Well, if you’re the patient getting operated on, maybe you don’t think it’s so cool. Unless you’re the rare exception who likes needles in your gums.

But you should be excited, because this technique will allow your gums to be shaped with minimal risk, pain, and down-time. Its inherently minimally invasive and low-maintenance. There is no cutting or suturing, and healing is quick.

This technique was developed fairly recently by a man named Dr. Chao, and it is taking off internationally as the preferred method of gum shaping after periodontal or gingival treatment.

Note that this is solely meant to restore the gum line for the purpose of aesthetics and functionality. It is not gum disease treatment, and it must be done in a disease-free mouth. So this is something I’d do after my patient has successfully undergone therapy for gum disease and only needs the gums to shrink back up around the teeth.

It sure beats the traditional method, however, of grafting gum tissue from another area of the mouth.

Dr. Sperbeck, West Los Angeles

How do people end up with recessed gums? Gum recession is a common result brought about by gum disease  (or its more advanced stages of gingivitis and periodontitis) and abrasive over-brushing (brushing your teeth too harshly too often with the wrong brush). Perhaps poor dental work in the past has caused an imbalance in the mouth, possibly a bite malfunction that has, over time, negatively affected occlusal (bite) functionality.

As a side note, yes, even slight imbalances in bite mechanics can cause long-term diseases and vulnerabilities that seem unrelated. That’s why holistic dentistry is so important: we get to the root of the problem, considering the whole patient. If you try treating gum recession without first considering the possibility of TMJ problems, mercury poisoning and tissue rejection from amalgam fillings, or miscalculated restorations, you may only have to do it again, with poorer results each time.

So why is gum recession a problem? Recessed gums weaken and loosen the roots of teeth, exposing the vulnerable parts to physical injury and infectious bacteria. Gum recession sets the stage for tooth decay and tooth loss. Practicality aside, bad cases of gum recession are not aesthetically pleasing and may cause patients to be self-conscious.

In my next post, I’ll talk a little bit more about the Pinhole Surgery Technique (PST) by Dr. Chao that’s used to correct gum recession without surgery.

What about you? Have you had any experience with gum recession, or do you know someone else who has? News of this Pinhole Surgery Technique may be a welcome relief, then… or maybe something you wish your dentist knew a long time ago.

Dr. Sperbeck, West Los Angeles

Traditionally, the way gum recession is treated is by performing gum grafts. Gum grafts are essentially stitching extra gum tissue (taken from elsewhere in the patient’s mouth) to the affected area, sewing everything up, and waiting several months for it to merge and heal and return the patient to normal. This method is effective and is how dentists are trained to treat more severe cases of gum recession. However, gum grafting is slow, invasive, riskier, and generally an involved, expensive process that interferes with the patient’s daily life.

That’s why I am so excited about the PST. If you saw the video I previously shared, you can see an illustration of the two methods compared side-by-side. The PST is a quick, simple, low-maintenance procedure with healthy and natural-looking results. I imagine patients would watch it and think, “Why on earth have dentists not come up with this sooner?” I agree. Sometimes solutions come along that are just so logical, so sensible, it makes you wonder why we even started out with more complicated treatments. Kudos to Dr. Chao!

PST is a method by which a tool is inserted directly into the gum tissue and is used to gently, partially separate the tissue from the underlying facial bones. The tool is like a hooked needle, which sounds awful, but it means nothing gets sliced up; the only mark left behind is — you guessed it — a little pinhole that heals up in a matter of hours.

After the insertion and loosening of the gum tissue, the gums are then pushed downward (or upward, depending on where we’re working) in sweeping motions around sterile teeth. When the gums are nice and cozy up against the teeth again, treatment is finished. Collagen is then inserted behind the gums to stabilize them and speed up the healing process.

Essentially, the Pinhole Technique not only physically manipulates the gums so that they once again surround and envelop the teeth, but also stimulates the surrounding area so the gums continue to grow and flourish and stay put in their proper place. A clean, disease-free environment is important, however, and this technique is not appropriate while gum disease is present.

Healing takes place in a matter of days, even overnight for some cases. The patient may not have to take time off work or interrupt his or her busy life. The pain and medical risks are minimal, if any. It is truly amazing, and I’m excited to incorporate it into my practice. I hope many future patients will benefit from this new technique.

Dr. Sperbeck, West Los Angeles

I wrote a post on pericoronitis some time ago, and it remains the most popular post on this blog.

I’m going to pose a new concept for many readers:  Did you know that all of our adult teeth are supposed to fit in our mouths? And did you know that the reason they don’t is because of nutritional deficiencies starting from the time of conception in the womb and carrying on into a child’s adolescence? Crowded, crooked, and impacted teeth are a result of underdeveloped skull, facial, and palate structure. The exact causes behind an underdeveloped skull and skeleton are details for another post, maybe a different blog entirely, or you can overwhelm yourself with incredible information on this site or in this book. However, although other factors contribute, you can be sure that diet plays the leading role in determining both short- and long-term tooth and bone health.

