Periodontal Cosmetic Surgery in Virginia Beach, Virginia

Man With a Toothache - Dental Care in Virginia Beach, VA
The term “periodontics” refers to the dental specialty that pertains to the prevention, diagnosis and treatment of periodontal disease that affects the gums and jawbone. The gum tissues serve to surround and support the teeth and the underlying jawbone anchors teeth firmly in place. Periodontists have completed several years of extra dental training and are concerned with maintaining the function, health and aesthetics of the jawbone and tissues.

Reasons for periodontal treatment

Periodontal disease is a progressive condition which begins with mild gum inflammation called gingivitis. It is the leading cause of tooth loss in adults living in the developed world, and should be taken very seriously. Periodontal disease (often called gum disease) is typically signified by red, swollen, painful, or bleeding gums, but in some cases has no noticeable symptoms.

Periodontal disease generally begins when the bacteria living in plaque cause an infection in the surrounding tissues of the teeth, causing them to become irritated and painful. Eventually, this infection will; cause the jawbone to recede and the tooth to become loose.

Dental Implant Evaluation & Consultation

There are several reasons why periodontal treatment may be necessary:

  • Moderate/advanced gum disease – This occurs when the gums are bleeding, swollen or red around most teeth and the jawbone has begun to recede.
  • Localized gum recession – The infection which propagates moderate or advanced gum disease often begins in one area. Gum recession may also be caused due to over brushing with a hard bristle brush, or due to a tooth that is not positioned properly. Immediate treatment is required to prevent further spreading.
  • Before crown lengthening – The periodontist may lengthen the crown of the tooth by removing surrounding soft tissue to provide more tooth exposure.
  • Ridge augmentation – This procedure, often called “recontouring” may be required to correct an uneven gum line. Before embarking on treatment, a periodontist needs to treat any bacterial infections and periodontitis.

In the case of mild/moderate periodontal problems, the focus of the periodontist will be on curing the underlying bacterial infection and then providing advice on the most appropriate home cleaning methods.
Sometimes a deep scaling is needed to remove the bacterial plaque and calculus (tartar) from the teeth and tissues. Where periodontal disease is advanced and the jawbone has regressed significantly, more intensive cleaning may be recommended and loose teeth that cannot be saved will be removed.
The periodontist is trained in all aspects of dental implant procedures, which can restore functionality to the mouth when teeth have been affected by periodontitis.
Because periodontal disease is progressive, it is essential to remove the bacteria and calculus build up to halt the spread of the infection. Your dentist will be happy to advise you on effective cleaning methods and treatment options.
Orthodontic Procedures – Cosmetic Crown Lengthening

Short Looking Teeth may actually be the Proper Length

When a patient comes to us with an aesthetic issue such as having an ample amount of gums show when they smile, we have a solution for them. Drs Barr and Marinak have a procedure called cosmetic crown lengthening. This is a periodontal plastic surgery wherein excess gum and bone tissue can be reshaped to expose more of the natural teeth. This can be done for a single tooth or for an entire gum line to increase the area of the teeth for a fuller and less “gummy” smile. Crown lengthening can be done by itself or along with another restorative procedure.

3 Reasons for Crown Lengthening

Crown lengthening is a common procedure that has effective benefits. Most patients who have undergone this surgery are pleased with the results.
Restoration of Damaged Teeth

To increase the clinical crown below the gum line where teeth have been damaged from trauma or decay. Crown lengthening can be used to prepare the area for a restorative procedure and providing enough tooth structure so the new restoration will not come loose.

Cosmetic Surgery

Reduce the amount of extra gum tissue that makes teeth look aesthetically short. This procedure can achieve balanced, healthy looking smile.

Dental Crowns

Crown lengthening creates more space between the supporting bone and crown. This prevents the new crown from damaging gum tissues and bone once it is in place.

What does crown lengthening involve?

Crown lengthening is routinely performed under local anesthetic. This and the time involved to complete the procedure depend and how many teeth, bone and soft tissue are to be treated or removed. Any pre-existing dental crowns will be removed before the procedure, and replaced with new ones afterwards.
During the procedure, the oral surgeon will make a series of small incisions around the soft tissue in order to separate the gums away from the teeth. Even if only one tooth is requiring the reform, adjoining teeth are usually treated to provide a more even reshaping.

The removal of a small amount of tissue may provide enough tooth exposure to place a crown. In other instances, the surgeon will also need to remove a small amount of bone from around the teeth.

When the dentist judges that the correct amount of exposure has been made for the teeth, the treated tissue will be cleaned with sterile water and then be sutured with small stitches. The teeth will look noticeably longer following the surgery because the gums have been repositioned.

Preventing infection, the dentist will then secure the gums with an intraoral bandage. Prescriptions pain relief will be provided and an antimicrobial mouth rinse may be given to help reduce any growth of bacteria. The gums will be completely healed in approximately two to three months.
If you have any questions about crown lengthening, please call Drs. Barr and Marinak.
Periodontal Cosmetic Surgery – Crown and Tooth Lengthening Procedures


Before the fabrication of a crown or the setting of a filling, this procedure may be suggested to adjust the levels of the gum tissue and bone around the tooth. A new gum-to-tooth ratio is formed. Allowing a general dentist to reach the edge of the restoration and ensuring a proper fit to the tooth. It will provide enough tooth structure so the new restoration will not come loose. When you are brushing and flossing daily to prevent decay and gum disease, you will also be cleaning the restoration.

