Occlusal Adjustment & Re-evalauation
After the completion of your SRP's and OHI a comprehensive periodontal exam will be performed by Drs. Dennis Nishimine, Dee Nishimine, & Sophia Tseng. At this time we will see how much healing response has occurred to your gum tissues. This may be very dramatic because of your excellent daily Oral Hygiene procedures of brushing and flossing and the extensive SRP's that have been provided.
Occlusal Analysis and Adjustment
We will evaluate the occlusion (your bite) very carefully. As the healing has occurred, and the swelling of the gums have diminished the teeth may be hitting differently. We want the bite to be uniform and the pressure equally distributed on all of your teeth. We may provide minor occlusal adjustment to your teeth.
If your are having headaches or severe pain or discomfort to the Temporal Mandibular Joint, the occlusion may have a contributory role and much of this may be alleviated with occlusal equilibration. We will evaluate this very carefully and may refer you to other doctors that have greater training and expertise than we do.
The re-evaluation and new periodontal probings will provide input and allow us to determine your course of therapy. Ideally we want the pockets depths to be below 5mm in depth with no bleeding upon probing (BOP). If the pocket depths are greater than 5 mm or there is a lack of attached tissue Corrective Procedures are indicated to bring things back to a state of health.
Pocket depths that are greater than 5 mm and BOP should be treated to reduce them to below 3 mm in depth. Pockets that are deep indicate severe bone loss, or craters around the teeth that have lost bone. We are able to rebuild or regenerate the missing bone for you and reduce the pocket to bring them back to a state of health that you then can maintain. Your OHI on a daily basis of Brushing and Flossing are the key to long term success.
If you are lacking Attached Keratinized Tissue, gum recession we will recommend that we build this up with Soft Tissue Grafting. This will allow us to create a "mechanical barrier" for you and cover up the exposed root surfaces. This will enhance the aesthetics, reduce the sensitivity, and prevent tooth decay.
If Corrective Procedures are indicated we will discuss them at length at that time. We will make sure that you are very comfortable and sedation will be provided if needed. We want you to ask yourself where do you want to be with your oral health 15-30 years down the road. Periodontal therapy and dental implants will be very beneficial and we want to create "Beautiful Smiles Through Periodontics & Dental Implants."