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By Lee R. Cohen, D.D.S., M.S., M.S.
Fear of surgery is considered one of the main reasons why patients avoid treatment options that may help save their teeth. I, a dental phobic (yes I know the irony here), completely understand the anxiety related to a surgical procedure being performed in my mouth. For some unknown reason, the thought of sharp objects operating in my mouth is much more traumatic than on other areas of my body.
My understanding of these fears has led me to seek expertise in advanced treatments that can avoid the use of scalpels, stiches or graft material for my patients.
Periodontal (Gum and Bone)
Issues Often Leading to Tooth Loss:
Avoiding treatment due to surgical anxiety unfortunately lets the alternative, progression of the problem, occur. In the case of periodontal disease, this often means we are headed down the path to losing jaw bone, losing teeth and eventually more expensive (and invasive) treatment options. If there was a way to remove the barrier of fear and increase the amount of preventive treatment provided, many patients would retain their teeth much longer.
People often focus just on cavities. It is equally important to be sure the foundation remains strong to hold the teeth in the jaw. Periodontal disease is the disease of this surrounding gum and bone. A major recent study revealed that periodontal disease occurs in 50% of patients over the age of 30. It is actually more prevalent than Diabetes. We often see this disease manifest in one of two ways:
Gum Recession (loss) – As the gum tissue resorbs away, the bone underneath is also lost. Losing this bone causes teeth to become loose and eventually need to be removed. If you can look in the mirror and see the root of your tooth then you have lost jaw bone!
Periodontitis (Irreversible Jaw Bone Loss) –
A more silent and invisible form of the disease occurs below the gum line and is often not noticed as it is not painful. In this form of periodontal disease a combination of aggressive bacteria under the gum and your body’s response leads to destruction of the jaw bone supporting the teeth. Eventually, this bone loss will likely lead to tooth loss.
The Good News – Advanced Treatment Options without Traditional Surgery:
Scalpel-Free, Suture-Free and Graft-Free procedures are available to help treat both of the types of issues discussed above. These advanced procedures often have significantly less discomfort after surgery and have demonstrated amazing results. Below are procedures we perform regularly to treat the following issues:
Recession: PINHOLE GUM REJUVENATION
Pinhole Gum Rejuvenation is a procedure performed to help treat gum recession and slow jaw bone loss.
It is similar to a laparoscopic procedure performed on the abdomen. The treatment is performed entirely through a “pin hole”. Using specially designed instruments, the gum tissue is loosened and moved over the exposed root to a more ideal position. Because there are no incision or stiches placed, decreased post-operative symptoms occur (pain, bleeding and swelling). In addition, the result is immediate.
Periodontal Disease (Jaw Bone Loss):
LANAP (Laser Periodontal Therapy)
The goal of any periodontal therapy is to decrease the deep space that develops under the gum as jaw bone is lost (we often call this a deep pocket). Traditional surgery typically exposes the area and allows for tissues to be sutured closer to the bone (decreasing the deeper space that exists below the gum). LANAP therapy utilizes a specific laser that has been proven to kill periodontal bacteria while helping form new gum and bone tissue. Instead of surgically opening the area, a healthy space is created that allows your own healing to develop new tissue (bone and gum) and decrease the space between the initial gum level and bone. An easy comparison would be allowing a fracture of the arm to heal. A clot forms and develops new bone and tissue to repair the area. Treatment is painless and no post-operative pain medications are needed.
It is important to realize that no treatment will work in every situation and that a complete periodontal evaluation is needed to determine what treatment is ideal in each case. In our practice, we have seen an incredible response to both of these therapies. Patients have been extremely happy with their outcomes and equally thrilled with the less invasive (and less painful) techniques.
Lee R. Cohen, D.D.S., M.S., M.S., is a Dual Board Certified Periodontal and Dental Implant Surgeon. He is a graduate of Emory University and New York University College of Dentistry.
Dr. Cohen completed his surgical training at the University of Florida / Shands Hospital in Gainesville, Florida. He served as Chief Resident and currently holds a staff appointment as a Clinical Associate Professor in the Department of Periodontics and Dental Implantology. Dr. Cohen lectures, teaches and performs clinical research on topics related to his surgical specialty.
The focus of his interests are conservative approaches to treating gum, bone and tooth loss. He utilizes advanced techniques including the use of the Periolase Dental Laser (LANAP procedure) to help save teeth, dental implants, regenerate supporting bone and treat periodontal disease without the use of traditional surgical procedures. Additionally, Dr. Cohen is certified in Pinhole Gum Rejuvenation, which is a scalpel and suture free procedure to treat gum recession with immediate results.
Dr. Cohen uses in-office, state of the art 3D CT imaging to develop the least invasive dental implant and bone regeneration treatment options. Dr. Cohen and his facility are state certified to perform both IV and Oral Sedation procedures. Botox® and Dermal Fillers are also utilized to enhance patients’ cosmetic outcomes.
Dr. Cohen formerly served on the Board of Trustees for the American Academy of Periodontology and the Florida Dental Association. He is past president of the Florida Association of Periodontists and the Atlantic Coast District Dental Association. Dr. Cohen is a member of the American College of Maxillofacial Implantology and the American Academy of Facial Esthetics. In addition, he has been awarded Fellowship in the American College of Dentists, International College of Dentists and the Pierre Fauchard Academy.
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