Periodontist - Port Huron
2425 Military Bldg. 3
Port Huron, MI 48060
(810) 985-6600

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Dr. Sweeney’s practice provides a variety of surgical services. He prides himself on the fact that he is very conservative in his treatment recommendations and limits surgery to the areas where it is absolutely necessary. Periodontal procedures are available to regenerate the bone and gum tissue to their original function and cosmetic appearance.

Cosmetic Periodontal Surgery

If you are unhappy with the appearance of short unsightly teeth due to excessive gingiva (gums), this can be greatly improved by a combination of periodontal procedures by Dr. Sweeney and if necessary, cosmetic dentistry by your dentist.

The most common condition is “too much” gum tissue, or a “gummy smile.” Your general dentist or Orthodontist will usually recognize this and refer you to our office. The specific dental term is called “Passive Eruption.” When this occurs, it is usually hereditary. The bone is “too close” to the neck of the tooth, and causes the gums to extend too far down on the tooth. The end result is that the tooth appears too short or too small, which it isn’t; it’s simply covered up by excess gum tissue. Dr. Sweeney can correct this problem with a surgical procedure that addresses the bone problem, and ultimately, exposes more of the natural tooth structure. The cosmetic result is a more pleasing, “toothy smile.”

Gum Grafting Procedures

(Subepithelial connective tissue grafts)

These procedures are a predictable way to cover unsightly, sensitive or exposed root surfaces and to prevent future gum recession. When recession of the gingiva occurs, the body loses a natural defense against both bacterial penetration and trauma. Side effects include thermal sensitivity and a risk for root caries. When gum recession is a problem gum reconstruction using grafting techniques is an option.

When there is only minor recession, some healthy gingiva often remains and protects the tooth, so that no treatment other than modifying home care practices is necessary. However, when recession reaches the mucosa, the first line of defense against bacterial penetration is lost.

Gum Grafting Overview

In addition, gum recession often results in root sensitivity to hot and cold foods as well as an unsightly appearance to the gum and tooth. Also, gum recession, when significant, can predispose to worsening recession and expose the root surface, which is softer than enamel, leading to root caries and root gouging.

A gingival graft is designed to solve these problems. A thin piece of tissue is taken from the roof of the mouth, or gently moved over from adjacent areas, to provide a stable band of attached gingiva around the tooth. The gingival graft may be placed in such a way as to cover the exposed portion of the root.

The gingival graft procedure is highly predictable and results in a stable healthy band of attached tissue around the tooth.

Crown Lengthening

When decay occurs below the gumline, it may be necessary to remove a small amount of bone and gum tissue. Your dentist may ask for this procedure before he or she makes a new crown for your tooth. This will allow your general dentist adequate room to place a quality final restoration. Another indication for crown lengthening is when the front teeth are too short or of uneven length.


Osseous Surgery

Traditionally, gum disease is treated by eliminating the gum pockets. The infected gum tissue is trimmed away, and uneven bone tissue re-contoured. Although this is still an effective way of treating gum disease, new and more sophisticated procedures are used routinely today.

Guided Tissue Bone Regeneration

This surgical procedure "regenerates" the previously lost gum and bone tissue. Most techniques utilize membranes, which are inserted over the bone defects. Some of these membranes are bio-absorbable and some require removal. Other regenerative procedures involve the use of bioactive gels.

Non-Surgical Services

We can use modern techniques to help stabilize periodontal disease. The emphasis in Dr. Sweeney’s practice is conservative periodontal therapy. Many times, the early stages of periodontal disease are best treated with non-surgical periodontal therapy. Even in most severe cases of periodontal disease, non-surgical periodontal therapy most often precedes surgical therapy. This is done so that the overall tissue quality is improved prior to surgery and also limits the areas of required surgery.

Scaling and Root Planing

Many times, the early stages of periodontal disease are best treated with non-surgical periodontal therapy. Even in severe cases of periodontal disease, non-surgical periodontal therapy often precedes surgical therapy. This is done to improve the overall tissue quality prior to surgery and also to help limit the areas requiring surgery.

Scaling and Root Planing Overview

Treatment methods depend upon the type of disease and how far the condition has progressed. The first step is usually a thorough cleaning that may include scaling to remove plaque and tartar deposits below the gumline.

Subgingival Scaling:
Cleaning the tooth below the gumline.

The tooth roots may also be planed to smooth the root surface allowing the gum tissue to heal and reattach to the tooth. In some cases, the occlusion (bite) may require adjustment.

Root Planing:
Smoothing the tooth root

Antibiotics or irrigation with anti-microbials (chemical agents or mouth rinses) may be recommended to help control the growth of bacteria that create toxins and cause periodontitis. In some cases, your doctor may place an antibiotic in the periodontal pockets after scaling and planing. This may be done to control infection and to encourage normal healing.

When deep pockets between teeth and gums are present, it is difficult for your doctor to thoroughly remove plaque and tartar. Patients can seldom, if ever, keep these pockets clean and free of plaque. Consequently, surgery may be needed to restore periodontal health.

