Tooth Abscess

Dental Abscess

A dental abscess is an infection of the mouth, face, jaw, or throat that begins as a tooth infection, decay or cavity. These infections are more common in people with poor dental or overall health and result from lack of proper and timely dental care.
When bacteria infect the nerve of the tooth, they can extend into the gums, the cheek, the throat, beneath the tongue, or even into the jaw or facial bones. A dental abscess develops and can become very painful when tissues become inflamed. As the bacteria multiply and continue to destroy tooth, bone and gum tissue, pus collects at the site of the infection and becomes progressively more painful until it either ruptures and drains on its own or is drained surgically. Sometimes the infection can progress to the point where swelling threatens to block the airway, causing difficulty breathing (Ludwig’s Angina). Dental abscesses can also make you generally ill, with nausea vomiting, fevers, chills, and sweats. In very rare occasions, it may cause abscess of the brain (from an upper tooth abscess). Even worse, there have been incidences of death from an untreated tooth abscess.

Symptoms of a Dental Abscess

Symptoms of a dental abscess typically include:

• Pain
• Swollen glands of the neck
• Swelling of the gum over the infected tooth (may look like a pimple)
• Sensitivity of the teeth to hot or cold
• Redness of the mouth and face
• Bad or bitter taste
• Bad breath

Symptoms of an advanced tooth abscess infection may include:

• Swelling of the face or neck region (cellulitis) – a very serious symptom
• Nausea
• Vomiting
• Fever
• Chills
• Difficulty fully opening your mouth or swallowing

When to Seek Medical Care for a Dental Abscess
If you think you have an abscess you need treatment IMMEDIATELY. Call your dentist. If you cannot reach a dentist, go to a hospital’s emergency department for evaluation, especially if you feel sick.
Untreated abscesses may get worse and can lead to life-threatening complications.
Exams and Treatment for a Dental Abscess
A dentist will need to examine you and determine the cause of the abscess. Dental x-rays will help determine the source of the abscess and the extent of its damage. Prompt treatment usually cures the infection.
The treatment goal for a dental abscess is to save the tooth and cure the infection and prevent complications. Depending on the size of the abscess and the state of the tooth causing the abscess, various forms of treatment may be indicated, including root canal, incision and drainage or gingival scaling. In some cases, the abscess has caused severe bone damage around the infected tooth and the tooth may need to be pulled (extraction). Some people may need to be admitted to the hospital.

Gum Recession

A specialist is a person who concentrates primarily on a particular subject or activity, a person highly skilled in a specific and restricted field. A periodontist is a general dentist with advanced education in periodontics. They are specialized in the treatment of periodontal disease, treatment of gum recession, bone grafting, and placement of dental implants. The American Dental Association, along with the American Academy of Periodontology, requires periodontists to have at least 3 years of post-doctoral, advanced specialty training in Periodontics and Implantology from an accredited program after graduation from dental school.

A general dentist can practice Periodontics or place implants, but cannot claim to be a specialist in the field, nor do they have the additional training or expertise to perform more complicated procedures. Generally, a non-specialist’s training consists only of short courses in diagnosis and treatment with minimal hands-on experience. Furthermore, most periodontists undergo hundreds of hours in periodontal and implant related continuing education every year, and are well versed in the latest science and literature in their field. Their constant exposure to the most challenging of cases allows them to remain experts in the latest techniques and materials.
Some periodontist choose to receive board certification in Periodontics and become a Diplomate of the American Board of Periodontology which requires even more stringent written and oral examinations. The intent of board certification is to demonstrate that a certified dental specialist has successfully completed an approved educational program and an evaluation. This includes an examination process designed to assess the knowledge, experience and skills requisite to the provision of high quality patient care in that specialty.

Gum Graft

One of the problems more readily identified by patients is gum recession. This occurs mainly in patients with thin, fragile gums, or patients suffering from the gum disease. Gum recession can make your teeth feel sensitive and look longer than usual. This lengthy tooth look will give the appearance of an older smile, hence the expression ‘Long in the tooth’.
Recession may result in sensitive teeth because the exposed roots are more vulnerable to temperature changes and the effects of sugary or acidic foods. More often, however, recession is not associated with any pain or sensitivity, and may progress unnoticed for years. Gum recession, if left untreated, may progress to further gum disease, bone loss, root decay, and eventual tooth loss.

http://perio-implant.com/

Gum recession is treated through Soft Tissue Grafting procedures. These techniques are predictable in creating thicker, stronger gum tissue. This prevents further recession and in most cases covers the exposed portions of the tooth roots. One or several teeth can be treated at the same time. Historically, the patients own tissue is used for soft tissue grafting. The most common donor site is the side of the palate, where the tissue is thick enough to serve as a harvesting site. The tissue that is ‘borrowed’ from the palate will completely regenerate. While autografting (using the patient’s own tissue) is the undisputable ‘gold-standard’ for soft tissue grafting, there are other alternatives including the use of donor tissue (ie. AlloDerm®).

