Periodontal Services

Non-surgical techniques are the first line of intervention for gum problems. Gum disease that has advanced beyond healing with treatments such as deep cleaning, antibiotics, or medications applied to the root line (below the gum line) require periodontal surgery.

Kimberley Zaremba-Rabatin D.M.D performs her surgeries using both traditional and laser techniques. She is certified as a Laser Assisted New Attachment Procedure (LANAP) provider. LANAP is the only FDA cleared laser treatment for gum disease. Evidence from both clinical and laboratory research confirms the success of this laser treatment. Traditional surgery is done with anesthetic and involves the use of a scalpel to make cuts as small as possible to attain maximum results. The choice will be related to the stage of gum disease, your preference, and medical factors. Talk with Dr. Zaremba-Rabatin to decide which surgery is right for you.

Periodontal Deep Cleanings are generally the first line of non-surgical treatment for gum disease if self-care with flossing and dental rinses don’t help. These cleanings consist of scaling and root planing (SR&P). This is performed to remove the actual cause of the gum disease, bacteria and plaque that has formed under the gum.

Scaling and root planing consists of the administration of a local anesthetic prior to scaling all of the plaque, tartar, and bacteria from all areas of the tooth and exposed root surfaces. Planing then smoothes out any rough areas on the root surfaces that might collect more bacteria, plaque and tartar. By removing the cause of periodontitis (loosening and irritation of the gums around the teeth), the affected tooth can reattach to the gum after healing and may not require any further intervention. Paying close attention to brushing and flossing habits and using a fluoride rinse are things that can be done at home to prevent further gum issues. More frequent exams may be necessary to ensure that the affected teeth and gums are healthy and stay that way!

For severe cases of gingivitis, OralDNA® is a clinical test that can offer information about precisely what bacteria are present in the patient’s mouth and in what amounts. The procedure for specimen collection is quite easy. The patient simply swirls saline in his or her mouth for 30 seconds and then spits the liquid into the collection vial. The vial is sent out for testing and results are sent back to Dr. Zaremba-Rabatin.

Test results indicate the amounts of high and low-risk pathogens found in the sample and the profile of each bacteria. Results also include the percentage of risk for disease progression and potential for tooth loss. With this information, Dr. Zaremba-Rabatin can prescribe an antibiotic that is highly effective for the particular bacteria that places the patient at risk. Some bacteria are more aggressive, and by identifying the strain, antibiotic treatment will target the correct pathogen and yield better results.

Have you heard the expression “a gummy smile?” It describes someone that has less tooth above the gumline that usual. This may not be a problem, but if a tooth breaks off or has decay, Dr. Zaremba-Rabatin may need to place a filling or crown. In order to do so, more of the tooth must be exposed above the gumline.

Local anesthesia is given and, depending on the amount of tooth that must be cleared and whether it is gum removal or gum and some bone removal, the doctor will expose the necessary amount of tooth. The gums will be stitched shut for healing.

In seven to ten days, the stitches will be removed, but the final crown will not be placed until about three months later, when the gum has healed and is no longer inflamed. At that time the the crown will fit well.

A gum graft is a solution offered for your sensitive receding gums. When gums recede, the lower part of the tooth and the upper portion of root is exposed and becomes extremely sensitive. The gum pulls away from the root and the exposed portion of tooth. The resulting “pocket” collects bacteria and develops infection. Ultimately, this may lead to damage to the bone of the jaw supporting the tooth. There are three kinds of soft tissue grafting procedures.

Connective Tissue Grafts

In this gum grafting method, a small amount connective tissue is taken from the roof of the mouth. The collected tissue is then sewn to the gum tissue around the exposed portion of tooth and root.

Free Gingival Grafts

Similar to the connective tissue graft, the roof of the mouth is used for supplying the grafting material. Instead of taking connective tissue from under the skin in the roof of the mouth, the skin itself is used to attach to the gums. This is generally used for patients that need larger grafts.

Pedicle Grafts

This gum graft procedure uses tissue from the gums near the receding gum. A flap is cut and the tissue is pulled over the exposed root and stitched. This keeps one edge of the new graft (pedicle) attached. Pedicle grafts are used for patients with enough gum tissue near the affected tooth.

After any grafting procedure, Dr. Zaremba-Rabatin will provide specific instructions for the following weeks.

If you experience any of these symptoms, please make and appointment with Dr. Zaremba-Rabatin:

• a sore in your mouth that won’t heal after more than two weeks
• red or white patch on your gum
• gum swelling that won’t go away
• observe unusual changes in your gums that may cause teeth to loosen

Abnormal oral tissue can be an indicator of oral cancer. The doctor will remove a small piece of the questionable tissue and send it to a lab for testing. The biopsy is used to diagnose a variety of gum conditions as well as oral cancer.

When a tooth is lost or removed, a dental implant can be placed a natural-looking and strong implant can be placed. Leaving a gap where a tooth has been removed can lead to movement of other teeth, rearranging your bite pattern and the look of your smile. It can also promote bone loss in the area of the empty socket.

An implant is nothing like a denture or bridge. It is a permanent tooth replacement. It stays right in your mouth and looks and feels like a natural tooth. An implant is made up of three parts: the implant itself, an abutment, and a crown. The implant is basically a screw that will attach your new tooth to the bone. The bone will grow around it and secure it in place. The abutment permanently connects the implant to the crown. The last part is the crown, the part that looks like the tooth.

Your implant will repair your smile so it looks natural, allows you to eat normally, and returns any confidence lost from a missing tooth.

To maximize the efficacy of an implant, if necessary, a bone graft will accompany the implant process. Either a piece of the patient’s own bone or a bone grafting material will be used to ensure that the bone can support the implant. The graft will be done prior to the implant and have to heal completely before the implant procedure.

A frenectomy, most often performed on children, is the removal of the tissue from the upper gums that extends between the front two teeth, which causes a gap. On the lower jaw, the tissue that connects the tongue to floor of the mouth is too short and limits the ability to move the tongue properly. The procedure is done with a soft tissue laser and have a fast, easy recovery.