That being said, if we and our mothers all had perfect diets, pericoronitis would be a rare infection. But it is not. Pericoronitis is ubiquitous nowadays because the health of our society has swiftly deteriorated in the last century, thus wisdom teeth have no room to grow straight or emerge quickly in our small skulls and narrow palates. It’s too bad that the time for prevention and healthy bone development is long past by the time wisdom teeth start coming in for most people. Invasive surgeries and removals are not only normal, but expected.

Since wisdom teeth typically grow in crookedly, large pockets between the tooth and gums form as the tooth erupts slowly, partially, or in the wrong direction. These pockets are hard to see and reach for cleaning. They are perfect breeding grounds for infection if malignant bacteria find their way to the area and set up camp. The infection feels more serious than it really is, but it should be monitored because it could easily spread and become a sincere threat to your immune system (although the pain is almost always enough to get your attention). It can last for about two weeks, give or take. The minute your gums feel sore in the area is the minute you need to find a sink, an irrigator, and hydrogen peroxide. A clean mouth and a steady intake of probiotics are essential for overcoming this miserable form of gum disease.

Anyone out there suffering from it right now? My next post will go over some of the more useful, natural ways to soothe the pain and help your body fight the infection.

Dr. Sperbeck, West Los Angeles

There are different degrees of gum disease. Sometimes it’s mild, manifesting itself as soft tissue swelling, redness, or sensitivity. Other times it’s severe, probably a case that has been neglected too long. Recessed tissues, deep pockets, extreme pain, bad tastes/smells, and an ongoing infection are indicative of periodontitis.

If you have been diagnosed with periodontitis, your level of treatment will depend on the severity of your case. Obviously, mild cases will heal up quickly if you receive prompt treatment and you take care of yourself. A more serious condition of gum disease could take months to properly recover from. Diseased gums that have shrunken and shriveled off teeth need time and a clean, clean environment in order to grow back and fit snugly around them again.

Conventional periodontal therapy/surgery is effective but invasive. In order to remove diseased tissue, parts of the gums and teeth may be simply cut out instead of treated. Ironically, this kind of treatment leads to a longer, harder recovery and can weaken oral health permanently. Risk of mistakes on the dentist’s part increase as well.

In a holistic practice, however, where a laser is used in conjunction with ozone gas, surgery is almost never necessary. Dental laser wavelengths can be calibrated, in a sense, to perform many different functions ranging from gentle cleaning of diseased tissue — without damaging normal tissues in the same area — to cutting and reshaping of tissue. It is completely non-toxic and much less painful than regular slicing and dicing because of its inherent cauterizing properties. Bacteria cannot survive under a laser’s beam, so the process of sterilization is furthermore simplified, especially with additional blasts of ozone gas. Not to mention, recovery is faster and smoother because of minimal intervention and blood flow stimulation.

Perhaps you’ve been diagnosed with gum disease. During an initial inspection of your periodontal health, the degree of the disease will be evaluated and your individual prognosis will be determined. You’ll be instructed on the steps you must take in order to heal. At your appointment, your mouth and teeth will be cleaned and thoroughly prepared so the environment is in the best possible shape for a temporary “construction zone.”

At the site of treatment, the gum pocket(s) will be separated from the tooth with an instrument, and the laser will be used to clean away the infection and dead/decaying parts of the tooth and gums. All exposed surfaces of the tooth and gums are prepared to bond together again so healing may occur. Blood clotting stimulation may be administered to further speed up healing. The process is quite speedy; most cases can be taken care of in a single appointment and may also leave the patient in conditions good enough to return to work the next day.

As always, however, the best cure for a disease or infection is prevention in the first place. My laser adds a fantastic element of superior dental care to this practice, but as the patient, preventing gum disease by yourself in the first place is the best route to take.

Happy flossing!

Dr. Sperbeck, West Los Angeles

I recently purchased a PerioLase dental laser. It’s a fabulous tool.

Periodontitis, or gum disease, happens when a bacterial infection develops between the teeth and gums. Naturally, gums are supposed to fit around the teeth snugly. A shallow pocket, however, does exist between healthy teeth and gums, one that should not be deep, painful, or swollen.

The presence of these pockets is why it’s so important to floss. Too many people are lazy about flossing and/or irrigating. The truth is that food will get stuck in those pockets and literally rot right there in your mouth. Pathogenic bacteria will find that leftover food and feast on it. Unfortunately, surrounding tissues are victimized as well while the body’s immune system tries to eliminate the infection. Oral sensitivity, pain, and bad smells will ensue. It sounds disgusting because it is. So floss!

Treating periodontitis traditionally has required incisions and stitches; that means pain and bleeding. Surgical methods of gum disease therapy are still the norm. The vast majority of dentists don’t care for the cost and training involved in adding a laser to their practice. Their reasoning is that it cannot completely replace a drill, so why bother?

The beauty of laser therapy is that it is clean, quick, and virtually painless. There is little to no need for anesthesia (which, if needed, would be local) and it yields great results. One laser can be adjusted to different strengths for different uses. I’ll go over that and how we’d apply it to real-life situations in the next post.

Dr. Sperbeck, West Los Angeles