Laser Gum Surgery

(Laser Assisted New Attachment Procedure) is a patented periodontal treatment which has obtained FDA approval for gum disease treatment in 2004. Currently, not many other periodontal clinics in the area with properly trained doctors to offer LANAP® procedure for their patients . Florida Institute for Periodontics & Dental Implants is proud to be able to make this treatment available to gum disease sufferers in South Florida.
There is no cutting and no suturing in LANAP® Proceudre, and much less pain and discomfort during and after the procedure, compared to standard periodontal surgery. The duration of the procedure is also shorter then traditional periodontal surgery. Generanlly LANAP® is more selective and less invasive then traditional surgery.
LANAP® procedure does not include the major loss of gum tissue which is almost always involved in traditional surgery. The gum loss can lead to increased teeth sensitivity caused by exposed roots and other periodontal problems.The laser used with LANAP® targets only damaged tissue, which has different light absorption than healthy tissue, without impacting healthy gum and bone.

Most of our patients recover within 24 hours, which make LANAP® very convenient and less problematic, then traditional periodontal surgery, where recovery can take between 2 to 4 weeks and is associated with considerable pain and swelling.

1. Perio probe accurately record excessive gum pocket depth.
2. Digitally pulsed laser light energy removes bacteria, pathological proteins and the diseased tissue from the inner pocket lining, sterilizing the pocket bacteria responsible for gum disease ,leaving the healthy tissue intact.
3. As the pocket opens, the laser energy loosens the hard deposits allowing for ultrasonic scaler and special hand instruments to remove root surface accretions.
4.  The pocket is re-entered with the laser light to create a gel-clot containing stem cells from the bone and aids in sealing the pocket closed, so new germs or food debris can get inside the pocket allowing the gum to heal.
5. Reattachment of connective tissue to the clean root surface, with a stable fibrin clot and gingival crest to create a closed system
6. Bite trauma is adjusted
7. New attachment is regenerated.  New bond and new ligament is formed and healing occurs.

Dental Implants

Benefits of Dental Implants

Dental implants are the most advanced tooth replacement option available to our patients. Done correctly, they are highly esthetic and will look and feel like your own teeth. Equally important, dental implants are the only tooth replacement option that maintains the jaw bone that is so critical for facial esthetics. Following loss of a tooth, the jawbone will naturally resorb (atrophy) unless replaced by a dental implant. This is traditionally what happens under bridges and dentures, a process that can give denture patients a prematurely aged, “sunken-in” look.

Besides saving bone, dental implants also save teeth. Prior to implants, fixed (non-removable) bridge-work which was used to replace missing teeth required the shaving down of adjacent teeth to serve as anchors. Besides requiring the grinding-down of sound tooth structure, this would often result in the immediate or future need for root canal treatment of the anchor teeth. Capped and root canaled anchor teeth are more vulnerable to cavities and fractures. With implants, missing teeth can be replaced without touching adjacent teeth. The results are individual tooth restorations that are easier to clean. Implants help distribute biting forces and therefore protect, not weaken, adjacent teeth.

Dental implants cannot get cavities nor will they require root canals, making them the ideal option for patients with a history of cavities or failed root canals. A properly placed, healed, and well-maintained dental implant will serve as a permanent (lifetime) tooth replacement.

Dental implants are titanium anchors used to permanently replace teeth that are missing, cannot, or should not be saved. Dental implants themselves serve as tooth root replacements to support caps, bridges, or dentures. Developed in the 1960’s, modern dental implants revolutionized dentistry and have become the standard of care for replacement of missing or soon to be missing teeth.Our doctors have vast experience in the placement of dental implants. They have lectured nationally and internationally on implants, taught and mentored other doctors, and published numerous articles on dental implants.

Long Term Success

Modern dental implants are highly reliable and exponentially stronger than the tooth roots they are replacing. Recently, the development of stronger titanium alloys (titanium) and implant-surface technology has dramatically improved dental implant success. Today, dental implants have become the single most successful implantable device in dentistry or medicine.

