Periodontal Associates
1517 Mall Dr.
Iowa City, IA 52240
E-mail us
Dr. Borgwardt: (319) 337-3588
Dr. Romanowski: (319) 337-5752
Fax: (319) 351-8348
Monday - Friday: 8 AM - 5 PM

Treatment of Gum Disease

Treatment of Gum Disease

If your dentist has concerns that you may have a form of periodontal disease he or she may refer you to a periodontist for an evaluation.  (Click here to learn more about periodontal disease) During your periodontal exam, the spaces between the teeth and the gums will be measured, any looseness of the teeth will be assessed, and your x-rays will be evaluated to determine the strength of the bone supporting the teeth.

Treatment of periodontal disease varies depending on the level of periodontal disease and is aimed at the least invasive and most cost-effective option.   Most often, periodontal disease is treated non-surgically through Scaling and Root Planing, commonly referred to as a “Deep Cleaning.”  During the deep cleaning, plaque and calculus (tartar) are removed from the root surfaces of the teeth below the gumline, beyond where you are able to clean with a toothbrush, and deeper than what is possible with a regular dental cleaning.  Occasionally, antibiotics may also be used depending on the individual situation.

Pocket Reduction Surgery

All teeth have spaces between the gums and the teeth.  In healthy situations, these spaces are tight and shallow.  With periodontal disease, inflammation in the gum tissue causes the tissue to move away from the tooth and creates deeper spaces or “pockets.”  As the pockets become deeper, your toothbrush can no longer reach the area for cleaning, and it creates a space that bacteria can hide and accumulate.  This can lead to bone loss around the teeth, and if untreated, to tooth loss.  

To prevent further bone or tooth loss your periodontist may recommend a pocket reduction procedure.  During this procedure, the periodontist gently folds the gums back from the teeth, and removes the disease-causing bacteria.  In some cases, irregular bone may be smoothed to prevent areas where bacteria can hide.  The gums are replaced and the pockets are removed creating a healthier situation, and one in which you and your hygienist are better able to clean and maintain health.     

Bone Regeneration Procedures

Inflammation from untreated periodontal disease can lead to loss of the supporting bone of the teeth.  Bone loss can lead to looseness of the teeth, and in advanced cases, to tooth loss.  In some cases, procedures can be performed to regenerate the lost bone and tissue.  

During this procedure, your periodontist gently folds the gums back from the teeth, and removes the disease-causing bacteria.  Bone graft material, dissolvable membranes (filters), and/or tissue-stimulating growth factors (proteins) may be placed to aid your body’s natural ability to regenerate bone and tissue.  This procedure can restore the bone to healthy levels and increase support for the teeth.

Bone Regeneration performed by Dr. Derek Borgwardt, DDS, MS Periodontal Associates Iowa City, IA

Gum Tissue Grafting

Gum tissue recession is a very common condition in which the gum tissue wears away or moves away from the neck of the tooth exposing a portion of the root of the tooth.  Recession can be caused by a number of contributing factors including periodontal disease, aggressive tooth brushing, and a genetic predisposition to thin tissue and recession.  Not all gum tissue recession is problematic, however, in many cases it can lead to a higher risk for cavities, tooth sensitivity, and in severe cases, tooth loss.  

Gum tissue grafting can be performed to cover exposed root surfaces, and to increase the thickness of gum tissue to prevent further recession and tooth loss.  Grafting is also often performed before, during, or after orthodontics (braces) for patients with thin gum tissue, as movement of the teeth can lead to recession.  The specific type of grafting varies depending on the individual situation, and may involve rotating tissue from an adjacent tooth, taking a small piece of tissue from the roof of the mouth, or using a donor tissue to cover the exposed root.  In addition, grafting is often performed for esthetic reasons to cover root surfaces, and prevent the appearance of “long” teeth leading to a healthier and younger looking smile.
Grafting & Implant Surgery by Dr. Derek Borgwardt, DDS, MS; Periodontal Associates Iowa City, IA Implant Restoration performed by Dr. Chris Barwacz DDS, FAGD; University of Iowa Grafting & Implant Surgery by Dr. Derek Borgwardt, DDS, MS;


Cosmetic Procedures

Crown Lengthening Surgery

Crown lengthening is a minor procedure in which gum tissue, and in some cases a small amount of bone, is removed from around the tooth to actually “lengthen” the amount of tooth that is visible above the gum tissue.  

Often times, if a tooth has cracked or has a deep cavity or filling, crown lengthening may be necessary to expose more tooth surface prior to your dentist placing a crown (cap) or bridge   In addition, crown lengthening can be performed for cosmetic reasons to treat patients who may have a “gummy” smile and desire a more natural appearance.  

