High-Tech Tools Clean Gums, Redo Smile

Laser kills periodontal disease. A 3D system places new teeth precisely.

Somewhere between Illinois and Florida, there’s a Goldilocks climate that’s not too cold in the winter and not too hot in the summer that Mike Foley would consider the ideal place to live. He just hasn’t found it yet.

Mike worked as a firefighter in his native Chicago for 34 years. When he retired a few years ago, Mike and his wife moved to Florida. However, he soon soured on the Sunshine State.

“My wife likes the weather, but if it were up to me, I’d be long gone from here,” Mike says. “It’s way too hot for me. But Chicago is way too cold. What I remember most about being a fireman up there is freezing like a Popsicle.”

During those frozen years, Mike let something go far too long – a serious dental issue that he finally addressed soon after the move south.

“I’ve had real bad crowding of my lower front four teeth all my life,” Mike details. “As I got older, those teeth also became loose, which was a bit of a problem. Because I couldn’t really bite into anything normally, I would always cut up my food into smaller pieces and chew it in the back of my mouth. When you’ve got a problem, sometimes you just adapt.”

Eventually, he went for a general cleaning from Joseph H. Farag, DMD, of Port Charlotte Dental Care. It was then that he learned the cause and extent of the issues he had long ignored.

“The dentist told me I’d be wasting my time with the cleaning because I had bad gum disease,” Mike remembers. “He said that was why my teeth were loose and that I needed to take care of that before we did anything else.”

LANAP Procedure

While evaluating Mike’s case, Dr. Farag explained that he could correct the gum disease by performing a gum treatment called LANAP, or laser-assisted new attachment procedure. It’s a treatment that, in addition to healing ailing gum tissue, can also improve the quality and density of the jawbone. In some cases, it can even spark the generation of new bone.

“Using the LANAP procedure, we are able to treat a patient’s entire mouth in about two hours,” Dr. Farag explains. “During that time, we make three passes with the laser and clean, disinfect and sanitize the gums without cutting anything open.”

During the first pass, Dr. Farag details, the energy from the laser kills all bacteria in the gums, vaporizes the diseased gum tissue and dehydrates tartar on the teeth, which makes the tartar brittle and easy to remove.

During the second pass, the tartar is removed with a fine-tipped, vibrating, ultrasonic instrument. The teeth are then rinsed with an antimicrobial substance that halts the growth of bacteria. The diseased lining of the tissue is removed, and the bone surrounding the teeth is debrided of infected tissue.

During the final pass, an antimicrobial seal is created that prevents reinfection and releases growth factors from blood cells that help regenerate the attachment between the gums and the teeth.

“The patient doesn’t have any sensation of what we’re doing because we use a local dental anesthetic, just as if we’re doing a filling,” Dr. Farag says.

“That’s how patients stay comfortable during the process. And there’s no postop discomfort because we’re not traumatizing anything. The gums are not inflamed, so they’re not painful.”

Afterward, the patient is asked to briefly stay on a soft-food diet to prevent tearing of the new tissue, the dentist points out.

Dr. Farag recommended the LANAP treatment in part because he hoped it would allow Mike to retain his loose lower front teeth. However, Dr. Farag discovered that the damage to the jawbone holding those teeth was too extensive.

“Because of the severity of the periodontal disease, Mike had lost about 90 percent of the bone in that lower front area,” Dr. Farag confirms. “That’s why his teeth were so loose and why we eventually had to extract them.”

Replacement Plan

To replace the extracted teeth, Dr. Farag recommended a plan in which he would use two dental implants as the foundation for a fixed four-tooth bridge that would restore proper function and greatly enhance the aesthetics of Mike’s smile.

Dental implants are root-shaped, screw-like bodies that are surgically placed into the jawbone. Once an implant is in the jaw, bone naturally grows around it to form the foundation for an abutment and replacement teeth.

The replacement teeth can be a crown cemented or screwed onto the abutment, a partial bridge that can be affixed to one or more implants, or a full denture that can be fastened to a series of implants.

Prior to seating an implant, some patients require a bone graft designed to enhance the volume of the jawbone. By using autologous bone or a synthetic bone substitute, the graft gives the jawbone the strength to support an implant.

Bone grafts are not always necessary, but for patients who have been missing teeth for many years, they are often required because bone mass deteriorates when there is no pressure from chewing to stimulate natural bone regeneration.

“I can eat anything I want now.… And my teeth look great.” – Mike

Mike had suffered a great deal of bone loss in the lower front area of his mouth, but Dr. Farag was able to avoid performing a bone graft by using a 3D planning platform called X-Guide® to determine the precise placement and size of the implants.

“The lower teeth are pretty small in diameter and there wasn’t much bone left, but the X-Guide system allowed us to get the right diameter implants and place them in the sockets of what bone we had left to work with,” Dr. Farag reports.

“That’s the great advantage of the X-Guide system. It allows us to do all the planning virtually on a computer, where we can see exactly how the implants will line up with the opposing jawbone and teeth that we’re keeping.”

Smile With Pride

The final phase of Mike’s treatment plan was the placement of the implants and the creation of a bridge. After wearing a temporary bridge that allowed the implants to fuse properly with the jawbone, Mike was fit with a permanent bridge.

Mike now has a smile he’s proud of and lower teeth that are strong enough to bite into any sandwich, apple or corn cob. Not surprisingly, he says the work Dr. Farag did has made his life better and easier.

“I can eat anything I want now, and I don’t have to cut everything up before I eat it, which is really nice,” he says. “And my teeth look great. Those lower four teeth aren’t crowded anymore the way they used to be. They look perfect.

“Dr. Farag did a great job, and there was no pain or anything. I was a little worried about that because I’d heard some horror stories about what happens when you have gum treatment, but the LANAP procedure went just fine.

“I definitely feel like I made the right choice in going to see Dr. Farag because he’s got all the right tools a dentist needs to do things right. And he’s a good guy, no nonsense. I gladly recommend him to anyone. In fact, I already have.”

© FHCN article by Roy Cummings. mkb
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    • Port Charlotte Dental Care

      Dr. Farag provides a full range of quality, caring dental services to the Port Charlotte community. He looks forward to hearing from the viewers of the Florida Health Care News website. For more information or to schedule an appointment, pl... Read More

    • Joseph H. Farag, DMD

      Joseph H. Farag, DMD, earned his Doctor of Dental Medicine degree from the University of Florida College of Dentistry, Gainesville, FL after completing his undergraduate degree at Florida Atlantic University, Boca Raton, FL. Dr. Farag served an... Read More