At Hospital Lane, referrals for specialist periodontal treatment are received by Craig Kennett BDS PhD FDS RCPS (Glas) and Ines Forte LMD (Lisbon) MClinDent(Lond) MRD RCS (Eng).
Alternatively, patients can make appointments directly with Reception for direct access to specialist care.
Specialist periodontal treatments
Patients can benefit from seeing a Periodontist to treat more advanced gum disease or specific gum problems. The Periodontist has had advanced training in using microsurgical techniques for gum treatment that is more intensive and may be beyond the scope of a Dental Hygienist or general Dentist due to the technical difficulties involved. Specialist equipment such as dental lasers and micro-surgical tools used by the Periodontist can help achieve optimum treatment outcomes. As with all periodontal treatment, the patients home care is a vital aspect in the success of treatment.
The Periodontist will be able give patients detailed analysis and advice on the treatment options available and lifestyle factors which can aggravate periodontal problems. In addition, long-term treatment planning is often invaluable for patients with more developed gum problems.
Laser treatments
The Waterlase MD laser uses a unique combination of laser energy and water to provide gentler, more precise treatment that conserves healthy tissue and minimises pain and discomfort. In addition, the laser sterilises as it removes diseased tissue and provides a sealing clot that inhibits re-infection.
More information on laser treatment
The use of lasers in dentistry offer us a unique way of offering our patients more versatile and effective ways of treating their dental problems and have been particularly effective in the treatment of gum disease, gum reshaping and for treating problems around implants such as peri-implantitis.
We have incorporated the use of both a diode laser and a Waterlase MD laser within our treatment protocols.
The Waterlase MD cuts hard and soft tissue and gives us versatility to carry out a range of procedures.
It cuts with minimum heat, minimising heat damage to the surrounding tissues. It also seals blood vessels as it cuts reducing bleeding which is good for both the operator and the patient. This results in less swelling and post-operative pain and sensitivity as well as faster healing times.
This has a positive impact for our patients and makes more involved procedures more straightforward for ourselves and more acceptable for patients, cutting down healing times and reducing the length of time required between the surgical and restorative phases of treatment.
Infra bony defect pre laser treatment
After laser treatment
A narrow, long, flexible radial firing tip makes the Waterlase an excellent tool as an adjunct for non-surgical periodontal treatment for moderate periodontal disease cases, as it will allow access to deeper infected tissues and difficult to access areas, such as the area between the roots of teeth and between teeth without the need to surgically lift the gum and expose the tooth root, so this can therefore reduce the necessity for a surgical approach.
Where there is no option, it is still very useful in a surgical approach for the same reasons and will help to thoroughly remove infected tissue from a bony defect with the minimum of trauma, thereby improving the healing experience for the patient.
We have used the Waterlase MD for a number of other procedures such as aesthetic gum reshaping and by changing the settings, one can alternate between altering the shape of both soft and hard tissue for more effective sculpting and reshaping. This often results in a flapless procedure without the need for suturing and therefore gives a highly accelerated healing process with less pain and discomfort.
In the same way, soft tissue procedures such as gum overgrowth management, removing inflamed tissue around wisdom teeth, fraenectomies, and polyp removal have all become relatively straightforward using this tool.
Soft tissue polyp on corner of lower lip
Excellent healing 1 week after the removal with a diode laser in a no stitches approach
The waterlase MD may also assist with more challenging procedures such as removing the roots of teeth as it allows improved access to the root with minimal bleeding and trauma and also results in faster healing times.
As one of our specialist areas is the treatment of diseases around implants such as peri-implantitis and implant mucositis, we have found that the Waterlase has been a really useful tool to minimise the need for a conventional surgical access technique and so the use of sutures is not always necessary. It is an excellent tool for removing the inflamed tissue around the implant which promotes the bone loss. It can also be used to help decontaminate the surface of an implant.
Diseases around implants can be treated – this implant shows deep pocketing with suppuration
We have also used the diode laser for more simple soft tissue cases and periodontal treatment, but we have found also that a very interesting use is to produce low level laser therapy as an adjunct to the Waterlase. The dual stimulation of the diode and waterlase has been shown to promote rapid healing and reduces post-operative pain and swelling.
Radiograph showing classic funnel shaped defect around single tooth implant
The diode laser low-level laser therapy has been used in our Clinic to reduce the problems that patients have with TMJ myofacial pain, promote quick healing of apthous and herpetic ulceration and of course in conjunction with the Waterlase in surgical procedures to reduce post-operative pain.
Combined surgical approach with laser decontamination and removal of coronal threads of implant.
Aesthetic recontouring
The architecture of the gum surrounding teeth has a significant impact on dental aesthetics. For a good cosmetic appearance the proportions of the teeth need to be correct and a degree of balance and harmony in the surrounding soft tissue is important. Asymmetry and ‘gummy’ smiles can be corrected in some cases with recontouring of the gum.
A variety of techniques can be used depending on the clinical situation and this can be achieved using conventional or laser assisted techniques.
Before
After crown reshaping upper right central incisor using laser surgery
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