Periodontal Treatment

The goal of the specialist periodontal treatment is to retain painless and functional teeth by cleaning thoroughly the pockets surrounding your teeth and implants so as to arrest or slow down the damage of the supporting gum and bone. You will have the best chance for successful periodontal treatment when you also adopt a daily routine of good oral care and stop tobacco use.

Oral Hygiene

Healthy teeth and implants do not only enable you to look and feel good, they make it possible to eat and speak properly. Good oral health is important to your overall well-being.

Daily preventive care, including proper brushing, interdental brushing and flossing, will help stop problems before they develop and is much less painful, expensive, and worrisome than treating conditions that have been allowed to progress.

Preventative Measures

Brushing and cleaning interdentally twice a day.
Eating a balanced diet and limiting snacks between meals.
Using dental products that contain fluoride, including toothpaste.
Rinsing with a fluoride mouth-rinse if advised.
Making sure that your children under 12 drink fluoridated water or take a fluoride supplement if they live in a non-fluoridated area.
Make sure you stick to a regular scale and clean every 3 to 6 months.

Non-Surgical Periodontal & Peri-Implant Conditions

Scaling & Root Planing

Non-Surgical Debridement

Scaling removes calculus (tartar ) and bacteria from your tooth or implant surface and beneath your gums. It may be performed using a combination of manual, machine-driven instruments and Air-flow devices.

In fact, as specialists, we undergo extensive training and achieve clinical expertise in using Air-flow devices (high pressure guided spray with specified choice of powder) and in applying the use of laser devices as adjuncts to periodontal therapy.

Root planing is the process of selective smoothing over the root surfaces, discouraging further buildup of tartar and bacteria. Nowadays it is done selectively and in a very delicate, minimally invasive way with maximum effort to preserve the tooth, root and the gum surface and shape (also known as periodontal debridement).

During the treatment, you will be given detailed and tailored instructions on how to keep up with your oral hygiene between appointments, as this is important to help maintain healthy gums.

Surgical Periodontal & Peri-Implant Conditions

Flap Surgery

Pocket Elimination or Reduction Surgery

All these specialist procedures are performed with the use of magnifying loupes or microscopy and additional surgical lights. Surgical miniaturised dental instruments are also used.

Flap surgery is a process of lifting back your gum to allow cleaning of the roots of your teeth or the implant surface. This is done by making tiny incisions in your gums, reflecting the gum and cleaning the affected areas below the surface of your gums.

In some cases, the underlying bone may be recontoured before the gum tissue is sutured (stitched) back in to place.

Soft Tissue Grafts

Periodontitis and peri-implantitis often causes your gumline to recede, due to damage of the soft tissue. In this case the soft tissue needs to be reinforced. To do so, a small amount of tissue is taken from the roof of the mouth (palate) and attached to the affected areas. This helps to reduce further gum recession, cover up the exposed roots of the teeth and cosmetically enhance the look of your teeth and smile.

As an alternative to donating soft tissue from your own palate, synthetic gum tissues can be used in selected cases and grafted to the area of the recession.

Bone Grafting

If periodontitis or peri-implantitis have developed to a stage where the surrounding bone is largely resorbed, a bone grafting procedure is performed. Bone is added using small fragments of your own bone, a synthetic substance or from a donated source. Once added to the surround of your teeth and implants, this will help prevent loss of teeth by holding your existing teeth in place and also encourage regrowth of natural bone.

Bone grafting procedure is also often indicated before or during implant surgery shall there be insufficient native bone to house the intended implants in their jaws.

Guided Tissue Regeneration

When bone has been destroyed by bacteria, guided tissue regeneration is performed.

The first part of a regeneration treatment involves folding back the gums and removing disease-causing bacteria. Following this, bone grafts, membranes and/or tissue-stimulating proteins are inserted in between the gum and teeth. This encourages gum tissue to regenerate naturally around the teeth. These materials prevent unwanted tissue from entering the healing area, stabilise your natural growth factors and allows bone to grow back instead.

Whenever possible, it is the choice of treatment in periodontal disease management as we have now moved onto an era of rejuvenation/ regeneration of periodontal medicine rather than just halting the disease progression.

The choice of bone grafting materials, types of membranes and options of tissue-stimulating proteins should be individually customised by your periodontist in accordance to your condition.

Antibiotics

Specific topical (local) or systemic (pills) antibiotics have shown to help in controlling the gum disease. This adjunctive therapy that includes the use of specific pills may be necessary to completely eliminate infection-causing bacteria.

Alternatively, the insertion of a gel containing antibiotics in the space between your teeth and gums can be helpful. However, this is case-specific and not everyone can benefit from it in the long-term.

Holistic Periodontal Approach

Gum diseases have been proven to be a contributing factor in diabetes, heart disease, stroke, metabolic syndrome and low birth weight.

As a periodontal specialist that leads a multidisciplinary team, we believe that many dental conditions can be managed by taking a holistic approach to patient care.

This means carrying out an in depth assessment of your overall health conditions that include dental history, medical history, review of medications and supplements, and lifestyle analysis. This holistic assessment allows identification and diagnosis of imbalance in different aspects that may have contributed to diseases. We do not focus only on the symptoms, we care for finding and managing the cause. This guides us in establishing the best approach in our treatment plan to help you achieve optimal health and wellbeing that will sustain rather than camouflaging for the short-term only.

In many cases, the first step in a periodontal specialist treatment plan is a non-surgical and non-invasive approach to treat gum diseases.

This is accomplished through an individualised holistic periodontal therapy that may include:

Ultrasonic devices
Manual instrumentation
Air flow powder therapy
Adjunctive laser therapy
Adjunctive use of herbal antiseptics
Tailor-made home oral hygiene instructions
Integrated care (working together with your primary care provider to assist in diagnosing and correcting imbalances overall health)

Specialist Clinical Expertise

Based on Research & Clinical Experience

Over the years, Professor Quaranta has developed an extensive expertise and leadership in clinical research.

Together with his Clinical Research Team, he has studied and successfully practised most of the periodontal and peri-implant treatments including periodontal holistic approaches with Periodontal Medicine as the underlying concept.

For more information about it please see the Media page.

Any surgical or invasive procedure carries risks. Before proceeding with a surgical or invasive procedure, you should seek opinion from an appropriately qualified health practitioner.