• Is orthodontic treatment very painful?

    No. With better understanding of physiology of tooth movement and latest Technology, pain during orthodontic treatment is kept to the minimum.

    Initially when an appliance is given there is pressure on the teeth that can cause some discomfort and pain. This can be minimized by timely medication as prescribed by the orthodontist. There is NO constant pain or discomfort during the entire duration of orthodontic treatment. When the appliance is activated to exert pressure on the teeth the patient may experience pain for a couple of days. This subsides on its own and is usually bearable. If it is more, then the prescribed medicine can be taken to relieve the pain.

  • How much time is required for orthodontic treatment?

    The duration of orthodontic treatment varies according to the condition of the teeth and jaws at the beginning. On an average, treatment with the fixed braces takes about 1 to 2 years in cases where all the permanent teeth have erupted and there is minimal jaw discrepancy. The treatment time has reduced now with the use of “Friction-Free Ties” developed by us. We are able to complete treatment in a few months in some cases.

    In growing children where jaw discrepancies have to be corrected it may take 3 to 4 years. The treatment may be split into two phases. Jaw correction is done in the first phase with one of the various growth modification appliances at the orthodontist’s disposal. In the second phase, fixed braces are given to set the teeth in their proper positions.

  • What is Corrective Jaw Surgery?

    Corrective Jaw Surgery is considered when a person’s bite cannot be fully corrected with braces, or when braces cannot correct facial imbalance. Corrective Jaw Surgery is also known as Orthognathic Surgery. The word “orthognathic” comes from two Greek words – orthos, meaning straight, and gnathos, meaning jaws

    Orthognathic surgery generally consists of one or more of the following corrections: advancing the maxilla (upper jaw), advancing the mandible (lower jaw), and correcting the positioning of the chin

  • How often would you repeat Scaling and Root Planing?

    Well, technically you should never have to repeat SRP if it is done correctly. Let’s use an example. A patient comes in after an absence for about 3 years with 5 mm probing depths and bleeding throughout. Subgingival calculus is everywhere and they need SRP. If you do the SRP thoroughly, reevaluate and they now have normal pocketing you should keep them on 3 months for the next year. If they can maintain a good home care routine and comply with regular recalls, then they should be fine forever. If they skip steps, or slack off then SRP will need to be repeated

  • Do you think SRP should be performed before any surgery is done?

    SRP should be done prior to any type of surgery almost 100% of the time, simply because you want to reduce the bacterial load throughout a mouth before surgery so that the procedure has a better outcome. There are only a few exceptions to this, but you really can’t go wrong by doing SRP prior to any type of surgery

  • Once a patient has gone through SRP (1-3 teeth in 1 quad) should they be considered perio maintenance (4910) from now on? Can you alternate codes 1110 and 4910? Is 4910 only billable at the perio office?

    The general rule of insurance coding is that once you use a perio code for a patient in their care, then you must use 4910 as the continuation code. You cannot mix the codes based on coverage of what the patient wants or the benefits that they have because that is insurance fraud and you will get in trouble. Only occasionally, in very specific cases can you switch someone from a 4910 to a 1110, and it depends on the patient’s insurance carrier. 4910 code is applicable at any office and not just a perio office

  • What is the best way for a patient to control root sensitivity following SRP?

    Fluoride is the best way. It is important to remineralize the root surface and occlude the dentinal tubules to obstruct fluid exchange which causes sensitivity problems. Different types of fluorides and products work differently for each patient, sometimes it is trial and error to find the right one

  • Can a patient have periodontal disease if infection is not present?

    The simple answer is yes, but that question is loaded. The definition of periodontal disease is measurable attachment loss and infection does not need to be present to have attachment loss. However, 99% of the time there is infection or inflammation present to assist in the attachment loss. Think of the patient with immaculate home care with generalized recession and thin tissue. That patient is contributing to the attachment loss, but the biofilm that is present is more damaging because of the recession and thin tissue present than if the tissue was thick. So technically infection is present

  • How often are you using Perio Protect on your patients?

    Pretty much all the time. Even on a patient who has good home care, the additional benefit will keep them healthier. The most effective use is for patients with bleeding 4 and 5 mm pockets throughout their mouth and on 3 month recalls. The added benefit of the Perio Protect system really boosts their overall care

  • Can you talk about how the implant overcomes (or does it) the nature of the biological width?

    An implant doesn’t overcome the biologic width, it resets it. The biologic width is going to be present whether there is a tooth present or an implant. The body has to set up this relationship in order to preserve the health and integrity of the mouth. The biologic width of an implant is altered because there are different non-living components to factor in, but it is present. You will typically find deeper pocketing around implants because of the biologic width, and it depends on the implant fixture platform placement as it is related to adjacent teeth

  • Implants, to probe or not to probe? That is the question

    You must probe around implants like you would natural teeth because you need to know the health of the tissues holding the implant in place. If you don’t know what the tissue is doing, then you won’t know how to treat the patient.

