Dr. Israelson is a highly trained and experienced periodontist - a dentist who specialized in treating the soft tissues and bone surrounding the teeth, and at placing dental implants. He is a Diplomate of the American Board of Periodontology, the highest recognition granted in the profession for knowledge and clinical skill. From 1989 to 2000, he served as an an associate clinical professor in the Department of Periodontics at Texas A&M College of Dentistry (formally Baylor College of Dentistry) and currently serves as adjunct professor.
Dr. Israelson provides the full scope of periodontal services for adults and children. He uses advanced technology and gentle techniques to make treatment comfortable and produce stable, long-lasting results.
Gum disease is a very common problem. It is more than just gums that bleed from time to time. Anyone can have gum disease, even people who brush and floss each day. Gum disease is serious. It can lead to loose teeth, abscesses, and other oral issues. Gum disease can also be a contributing factor in stroke, heart attack, and other serious health issues. Here at Dr. Hilton Israelson, we treat people with gum disease daily. There are things that you need to do to keep your gums healthy.
A periodontal maintenance procedure (PMP) is defined as a procedure that is recommended following periodontal treatment (such as scaling and root planing) and continues at varying intervals, determined by the clinical evaluation of the dentist.
These intervals can be as frequent as every two months and they can be extended as long as six months, depending on the patient. Keeping up your PMP interval is important because periodontal disease can recur without adequate follow-up.
Our skilled and experienced hygienists provide thorough deep cleanings for our patients who have mild to severe gum disease. They use high-tech instrumentation to make the cleanings comfortable and efficient. Deep cleaning is a key element of gum disease treatment, and is often enough to reduce or even eliminate the pockets caused by the disease, many times avoiding the need for periodontal surgery.
Gum Graft Surgery
Gum grafting is a name for periodontal procedures dedicated to strengthening certain areas of the gums in order to cover up an exposed tooth root surface. These exposed roots could be the result of gum recession due to gum disease, bite overload, or poorly positioned teeth. This procedure is quite common, and while the name might sound scary, it is performed routinely and provides for excellent results.
If you are suffering from advanced periodontal or gum disease, Dr. Israelson might suggest osseous surgery. Osseous surgery, also referred to as pocket depth reduction, is usually recommended when non-surgical treatments such as scaling and root planning have failed to recondition the impacted tissue around your teeth.
Bone grafting is a surgical procedure that is used to fix problems associated with the bone or joints. It involves transplanting bone tissue, and in the field of dentistry, it is most commonly completed so that there is enough bone available to support dental implants.
At Dr. Hilton Israelson, we strive to keep your teeth in a beautiful, healthy state. Our preventive, cosmetic, and restorative services are designed to provide you with a lifetime of natural teeth. Unfortunately, this is not always the possible. Sometimes, tooth extraction may be a necessary step to improve your oral health. Not to worry, though, we offer several solutions that replace missing teeth!
Surgical Assisted Accelerated Orthodontics
Periodontally accelerated osteogenic orthodontics is typically used at the very beginning of your orthodontic treatment. This invaluable procedure involves corticotomies, or divisions in the underlying bone (the mandible or maxilla) while keeping the medullary vessels and periosteum intact. Splitting the bone into two pieces provides open space that accelerates tooth movement. The procedure may also involve bone grafting to enhance the volume of your ridge during treatment.
Periodontics is the oral health field devoted to caring for the supporting structures of the teeth, mainly the gums, surrounding bones, the jaw, and other associated tissues. A periodontist is a dental professional specializing in treating conditions and diseases of the periodontium.
In addition to focusing on diseases of the tooth-supporting structures and gums, these dental practitioners also have an expanding role in today’s dentistry.
Two specific areas in which Periodontics has become a huge part of dentistry is in implant and cosmetic technology. Because of a periodontist's expertise is in tissue engineering, soft tissue care, and the complexity of the surrounding structures, they often times make excellent dental implant surgeons. In cosmetics, our dental health experts here at Dr. Hilton Israelson are able to improve symmetry in the soft tissues, tone, color, and tissue quality of tissue through a number of different techniques.
What Exactly Does the Field of Periodontics Entail?