By appearance only, your teeth may appear to be too short. Some people have more gums covering their teeth than others. Underneath the gums the teeth could actually be average in length. To alter this appearance, we can perform the periodontal plastic surgery procedure called cosmetic crown lengthening or tooth lengthening. To do away with the excessive “gummy smile”, crown lengthening creates a new symmetry of the front teeth; developing the preferred proportions the width and height of the teeth. Cosmetic crown lengthening can be done along with other restorative dentistry procedures or by itself as a way to improve the esthetic smile.
Orthodontic Procedures – Gingivectomy

Eliminating excessive or diseased gum tissues to help develop oral hygiene.

In some cases when there is an excess of gum tissue, or cases when the gum disease cannot be cured with antibiotics and root planning, a periodontist or will remove a portion of gum. This may be performed with a laser to help develop proper proportions between the width and height of the teeth. After the gums have been treated, a protective putty may be placed over them while they heal. Depending on the extent of the gingivectomy procedure, it can be a few days or weeks for the gums to heal.

Periodontal Cosmetic Surgery – Minimal Invasive Gum Grafting

When recession of the gingiva (“gum”) occurs, the body loses a natural defense against both bacterial penetration and trauma.

When a patient has recession of the gums, the body begins to lose its natural defense against both bacterial penetration and trauma. In addition getting an unsightly appearance to the gum and tooth, the roots of the teeth increase in their sensitivity to hot and cold foods and liquids. In more advanced conditions, the gum recession can lead to a worsening decline and expose the root surface. Reconstruction of the gums using grafting techniques is a viable option when gum recession is substantial. The gingival graft procedure has predictable results in restoring a stable healthy section of attached tissue around the tooth.

The connective tissue graft.

The connective tissue graft is one of the most influential procedures a periodontal plastic surgeon can perform. Predictable in the capacity to cover the patient’s root surfaces, the result will be a comfortable solution a gum color match. There are variations on the technique that can be applied. One version that we have refined and utilize is be described as the Minimally Invasive Subepithelial Tissue graft (MIST) graft wherein a single incision is made into the palate. This is sutured closed, and the gum tissues in the areas of recession are only separated from the teeth rather than removed.
As no incisions have been made on the outside of the gums, there is no scarring and no color discoloration. The procedure is unnoticeable and the root of the tooth is now covered by gum tissue. This resourceful procedure has predictable results in restoring and preserving the patient’s teeth and gums.
Orthodontic Procedures – Soft, Tissue Gum Augmentation

Recession of the Gingiva

When the gingiva (gum) begin to recede or there is an inadequate amount of gums attached to your teeth, the body loses some of its natural defense system against bacteria and trauma.
To reconstruct the gum tissue, an option is to use grafting techniques. This procedure has a highly predictable outcome which results with a firm band of healthy tissue surrounding the tooth. Typically, procedures such as this are performed before orthodontic treatment to provide enough gum support for moving teeth.

Soft Tissue Grafting

There are many causes for receding gums such as periodontal disease, trauma, and over brushing. Soft tissue grafting is a means of resisting this decline. In some cases, the positioning of teeth lend themselves to gum recession which can lead to exposure of the roots.
When the roots are exposed, the tooth is more vulnerable to tooth decay and become sensitive to hot and cold foods. Soft tissue grafting can aid the tooth by covering the exposed portion and ad the thickening of tissue.

Of the three types of soft tissue grafting are the Connective Tissue Graft, Free Gingival Graft, and the Pedicle Graft.

Connective Tissue Graft

For large areas that need grafting, a cut is made in the mouth to produce a flap. Subepithelial connective tissue is taken from under the flap to be stitched to the gum surrounding the exposed root. The flap is stitched back down again.

Free Gingival Graft

For patients who have thin gums, this procedure will bring additional tissue to increase the gums around the tooth. A small strip of tissue is removed from under the top layer of the roof of the mouth. This tissue is then attached to the area being treated.

Pedicle Graft

During this procedure, the soft gum tissue is grafted from nearby the area being treated. A flap, called a pedicle, is partially cut and pulled over to cover the exposed root, and then it is sewn into place. This can only be done with patients who have enough gum near the tooth.
What does soft tissue grafting treatment involve?

The grafting procedure is generally performed under a local anesthetic depending on the extent of the area being treated. A small incision is made at the recipient site in order to create a small pocket. A split thickness incision is made the connective tissue graft is placed in this pocket and the donor tissue is placed between the two sections of this area. Proteins may be added to simulate and promote tissue growth. Sutures and surgical material will positioned and set to protect the treated area. Substantial healing will take place over the next six weeks.

Benefits of Soft Tissue Grafting

Developments in dental technology have made soft tissue grafting a predictable procedure with many uses to improve the condition of the gums.

Increased Level of Comfort
Soft issue grafting covers the exposed root with healthy gum tissue which can significantly decrease the discomfort from hot and cold foods.

Improved Smile
Soft tissue grafting can also be used as a cosmetic procedure. Recessed gums can emphasize the teeth making them appear to large or uneven. This cosmetic procedure can adjust the gum line aesthetically.

Improved Oral Health
Periodontal disease infects and destroys soft gum tissue. Combined with deep cleaning procedures, soft tissue grafting will protect the gums and can impede gum and bone loss.

If you have any questions about soft tissue grafting and gum augmentation, please call Drs. Barr and Marinak.

Periodontal Cosmetic Surgery – Soft Tissue Gum Graft

Occasionally, the quality of the gums surrounding the tooth is inadequate to resist normal function.

In case where the quality of the gums around the teeth receded has become deficient, an option to improve this condition may be a type of periodontal plastic surgery called a soft tissue graft or gingival graft. With this procedure, donor tissue is obtained from the roof of the mouth and then transplanted to the area around the tooth. In addition to the improvement in the quality of the new tissue, the healthier gums will now be more resistant to future recession.