The success of dental implants has been extensively reported to be in the high 90% range (96-98%). Numerous studies of modern dental implants, which have existed in their current form since the 1990′s, have shown similar success rates at 15 years.

Tooth Replacement

Dental implants can replace a single tooth, multiple teeth, or an entire arch of teeth. Once implants are placed and allowed to heal for a short period of time, the prosthesis (tooth replacement) is connected to the implant via an anchor called an abutment. Modern dental implants require far shorter healing times (4-6 weeks) than traditional dental implants, which required up to six months of healing. Implants can also be placed immediately into the area where a tooth has been extracted and can often have temporary teeth attached the same day of surgery.


A single missing, or soon-to-be-missing, tooth can be easily and predictably replaced with an implant-retained crown. An implant crown is highly esthetic and will feel and function like a natural tooth. There are multiple benefits to choosing dental implant over a bridge to replace missing teeth. When used to replace a single tooth, an implant, unlike a bridge, will not require the shaving-down of neighboring teeth. Also unlike a bridge, dental implant will maintain the bone around the missing tooth intact. An implant is also much easier to clean as compared to a bridge and will not be affected by cavities.
When replacing multiple teeth, dental implants can be used to support implant-bridges that are permanently fixed in your mouth and will not move around like partials or dentures. Because dental implants replace the roots of the missing natural teeth, they preserve the jawbone and prevent bone deterioration. This preservation of jawbone helps to keep both the bone and gum tissue from collapsing, a process that can give denture patients a prematurely aged, “sunken-in” look. With a traditional bridge, the cement that glues the bridge to the teeth will “wash-out” from underneath the bridge. This exposes the tooth, allowing cavities to form. Unlike a traditional bridge, dental implants do not get cavities, nor do they weaken adjacent teeth.

Periodontics

(Laser Assisted New Attachment Procedure) is a patented periodontal treatment which has obtained FDA approval for gum disease treatment in 2004. Currently, not many other periodontal clinics in the area with properly trained doctors to offer LANAP® procedure for their patients . Florida Institute for Periodontics & Dental Implants is proud to be able to make this treatment available to gum disease sufferers in South Florida.
There is no cutting and no suturing in LANAP® Proceudre, and much less pain and discomfort during and after the procedure, compared to standard periodontal surgery. The duration of the procedure is also shorter then traditional periodontal surgery. Generanlly LANAP® is more selective and less invasive then traditional surgery.
LANAP® procedure does not include the major loss of gum tissue which is almost always involved in traditional surgery. The gum loss can lead to increased teeth sensitivity caused by exposed roots and other periodontal problems.The laser used with LANAP® targets only damaged tissue, which has different light absorption than healthy tissue, without impacting healthy gum and bone.

Most of our patients recover within 24 hours, which make LANAP® very convenient and less problematic, then traditional periodontal surgery, where recovery can take between 2 to 4 weeks and is associated with considerable pain and swelling.

1. Perio probe accurately record excessive gum pocket depth.
2. Digitally pulsed laser light energy removes bacteria, pathological proteins and the diseased tissue from the inner pocket lining, sterilizing the pocket bacteria responsible for gum disease ,leaving the healthy tissue intact.
3. As the pocket opens, the laser energy loosens the hard deposits allowing for ultrasonic scaler and special hand instruments to remove root surface accretions.
4.  The pocket is re-entered with the laser light to create a gel-clot containing stem cells from the bone and aids in sealing the pocket closed, so new germs or food debris can get inside the pocket allowing the gum to heal.
5. Reattachment of connective tissue to the clean root surface, with a stable fibrin clot and gingival crest to create a closed system
6. Bite trauma is adjusted
7. New attachment is regenerated.  New bond and new ligament is formed and healing occurs.

Laser Periodontics

Periolase® & LANAP® – Laser Gum Surgery lanap
Periolase® The Periolase® operates at a specific wavelength that attacks bacteria and tartar, decontaminating the diseased tooth root and gum pocket. Healing after laser treatment generally involves little discomfort or swelling. Post-surgical recession and tooth sensitivity, which can be significant following traditional gum surgery, are also greatly reduced.