Gum Tissue Grafting

Gum tissue recession is a very common condition in which the gum tissue wears away or moves away from the neck of the tooth exposing a portion of the root of the tooth.  Recession can be caused by a number of contributing factors including periodontal disease, aggressive tooth brushing, and a genetic predisposition to thin tissue and recession.  Not all gum tissue recession is problematic, however, in many cases it can lead to a higher risk for cavities, tooth sensitivity, and in severe cases, tooth loss.  

Gum tissue grafting can be performed to cover exposed root surfaces, and to increase the thickness of gum tissue to prevent further recession and tooth loss.  Grafting is also often performed before, during, or after orthodontics (braces) for patients with thin gum tissue, as movement of the teeth can lead to recession.  The specific type of grafting varies depending on the individual situation, and may involve rotating tissue from an adjacent tooth, taking a small piece of tissue from the roof of the mouth, or using a donor tissue to cover the exposed root.  In addition, grafting is often performed for esthetic reasons to cover root surfaces, and prevent the appearance of “long” teeth leading to a healthier and younger looking smile.
Grafting & Implant Surgery by Dr. Derek Borgwardt, DDS, MS; Periodontal Associates Iowa City, IA Implant Restoration performed by Dr. Chris Barwacz DDS, FAGD; University of Iowa Grafting & Implant Surgery by Dr. Derek Borgwardt, DDS, MS;

Laser Assisted Gum Contouring

Many patients exhibit irregular or uneven contours of the gums around the teeth.  In the majority of cases this is completely healthy, however, if you are unhappy with the shape of teeth and gums, the tissue can often be sculpted to improve esthetics.  The procedure is very minor, and is often performed using a small, hand-held laser leading to minimal discomfort and increased healing times. 

Treatment of Gum Indentations

Often times after a tooth is extracted, the bone and gum tissue will collapse slightly in the area of the missing tooth causing an indentation.  In some cases, this can lead to an unnatural appearance and “long” replacement tooth.  Ridge Augmentation, consisting of bone or tissue grafting, can be performed to create a more natural appearance and a tooth that is easier to clean.  


Dental Implants

Dental Implants

Dental Implants are an artificial tooth root that is placed in the jaw to serve as a foundation for a replacement tooth that looks, functions, and feels like a natural tooth.  Modern implants have a very high success rate and preserve the integrity of the surrounding teeth, bone, and gum tissue.  Implants can be used to replace a single missing tooth, multiple teeth, to replace all teeth, or used to stabilize a loose denture.  In many cases, an implant-supported restoration is unmatched in regards to chewing function and esthetic appeal.


Other Surgeries

Crown Lengthening Surgery

Crown lengthening is a minor procedure in which gum tissue, and in some cases a small amount of bone, is removed from around the tooth to actually “lengthen” the amount of tooth that is visible above the gum tissue.  

Often times, if a tooth has cracked or has a deep cavity or filling, crown lengthening may be necessary to expose more tooth surface prior to your dentist placing a crown (cap) or bridge   In addition, crown lengthening can be performed for cosmetic reasons to treat patients who may have a “gummy” smile and desire a more natural appearance.  

Exposure of Impacted Canines

Occasionally teeth do not erupt as they typically should and become impacted or “stuck” below the gums.   This can occur with any tooth in the mouth, but is relatively common with upper canine or “eye” teeth.  

When teeth are impacted, your orthodontist will refer you for a minor surgical procedure in which the gum tissue is lifted to expose the buried tooth.  During the procedure a bracket or gold chain is bonded to the tooth that will allow your orthodontist to pull the tooth into it’s correct position.  In some cases, the gum tissue is replaced over the tooth with only the chain protruding through the tissue, and in other cases a small “window” of gum tissue may be removed to allow access to the tooth.  


Sedation

Sedation

Sedation involves delivery of medication through an IV to help you "sleep" through the appointment. While most patients do actually fall asleep for the appointment, you are able to respond to verbal commands, you continue to breathe on your own, and your protective reflexes remain intact. In addition to helping you sleep, the medication creates amnesia such that most patients have no memory of the procedure.

Sedation is available for all surgical procedures. Talk with the doctors at Periodontal Associates if you have anxiety or may be interested in sedation, and they will be happy to speak with you about specific instructions prior to sedation which include not being able to eat or drink for 6 hours prior to sedation, and bringing a driver with you to your appointment.

For many people with slight anxiety, nitrous oxide (laughing gas) or oral (pill) medications may be sufficient, and are also available.