’s) than that of your general dentist, it is because our hygiene team has specialized training, technology and instruments that facilitate precision cleaning in the areas that AZPerio’s board-certified specialists performed your procedure. Additionally, the hygienist is supervised by a periodontist to ensure optimal results. AZPerio will not charge any additional fees for services related to the periodontal maintenance therapy.

Can a General Dentist Perform an Implant Procedure?

The law allows general dentists to perform implants, but many choose to refer patients to a more experienced specialist, such as a board-certified Periodontist or Oral Surgeon. You should speak with your general dentist before scheduling the surgery to gather information on their level of training and how often they perform the surgery. Finding an experienced specialist, with appropriate credentials and training, provides you with the best chance for long-term successful implant placement.

It is important with any surgery to do your research and ask your dentist any questions or clarifications you need prior to scheduling the appointment for surgery. Ask your dentist to explain fully the dental implant process step by step so you can be sure you fully understand what to expect. This thorough vetting prevents any surprises or unexpected problems from emerging after your dental implant surgery.

What is the Importance of Specialization?

A periodontist has undergone three years of additional training beyond dental school to become an expert in the treatment of gum disease and the cutting-edge tooth replacement options. Visiting this type of specialist for your tooth replacement will ensure that the dental implants are placed with precision, superior expertise and reduced failure rates.

A general dentist spends their days performing a variety of general dentistry treatments, while occasionally providing dental implant services; a board-certified periodontist is a true specialist in this type of procedure. A board-certified periodontist is well-versed in the technical aspects of placement, which makes a significant difference, especially in more complex cases of tooth replacement. Additionally, surgical techniques and technology are likely to be more advanced in specialists’ offices, including techniques and advancements that allow for earlier, or immediate, placement of teeth on implants. A specialist’s fees are typically higher than a non-specialist/General Dentist because of their advanced training, evidence-based technology and superior outcomes.

When you’re considering dental implants, it’s critical, as with any surgical procedure, to make an informed healthcare decision.

What is the Importance of Board-Certification?

Board-certified periodontists are conveyed the title of Diplomates of the American Academy of Periodontology (AAP). They have been approved for Diplomate status by a panel of internationally respected peers for demonstrating a passion for continued professional development, self-evaluation, critical review of therapy results, and providing the best, most up-to-date care. AAP board-certification requires:

• 3+ years of periodontal training following completion of dental school at an American Dental Association/Commission on Dental Accreditation (CODA) accredited program;
• Additional education, training and evaluation from the American Board of Periodontology, an affiliate of the American Academy of Periodontology.

As a courtesy to our patients, we provided a list of questions below to ask the doctor you’re considering for placement of dental implants.

Credentials Questions

1. Are you a general dentist or a specialist?
2. If a general dentist, which specialists do you recommend who perform this procedure?
3. If a specialist, are you board-certified in your specialty (e.g. Diplomate of American Academy of Periodontology)?

Training Questions

1. Was your implant-specific training performed in a residency program at an accredited academic institution?
2. Where did you complete your training in implants?
3. How many implants did you place in training?
4. What was the length of your implant training?
5. How many implants do you place weekly/monthly/annually? Specialists typically perform 10+ per week, 40+ per month, 500+ per year.

Procedure-Specific Questions

1. What type/brand of implants do you use?
2. What is your rationale for using this brand?
3. What are the risks associated with the procedure?
4. Do you perform sinus lifts? If yes, how many? If no, what happens in the event I need a sinus lift?
5. What is the proposed treatment plan? What alternative treatment options are available, and what are the pros and cons of each?
6. Do you have case studies to prior procedures you can share with me?
7. What type of warranty/guarantee do you provide for this procedure?

General Questions

1. If you were having an implant placed, which specialist would perform your surgery? Why?
2. What are the risks associated with the procedure?
3. What percentage of your implants are placed and loaded on the same day?
4. What is the typical complete time of the treatment, from placement to final restoration?
5. Do you use cone beam computed tomography (CBCT) to locate the floor of the sinus, nerves, width of bone, etc. for precision implant placement?
6. What options do you offer for sedation?
7. If I am losing my tooth due to gum disease (periodontal disease), can this also happen to my implant?
8. What type of special home care and special instructions are required for my implant(s)?
9. What technology do you have available to retain as much bone as possible when removing a tooth for implant placement? I understand there is technology that minimizes trauma upon extraction and maximizes surrounding bone retention.
10. What else should I know about my tooth replacement options?

When you’re considering dental implants, it’s critical, as with any surgical procedure, to make an informed healthcare decision.