Approved by the Food and Drug Administration in 2004, this pulsing laser targets diseased gum tissue, which has different light absorbtion than healthy tissue, and leaves behind the healthy gum tissue.
The treatment protocol then helps connective tissue and bone to form between the gums and teeth. The laser’s heat also seals the gums with a “thermal blood clot” which creates a physical barrier, blocking any bacteria or tissue that could help recreate a gum pocket.
LANAP®

LANAP® is the first and only FDA-cleared laser protocol on the market. Its effectiveness is backed by both domestic and international studies*. LANAP® can save teeth that would otherwise require extraction by promoting bone regeneration around the tooth. LANAP® saves teeth, reduces pocket depth, and regenerates bone growth to achieve optimum periodontal health.
Benefits of LANAP®

    Faster Healing – LANAP® is minimally invasive and allows the body to recover and heal more quickly.
    Less Discomfort – The PerioLase® MVP-7™ incites bio-stimulation in the treated areas which expedites healing and makes the need for post-operative pain medication rare.
    Minimal Recovery Time – Most patients can immediately return to their daily routine.
    Little to No Gum Recession – Because the procedure removes only damaged tissue, gum line recession is minimal; the aesthetic appearance of the smile is maintained.
    Reduction in Gum Inflammation and Bleeding – The PerioLase® MVP-7™ targets inflammatory bacteria without injuring healthy tissue.
    Minimal Intra and Post-Operative Bleeding – PerioLase® MVP-7™ controls bleeding during surgery through the formation of clots and minimizes the risk of bleeding and complications.
    Saving of Teeth – Patients can keep their natural teeth sometimes even when the teeth have been deemed unsalvageable with traditional treatments.

Gum Grafting

Tissue Grafting

One of the problems more readily identified by patients is gum recession. This occurs mainly in patients with thin, fragile gums, or patients suffering from the gum disease. Gum recession can make your teeth feel sensitive and look longer than usual. This lengthy tooth look will give the appearance of an older smile, hence the expression ‘Long in the tooth’.
Recession may result in sensitive teeth because the exposed roots are more vulnerable to temperature changes and the effects of sugary or acidic foods. More often, however, recession is not associated with any pain or sensitivity, and may progress unnoticed for years. Gum recession, if left untreated, may progress to further gum disease, bone loss, root decay, and eventual tooth loss.
Gum recession is treated through Soft Tissue Grafting procedures. These techniques are predictable in creating thicker, stronger gum tissue. This prevents further recession and in most cases covers the exposed portions of the tooth roots. One or several teeth can be treated at the same time. Historically, the patients own tissue is used for soft tissue grafting. The most common donor site is the side of the palate, where the tissue is thick enough to serve as a harvesting site. The tissue that is ‘borrowed’ from the palate will completely regenerate. While autografting (using the patient’s own tissue) is the undisputable ‘gold-standard’ for soft tissue grafting, there are other alternatives including the use of donor tissue (ie. AlloDerm®).
For more information on the use of donor tissue for grafting, see the section labeled AlloDerm®.

Gingivitis

Periodontal Cleaning

The longer plaque remains on the teeth, the more likely it is to harden into calculus, requiring professional removal. This calculus harbors food products, bacteria and toxic bacterial materials that damage adjacent gums, supporting bone and teeth, if not removed in time. The frequency for periodontal maintenance varies for each individual and is generally between 3 and 6 months. The effectiveness of home plaque removal, success of previous treatment and susceptibility to disease recurrence effect the maintenance interval. Other factors such as health status, cigarette smoking and taking certain drugs can increase the need for frequent professional prophylaxis.Periodontal maintenance, also known as preventive periodontal prophylaxis, supportive periodontal treatment or periodic dental cleaning, is an essential part of obtaining and retaining dental health. All patients, including those who have been treated for periodontal disease, patients who have never had periodontal disease and even patients who have had teeth replaced with dental implants, benefit from this treatment.
It is a well-established fact that tooth decay, periodontal disease and many problems with dental implants are caused by bacterial accumulations on the teeth and gums. Even meticulous home care practiced by the most motivated patients, leaves areas of hidden plaque accumulation.

During your one-hour visit, our experienced, skilled hygienists review your medical history and update your records. Dental radiographs (X-rays) are assessed and updated if they are not current. Next, your teeth and gums will be meticulously evaluated, then cleaned with a personalized regimen using instruments, ultrasonic machines and polishers. If necessary, we use special materials to decrease tooth and gum sensitivity and nitrous oxide (laughing gas) to reduce anxiety to insure comfort during your appointment.
If periodontal pockets are noted to increase or become infected, a variety of options are available. In consultation with your periodontist, the hygienist might recommend treatment with localized antibiotics, non-surgical or surgical periodontal therapy. If teeth are noted to have decay, failing fillings or deteriorating restorations, we will immediately alert your dentist of the condition to allow early, conservative correction. We often encourage our patients to rotate their dental prophylaxis visits with their dentists to allow more critical monitoring of teeth and restorations. “Alternating maintenance” is usually adequate to maintain healthy teeth and gums for most patients as long as they stay on schedule with both our office and the dentist’s office. Dental implants also need periodic maintenance to stay healthy. Much like natural teeth, bacterial plaque and calculus can deposit on the implants and associated crowns, bridges and attachments. Unlike teeth, they are no longer susceptible to decay, but can be severely damaged by bacterially induced bone loss.
We pride ourselves on our maintenance services and often are told that our patients “have never had a better cleaning anywhere”! In fact, many patients who are dentally healthy and have never needed our corrective services use our hygienists for our outstanding preventive dental services. We firmly believe that meticulous home care combined with periodic, thorough professional maintenance can prevent periodontal disease or its recurrence!