Oral Pathology

The inside of the mouth is normally lined with a special type of skin (mucosa) that is smooth and coral pink in color. Any alteration in this appearance could be a warning sign for a pathological process. The most serious of these is oral cancer. The following can be signs at the beginning of a pathologic process or cancerous growth:

  • Reddish patches (erythroplasia) or whitish patches (leukoplakia) in the mouth
  • A sore that fails to heal and bleeds easily
  • A lump or thickening on the skin lining the inside of the mouth
  • Chronic sore throat or hoarseness
  • Difficulty in chewing or swallowing

These changes can be detected on the lips, cheeks, palate, and gum tissue around the teeth, tongue, face, and/or neck. Pain does not always occur with pathology and, curiously, is not often associated with oral cancer. However, any patient with facial and/or oral pain without an obvious cause or reason may also be at risk for oral cancer. We would recommend performing an oral cancer self-examination monthly and remember that your mouth is one of your body's most important warning systems. Do not ignore suspicious lumps or sores. Please contact us so we may help.

Oral Hygiene

While brushing the outside surfaces of your teeth, position the brush at a 45-degree angle where your gums and teeth meet. Gently move the brush in a circular motion several times using small, gentle strokes. Use light pressure while putting the bristles between the teeth, but not so much pressure that you feel any discomfort.

When you are done cleaning the outside surfaces of all your teeth, follow the same directions while cleaning the inside of the back teeth.

To clean the inside surfaces of the upper and lower front teeth, hold the brush vertically. Make several gentle back-and-forth strokes over each tooth. Don't forget to gently brush the surrounding gum tissue.

Next you will clean the biting surfaces of your teeth. To do this use short, gentle strokes. Change the position of the brush as often as necessary to reach and clean all surfaces. Try to watch yourself in the mirror to make sure you clean each surface. After you are done, rinse vigorously to remove any plaque you might have loosened while brushing.

If you have any pain while brushing or have any questions about how to brush properly, please be sure to call the office.

How to Floss:

Periodontal disease usually appears between the teeth where your toothbrush cannnot reach. Flossing is a very effective way to remove plaque from those surfaces. However, it is important to develop the proper technique. The following instructions will help you, but remember it takes time and practice.

Start with a piece of floss (waxed is easier) about 18" long. Lightly wrap most of the floss around the middle finger of one hand. Wrap the rest of the floss around the middle finger of the other hand.

To clean the upper teeth, hold the floss tightly between the thumb and forefinger of each hand. Gently insert the floss tightly between the teeth using a back-and-forth motion. Do not force the floss or try to snap it in to place. Bring the floss to the gumline then curve it into a C-shape against one tooth. Slide it into the space between the gum and the tooth until you feel light resistance. Move the floss up and down on the side of one tooth. Remember there are two tooth surfaces that need to be cleaned in each space. Continue to floss each side of all the upper teeth. Be careful not to cut the gum tissue between the teeth. As the floss becomes soiled, turn from one finger to the other to get a fresh section.

To clean between the bottom teeth, guide the floss using the forefinger of both hands. Do not forget the back side of the last tooth on both sides, upper and lower.

When you are done, rinse vigorously with water to remove plaque and food particles. Do not be alarmed if during the first week of flossing your gums bleed or are a little sore. If your gums hurt while flossing you could be doing it too hard or pinching the gum. As you floss daily and remove the plaque your gums will heal and the bleeding should stop.

Caring for Sensitive Teeth

Sometimes after dental treatment, teeth are sensitive to hot and cold. This should not last long, but only if the mouth is kept clean. If the mouth is not kept clean the sensitivity will remain and could become more severe. If your teeth are especially sensitive consult with your doctor. They may recommend a medicated toothpaste or mouth rinse made especially for sensitive teeth.

Choosing Oral Hygiene Products

There are so many products on the market it can become confusing and choosing between all the products can be difficult. Here are some suggestions for choosing dental care products that will work for most patients.

Automatic and "high-tech" electronic toothbrushes are safe and effective for the majority of the patients. Oral irrigators (water spraying devices) will rinse your mouth thoroughly, but will not remove plaque. You need to brush and floss in conjunction with the irrigator. We see excellent results with electric toothbrushes called Rotadent and Interplak.

Some toothbrushes have a rubber tip on the handle, this is used to massage the gums after brushing. There are also tiny brushes (interproximal toothbrushes) that clean between your teeth. If these are used improperly you could injure the gums, so discuss proper use with your doctor.

Fluoride toothpastes and mouth rinses if used in conjunction with brushing and flossing can reduce tooth decay as much as 40%. Remember, these rinses are not recommended for children under six years of age. Tartar control toothpastes will reduce tartar above the gum line, but gum disease starts below the gumline so these products have not been proven to reduce the early stage of gum disease.

Anti-plaque rinses, approved by the American Dental Association, contain agents that may help bring early gum disease under control. Use these in conjunction with brushing and flossing.

Your periodontist is the best person to help you select the right products that are best for you.

Professional Cleaning

Daily brushing and flossing will keep dental calculus to a minimum, but a professional cleaning will remove calculus in places your toothbrush and floss have missed. Visit your periodontist, as he or she is an important part of your program to prevent gum disease. Keep your teeth for your lifetime.