What is a Comprehensive Periodontal Evaluation?
A Comprehensive Periodontal Evaluation, or CPE, is a way to assess your periodontal health by examining:
Your bone structure
Your risk factors
When your dental professional, such as a periodontist or dental hygienist, performs this evaluation, they will look at these six areas to determine the state of your periodontal health.
Why do I need a Comprehensive Periodontal Evaluation?
Recent research has indicated that the prevalence of periodontal disease in the U.S. may be significantly higher than originally estimated. This means that all adults should thoroughly assess the state of their periodontal health to receive accurate information about the health of their mouths.
By assessing your oral health on an annual basis, you and your dental professional will know how healthy your mouth is, and will be better able to notice any conditions, such as periodontal disease, that may need additional treatment.
Research has also shown, and experts agree, that there is an association between periodontal disease and other chronic inflammatory conditions, such as diabetes, cardiovascular disease, and respiratory diseases. Therefore, it is very important to treat the inflammation that causes periodontal disease as soon as possible to ensure that your entire body stays healthy.
Your Comprehensive Periodontal Evaluation Checklist
To help you learn more about the state of your oral health download the Comprehensive Periodontal Evaluation checklist from our website (CPE), print it out, and bring it to your next dental appointment.
Non Surgical Procedures
Scaling and Root Planing
Scaling and root planing is a careful cleaning of the root surfaces to remove plaque and calculus [tartar] from deep periodontal pockets and to smooth the tooth root to remove bacterial toxins. Scaling and root planing is sometimes followed by adjunctive therapy such as local delivery antimicrobials, systemic antibiotics, and host modulation, as needed on a case-by-case basis.
Most periodontists would agree that after scaling and root planing, many patients do not require any further active treatment. However, the majority of patients will require ongoing maintenance therapy to sustain health.
Periodontal Surgical Procedures
Your bone and gum tissue should fit snugly around your teeth like a turtleneck around your neck. 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 live. As bacteria develop around the teeth, they can accumulate and advance under the gum tissue. These deep pockets collect even more bacteria, resulting in further bone and tissue loss. Eventually, if too much bone is lost, the teeth will need to be extracted.
A periodontal pocket reduction procedure has been recommended because you have pockets that are too deep to clean with daily at-home oral hygiene and a professional care routine.
During this procedure, Dr. Scheines folds back the gum tissue and removes the disease-causing bacteria before securing the tissue into place. 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.
Procedures that regenerate lost bone and tissue supporting your teeth can reverse some of the damage caused by periodontal disease.
Dr. Scheines may recommend a regenerative procedure when the bone supporting your teeth has been destroyed due to periodontal disease. These procedures can reverse some of the damage by regenerating lost bone and tissue.
During this procedure, Dr. Scheines folds back the gum tissue and removes the disease-causing bacteria. Membranes (filters), bone grafts or tissue-stimulating proteins can be used to encourage your body's natural ability to regenerate bone and tissue.
PRF (Platelet Rich Fibrin) is a new Technology. Basically, a bioactive “band-aid” that is created from your own blood and then placed in your surgery sites to promote healing. A sample of your blood is collected in a tube, just as it would be for a blood test. Dr. Scheines then uses a centrifuge to separate and concentrate on certain important cells and active proteins. After a fast preparation the bioactive clot, created just from your own blood, is now ideal for your procedure enhancing the healing process and promoting new tissue regeneration.
Soft Tissue Surgery
Exposed tooth roots are the result of gum recession. Gum graft surgery will repair the defect and help to prevent additional recession and bone loss
Gum grafts can be used to cover roots or develop gum tissue where absent due to excessive gingival recession. During gum graft surgery, Dr. Scheines takes gum tissue from your palate or another donor source to cover the exposed root. This can be done for one tooth or several teeth to even your gum line and reduce sensitivity.
What are the benefits of gum graft surgery?
A gum graft can reduce further recession and bone loss. In some cases, it can cover exposed roots to protect them from decay. This may reduce tooth sensitivity and improve esthetics of your smile. Whether you have a gum graft to improve function or esthetics, patients often receive the benefits of both: a beautiful new smile and improved periodontal health – your keys to smiling, eating and speaking with comfort and confidence.
Restorative related procedures
Aesthetic Crown Lengthening
You may have asked Dr. Scheines about procedures to improve a "gummy" smile because your teeth appear short. Your teeth may actually be the proper lengths, but they're covered with too much gum tissue. To correct this, Dr. Scheines performs an aesthetic crown lengthening procedure.
During the aesthetic crown lengthening procedure, excess gum and bone tissue is reshaped to expose more of the natural tooth. This can be done to one tooth, to even your gum line, or to several teeth to expose a natural, broad smile.
Functional Crown Lengthening
Dr. Scheines may also recommend functional crown lengthening to make a restorative or cosmetic dental procedure possible. Perhaps your tooth is decayed, broken below the gum line, or has insufficient tooth structure for a restoration, such as a crown or bridge. Crown lengthening adjusts the gum and bone level to expose more of the tooth so it can be restored.
A dental implant is an artificial tooth root that is placed into your jaw to hold a replacement tooth or bridge. Dental implants may be an option for people who have lost a tooth or teeth due to periodontal disease, an injury, or some other reason.
Single & Multiple Implants
Replacing a Single Tooth If you are missing a single tooth, one implant and a crown can replace it.
Replacing Several Teeth If you are missing several teeth, implant-supported bridges can replace them.
Replacing All of Your Teeth If you are missing all of your teeth, an implant-supported full bridge or full denture can replace them (All on 4 & Overdentures)
All on 4
All On Four procedure is a technique where four to six or more implants are placed into the jaw and in most cases (95%) fixed teeth can be attached at the time of procedure. It is a one day procedure, patients leave our office on procedure’s day with teeth attached to the implants.
The All-On-Four method in which the implants are placed eliminates the standard healing time and bone grafting that applies to other types of dental implant solutions before immediate teeth are attached.
A key to implant success is the quantity and quality of the bone where the implant is to be placed. The upper back jaw has traditionally been one of the most difficult areas to successfully place dental implants due to insufficient bone quantity and quality and the close proximity to the sinus. Sinus augmentation can help correct this problem by raising the sinus floor and developing bone for the placement of dental implants
Guided Bone Regeneration
Deformities in the upper or lower jaw can leave you with inadequate bone in which to place dental implants. To correct the problem, the gum is lifted away from the ridge to expose the bony defect. The defect is then filled with bone or bone substitute to build up the ridge. Ridge modification has been shown to greatly improve appearance and increase your chances for successful implants that can last for years to come.
Peri-implant diseases are inflammatory conditions affecting the soft and hard gum tissues around dental implants. Similar to a natural tooth, bacteria can build up on the base of the implant, below the gum line. Over time, the bacteria irritate the gum tissue, causing it to become inflamed, damaging the tissue and if not caught early, causing the bone structure below the implant to deteriorate.
Other risks factors for developing peri-implant disease include previous periodontal disease diagnosis, poor plaque control, smoking, and diabetes. It is essential to routinely monitor dental implants as part of a comprehensive periodontal evaluation.
The up side to dental implants is they function just like your natural tooth. The down side is, they are capable of becoming diseased just like a natural tooth. With a proper oral health routine, your dental implant can last a lifetime
Orthodontics related procedures
A frenectomy is simply the removal of a frenum in the mouth. A frenum is a muscular attachment between two tissues. The limited movement of the lip caused by the frenum can lead to mouth breathing or extended tissue can come between the two front teeth and create a gap (diastema).
Gingivectomy is best described as a procedure where excess gum tissue is recontoured during or after orthodontic treatment