Dry Mouth

Companies manufacturing these mini-implants, often with no research and development and poor quality control, market their products to non-implant specialists as an ‘easy’ implant, one that doesn’t require as much training or skill to place. Of greater concern is a current trend by some (unscrupulous) clinicians to use mini-implants instead of the stronger, more predictable conventional implants, without notifying their patients. The discerning dental patient should approach mini-implants with caution.Though often touted in commercials and the web as a ‘significant advancement in the field of Implant Dentistry’, small diameter one-piece dental implants, better known as mini dental implants, have been around for nearly two decades. They were originally developed as transitional (temporary) implants used to stabilize temporary bridges and dentures. Since these implants often fail to integrate with the bone, they would usually be kept only for a few months and then removed.Over the years a number of clinicians and companies began to market mini-implants for definitive support to dentures, bridges, and crowns. Though there are real indications for the use of mini-implants (see below), it is our opinion, and the opinion of every leading organization in the field of implantology, that mini-implants should not be routinely considered as a first treatment alternative. Even with recent advances in mini-implant surfaces that promote better integration to bone, there are only a handful of poorly controlled studies, and not a single long-term study, that examines the success rate or predictability of mini-implants. This should be compared with the nearly forty years of extensive data, and tens of thousands of studies, which have proven the long-term success of conventional dental implants. Having said this, and as long as the patient and clinician understand and discuss the limitations of mini-implants, there are a limited number of scenarios where mini-implants should be considered. These include:

• Cases of a severely atrophic (resorbed) mandible, where bone grafting is not indicated, and implants are needed to aid in retention of a lower denture
• Cases where significant medical issues preclude surgical access for the placement of conventional implants
• Cases where there isn’t sufficient space to place a conventional dental implant and orthodontic opening of the space is not possible/indicated

The doctors at the Florida Institute for Periodontics and Dental Implants are fully trained in the placement of mini-implants and available to discuss this as an option in the appropriate cases. Please feel free to contact us with questions regarding mini-implants.

For more information on Mini Implants and related, please contact us.

Florida Dental Implants

Our doctors have vast experience in the placement of dental implants. They have lectured nationally and internationally on implants, taught and mentored other doctors, and published numerous articles on dental implants.
Dental implants are the most advanced tooth replacement option available to our patients. Done correctly, they are highly esthetic and will look and feel like your own teeth. Equally important, dental implants are the only tooth replacement option that maintains the jaw bone that is so critical for facial esthetics

Smile Lift Procedure

Esthetic crown lengthening, also known as gum recontouring or a “gum lift”, can instantly provide a new beautiful smile by exposing hidden tooth structure buried under excessive gum tissue. This allows patients to show off their new smile within minutes of the procedure. The doctors at the Florida Institute for Periodontics and Dental Implants have a long and successful history of treating esthetically challenged smiles with esthetic crown lengthening.
Beautiful smiles are the result of several inter-related elements: the teeth, the gums and the lips. There are two instances in which gum recontouring is necessary. First, teeth may appear short and square, often resulting from tooth structure being hidden beneath the gums. This may be accompanied by a high smile line, resulting in the appearance of a ‘Gummy Smile’. In these instances, doctors at the Florida Institute for Periodontics and Dental Implants reshape the gums and supporting tissues. This exposes the unseen portion of your natural teeth, instantly creating a vibrant and healthy looking smile.
In the second instance, patients may want to alter the appearance of their teeth due to wear, poor shape, disproportionate size, or unattractive color. Under these circumstances, gum recontouring provides the restoring doctor with the proper frame onto which new restorations such as veneers and crowns can be placed.
Typically patients experience only mild discomfort and simply require over-the-counter analgesics following this treatment. Providing a balanced and properly designed stage allows teeth to shine beautifully. Esthetic crown lengthening provides some of the most striking and immediate results to our patients.
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