The phrase periodontium refers to the structures that directly surround, protect, and support the teeth. It is composed largely of the gingival tissue and the supporting bone. It consists of a number of gingivae, ligaments, bones, and tissues. Here is a little bit more about its makeup:
Normal gingiva usually ranges in from a light coral ink in color to a heavy pigmentation. The connective fibers and soft tissues protecting and covering the underlying cementum, alveolar bone, and the periodontal ligament are called gingivae. They are categorized into three separate groups; free, attached and Interdental gingiva. Each of these groups, though biologically different, are all designed to help defend against bacterial and mechanical and destruction.
The tissues which are above the crest of the alveolar bone crest are known as the free gingiva. In a healthy periodontal region, this gingival margin is the tissue fibers which encompass the cemento-enamel junction, a small line that goes around the circumference of the tooth in the place where the crown’s enamel surface meets the outer cementum layer of the root. A healthy, non-diseased, gingival sulcus will typically be about 0.5-3mm in-depth, although this measurement will usually increase in cases of periodontal disease. The oral sulcular epithelium is a non-keratinized layer which lines the gingiva sulcus. It starts at the gingival margin and goes to the sulcus base where the attached gingiva and junctional epithelium begins.
The aforementioned junctional epithelium is a band which is found at the base of the gingival sulcus and it surrounds the tooth. It sets the boundaries for the area of separation between the free gingiva and the attached gingiva. It also provides a special barrier of protection for microorganisms residing in and around the sulcus. Collagen fibers help to bind the attached gingiva securely to the periodontium, including the alveolar bone and the cementum. It varies in width and length, depending on the specific location in the individual’s oral cavity. The attached gingiva lie in-between the free gingival groove or line and the mucogingival junction. Attached gingiva dissipate masticatory and function stress which are placed on the tissues when performing common activities such as brushing teeth, speaking, and mastication. When healthy it is usually coral pink or pale pink in color.
The Interdental gingiva fill the space below a tooth contact point, between the two adjacent teeth. It will normally be shaped like a pyramid or triangle and is made up of the lingual and facial Interdental papillae. The center or middle part of these papilla consist of attached gingiva, while the tip and borders and tip are made by the free gingiva. The col is the central point between the Interdental papillae. It is a concave or valley-like depression lying directly below the contact point between the lingual and facial papilla. The main function of theses interdental gingiva is to help prevent food impaction while chewing.
The alveolar Mucosa is a non-keratinized area of tissue located just beyond the mucogingival junction. It is not as firmly attached as other parts of the periodontium and is usually more red in color than attached gingiva, which makes it easier to identify. It allows for the movement of the lips and cheek whenever we try to talk or chew. Next is the periodontal ligament, which is the connective tissue that joins the cementum, the outer layer of the root of the tooth, to the alveolar bone. It is comprised of several complex and detailed fiber groups that go in different directions and insert themselves into the bone and cementum. This ligament is mostly made up of collagen fibers, but it also houses nerves and blood vessels within its loose connective tissue. Mechanical and functional loads which are placed on the teeth when chewing, as well as other external impacts are absorbed by this ligament, aiding in tooth protection within their sockets.
Continuing on through the periodontium, surrounding the teeth and forming the bony sockets that support each individual tooth is the alveolar bone. The lingual and buccal plates, as well as the socket lining are composed of dense, yet thin, cortical or compact bone. Within these dental sockets and cortical plates is cancellous bone, a trabecular or spongy type of bone that is much less dense than compact bones. And finally, we come to the outer layer of the root of the tooth, or, the cementum. It overlies the layer dentine on the tooth and provides the periodontal ligament’s collagen fibers to be attached to it. It not only protects the dentine; it also functions to provide sealing for the ends of the dentinal tubules which would otherwise be exposed. It is not as hard as dentine or enamel and it is usually light yellow in color.
Diseases of the Gingiva
The most common condition affecting the mucosal tissues or gingiva that surround the teeth is gingivitis. This is a very mild and early stage of periodontal disease, but it is by far the least destructive due to the fact that it doesn’t create changes to the periodontium or cause any sort of irreversible damage. It is easy to spot as most patients first notice light bleeding when eating food, brushing their teeth, or flossing. Other signs are redness, swelling, and inflammation of the gums and surrounding tissues. Gingivitis usually occurs as a result of a thin layer of biofilm and plaque accumulation which is typically associated with poor dental hygiene habits and practices. It is also typically painless, which is what allows it to progress if the patient isn’t proactive about their oral health and coming in for regular checkups and maintenance.
