Hygiene and Periodontics

Hygiene Services

Twice-daily brushings and regular flossing are excellent for maintenance between office visits, but a healthy mouth and beautiful smile require routine general and preventative care to stay that way. Our practice offers general care that includes regular oral examinations and cleanings. Our preventative hygiene services include fluoride, oral hygiene instruction, and periodontal (gum disease) treatments designed to help you maintain your smile’s health and beauty. Keep your teeth and gums strong and disease-free. Contact our office today to schedule a cleaning or consultation.


Non-Surgical Gum Therapy

It is possible that in spite of your best efforts you may require more aggressive gum therapy. Like many other ailments gum disease can be quite painless due to its slow progression.
After a thorough periodontal screening and examination we may choose more aggressive therapies aimed at eliminating or reducing the amounts of bacterial acids and plaque accumulating below the gum line, (generally cleaning and polishing of teeth is above the gum-line). This involves curettage and root-planing and/or treatment with site specific administration of medications to the affected gums. Curettage is the debridement of the soft tissue lining around the tooth. In disease this tissue is chronically irritated by bacteria deep below the visible gum-line and needs to be removed so that proper healing can occur. Root-Planing is the removal and smoothing of micro-amounts of root surface so that a clean and uninfected surface is presented to the healing lining of soft tissue. These two procedures are generally done simultaneously, may require local anesthesia and are skillfully done by our well trained hygienists under Dr. Kirshen's prescription.
Generally your condition is re-assessed in time and a decision is made about your next step should surgical intervention be required. Often surgery allows for complete healing of the gum and bone, reduced mobility of teeth and a greatly improved prognosis.
Dr. Kirshen's hygiene team will work with you to assure that you have access to the care that best suits your needs. They will also help you hone your home-care skills so that you can maintain the optimum level of health that you want.

Flap Surgery

Your bone and gum tissue should fit snugly around your teeth like a turtleneck. When you have periodontal disease, this supporting tissue and bone is destroyed, forming "pockets" around the teeth. Over time, these pockets become deeper, providing a larger space for bacteria to thrive and wreak havoc. As bacteria accumulate and advance under the gum tissue in these deep pockets, additional bone and tissue loss follow. Eventually, if too much bone is lost, the teeth will need to be extracted. Flap surgery is sometimes performed to remove tartar deposits in deep pockets or to reduce the periodontal pocket and make it easier for you or your dental professional to keep the area clean. This common surgery involves lifting back the gums and removing the tartar. The gums are then sutured back in place so that the tissue fits snugly around the tooth again. A pocket reduction procedure is recommended if daily at-home oral hygiene and a professional care routine cannot effectively reach these deep pockets. In some cases, irregular surfaces of the damaged bone are smoothed to limit areas where disease-causing bacteria can hide. This allows the gum tissue to better reattach to healthy bone. The teeth will appear longer as we are forcing recession to reduce the pocket depth. This may also cause tooth sensitivity as more root structure is exposed to the oral environment. Time will usually be the ultimate desensitized but if it persists then Dr.Kirshen can recommend various options to minimize the sensitivity beginning with special toothpastes such as Prevident Boost by Colgate, to treating the roots with desensitizing agents in office. Only in extreme cases may there be a need for root canal therapy or fully covering all the root surfaces using a crown procedure.