  • Our office recently purchased the “Gold” scalers for implants. Do you feel these are good/safe instruments?

    There are a lot of questions about how to clean implants. I have a very simple way of thinking about the cleanliness of implants. It is very difficult to damage an implant surface and if you are getting to the surface of the implant and not just the crown, then there is a bigger problem than a little bit of plaque. Implant surfaces also don’t collect much in the way of debris anyway because of the surface smoothness. The bottom line that I would recommend is to use what you have and when you get around an implant, just be a bit more careful, but don’t be afraid of them

  • What causes Periodontal Diseases?

    Periodontal disease is caused by plaque. Plaque is a colorless film which sticks to your teeth and gum line. If not carefully removed, this plaque will harden into a rough, porous substance known as calculus or tartar. The bacteria found in plaque produce toxins that irritate the gums. These toxins and the infections they cause, lead to periodontal disease

  • What is Periodontal Disease?

    Periodontal disease is a disorder that affects the supporting structures of the teeth. This infection is often referred to as gum disease. Once the process of has begun, the supporting gum tissue begin to deteriorate

  • What is Gingivitis?

    Gingivitis is an inflammation of the gums. It is usually caused by a reaction to the bacterial biofilm (sometimes referred to as plaque) that grows around the teeth

  • What are the symptoms of Gingivitis?

    Red, puffy, swollen, bleeding gums are signs of gingivitis.

  • What is Periodontitis?

    An infection of the gums that affects the supporting structures of the teeth. Periodontal disease is caused by the bacteria found in plaque.

  • Does Gingivitis lead to Periodontitis?

    While it is possible to have gingivitis that does not progress to periodontitis, if gingivitis goes untreated, it will very likely develop into periodontitis

  • What are the symptoms of Periodontitis?

    Early periodontitis can have no symptoms, which is why 3 out of 4 people are affected by periodontal disease. Once the process of periodontitis has set in, the supporting gum tissue, bone and ligaments that hold teeth in place begin to deteriorate. This can lead to bad breath, increasing space between the teeth, tooth mobility or deep aching pain around the teeth. In advanced cases, abscess may form between the roots and gums

  • After I have been treated for Periodontitis, can I get it again?

    Yes, periodontitis is a chronic disease caused by bacteria. It must be maintained once under control. The best way to prevent periodontal disease from returning is to commit to a daily regimen of brushing and flossing. Consistent home care partnered with regular dental hygiene appointments is the best way to prevent periodontal disease from returning.

  • How will I benefit from Dental Implants?

    Dental implants are life changing. They can restore your active lifestyle and take away the anxiety often caused by missing teeth or loose dentures. With periodontal implants you can work, play and eat whatever you like without worrying about your teeth! Dental implants are the permanent solution to a temporary problem

  • Additional benefits

    Improved Function and Ability to Chew

    Improved Speech

    Improved Oral Health

    Improved Appearance

  • How do Dental Implants work?

    Implants create a replacement for your missing tooth’s root. This provides a strong foundation for permanent or removable replacement teeth. Because nearby teeth are not altered to support a periodontal implant, more of your own teeth are left intact. Dental implants also allow easier access between teeth, making daily brushing and flossing effortless

  • How successful are Dental Implants?

    Success rates of dental implants vary, depending on where in the jaw the implant is placed and the skill of the doctor performing the procedure. Overall, dental implants successfully integrate with the bone in more than 97% of the cases

    The rate of success of implants placed at PNW Perio over 98%! If dental implants are cared for properly, they can last a lifetime. In those few cases where an implant becomes loose, your oral surgeon will remove the implant and place a new one in a slightly different position to achieve better integration with the bone

  • How painful is the Dental Implant procedure?

    Implant placement, like any surgical procedure has some associated pain. This will vary from patient to patient. Many of our implant patients comment that they were surprised at how minimal the pain and discomfort of their procedure was.

  • Do Dental Implants require special care?

    Natural teeth require conscientious at home care and regular dental cleanings. Your dental implants will require the same care. In order to keep your implant clean and plaque-free, daily brushing and flossing still apply!

  • How is a Bone Grafts performed?

    In order to effectively restore bone, a small piece of healthy bone is harvested from a suitable area of the patient’s body, usually from the chin or hip region. In an alternative procedure, new bone can be created by using Bone Morphogenetic Proteins (BMPs). These BMPs are well known for their bone and cartilage forming capabilities