Although improper dental care regimens are usually the culprit in the development of gingivitis, this is not always the case. There are other factors which can also lead to the onset of this early-stage periodontal issue. Sometimes certain medications can bring on this condition, as can systemic health conditions such as diabetes, cancer, and HIV or AIDS. Better dental care can drastically improve this condition very quickly, even to the point of reversing the damage it may have caused. Ignoring it and neglecting professional oral health treatments can have a devastating impact, however. Continued negligence can lead to the rapid advancement of periodontal, destroying tissue and causing gum recession, shifting teeth, and ultimately even the loss of teeth. It can also contribute to a number of other non-dental health related issues such as cardiovascular disease, diabetes, high blood pressure, and many others.
Symptoms and Signs of Periodontal Conditions and Diseases
We have already mentioned a few of the warning signs and red flags that there may be something wrong with your periodontium, but we would like to take a moment to cover a few more. When it comes to something as important as dental health, as well as the function and longevity of your teeth, it is imperative to understand when it is time to take action to prevent the development or spread of these devastating oral health conditions.
Of course, there is the issue with bleeding gums, which can arise at mealtime, or during your home maintenance routine such as when brushing and flossing. But other indicators include halitosis or chronic bad breath, a consistent foul taste in the mouth, gum recession, loose or shifting teeth, a noticeable buildup of plaque, and dry mouth, just to name a few. If you are currently experiencing one or more of these issues on a consistent basis, it really is time to come in and visit with a dental care specialist.
Causes of Periodontitis
There are a number of risk factors that can contribute to a person being at a higher risk of developing periodontal and gingival disorders. But it is important to note that the only mitigating factor for periodontal conditions or diseases is biofilm or bacterial plaque. With that being said, however, there are still several other factors besides poor oral hygiene that can help to create the conditions in which these diseases thrive. One such example is smoking, which produces a number of negative impacts on oral health, allowing the development and progression of gingival conditions. Among them are the fact that smoking destroys blood vessels which lower immune defenses, increases inflammation, and helps to from larger gum pockets than non-smokers, effectively creating a breeding pool for the germs and bacteria necessary to facilitate the growth of the disease.
Another example is excessive alcohol consumption, although it is necessary that more research be conducted as to the long-term effects of alcohol and how it impacts the periodontium and surrounding tissues. But recent current studies have suggested a moderate increase in the risk of progressive periodontal disease for patients who consume more than a moderate amount of alcohol. And as previously mentioned, diabetes can also play a significant role in the development and spread of periodontitis and other related issues. The main factor is the lack of blood sugar regulation which can wreak havoc on the oral health of the sufferer. And since diabetes also hinders the bodies’ natural ability to health itself, minor tooth and gum issues can become exacerbated due to the patient’s natural immunity-related insufficiencies.
Still, there are many other possible contributors when it comes to battling periodontal conditions. These include obesity, heart disease, stress and anxiety, osteoporosis, vitamin D deficiency, certain medications or illegal drug use, hematological disorders, pregnancy, and even genetics. While all of these causes are far less likely to be the driving factor than a lack of proper dental care, they also can’t be completely ignored either. And even if they aren’t the reason that a patient develops some kind of perio-related disorder, they can still have a negative impact on the treatment and recovery process so they need to be addressed and kept under control as to help facilitate improvement in their oral health.
Preventative Periodontal Care
The best way to deal with all of these issues concerning the periodontium and all of the many components which help to support healthy oral function is to simply not allow them to arise in the first place. This starts with a good and consistent at-home dental care routine and is supported by regular trips into our offices for regular checkups and scheduled cleanings. When you are in continual contact with our dental care professionals, they will be able to see any possible concerns long before they ever become serious conditions such as periodontal disease.
Even if you have already suffered minor or extensive damage due to neglect or improper treatment, there are still a number of options available to you not only to bring the condition under control, but also to provide restorative therapy to improve the appearance of your smile, as well as the health of it.
To find out more about how the dental specialists here at Dr. Hilton Israelson can help you and your family with your periodontal needs, please stop by our local office. You can also give us a call if you prefer to speak with us over the phone prior to coming in. We are available to take your call at (972) 669-9444 and as always, we look forward to hearing from you.