Periodontal Info

Implants, Periodontal Care,
& Oral Hygiene

Gum Grafting

When recession of the gingiva occurs, the body loses a natural defense against both bacterial penetration and trauma.  When gum recession is a problem, gum reconstruction using grafting techniques is an excellent treatment option.

When there is minor gum recession, some healthy gingiva often remains and protects the tooth so that no special treatment other than modifying home care practices is necessary.  When recession reaches the mucosa, the first line of defense against bacterial penetration is lost.  Gum recession often results in root sensitivity to hot and cold foods, and also to unsightly appearance of the gum and tooth.

A gingival graft is designed to solve these issues.  A thin piece of tissue is taken from the root of the mouth or gently moved over from adjacent areas to provide a stable band of attached gingiva around the tooth.  The gingival graft may be placed in such a way as to cover the exposed portion of the tooth.

Crown Lengthening & Gum Contouring

Sometimes patient’s teeth are quite small in relations to the gum tissue.  This can create an unattractive look –“gummy smile.”  Uneven gum lines can also be unattractive.  

The gum line and the bone just beneath the gum line can be lowered to change the appearance of your smile by exposing more of your natural teeth.  This treatment will create a more even gum line or make the teeth appear longer.  Gingival contouring is the process of re-contouring the gum only.  Crown lengthening refers to recontouring of both gum and supporting bone.

Ridge Augmentation

There are cases sometimes after an extraction, a sunken spot or concave appearance will develop in a patient’s gum line.  This may look unsightly and may jeopardize the appearance of a bridge that goes over the area.  Bone grafting material can be inserted under the gum to fill out this depression.  Ridge augmentation can also be used to build up an area of bone so that a dental implant can be placed.  

Periodontal Surgery for Orthodontics

Sometimes the orthodontist needs to work with a periodontist in order to achieve beautiful smiles.  Periodontal plastic surgery and dental implants can be done by a Periodontist in conjunction with braces to ensure optimal results.  Periodontist can also help with tooth extraction to make space in patients with crowing, or uncover teeth that are impacted in bone.


Temporary anchorage devices are utilized in conjunction with orthodontics to assist in moving teeth.  This specific procedure involves placement of the TAD (titanium bone anchor) directly through the gums into the bone.  TADS usage is revolutionary, eliminating unwanted moving of anchorage teeth, decreasing treatment time, and making headgear a thing of the past!

Canine Exposure

Canine Exposure involves opening a flap and removing small amounts of bone in order to bond orthodontic “button” to a tooth that is not properly positioned in the arch.  Once the button is bonded to the tooth, the orthodontist can move this tooth into the appropriate place.

Free Gingival Grafts (FGG)

 The Free Gingival Graft (FGG) is a surgical procedure performed by a Periodontist to increase the amount of keratinized surrounding a tooth or a dental implant.  Keratinized tissue plays a significant role helping to maintain and facilitate oral hygiene.  Dr. John Miller will discuss the benefits of Free Gingival Graft (FGG) in your consultation.  

Periodontally Accelerated Osteogenic Orthodontics (PAOO)

PAOO is ideal for patients who desire braces, but do not want to go through the long treatment time.  The PAOO treatment involves a procedure where the gum tissue is gently separated from the bone, making a “flap.”  The bone is then activated by creating small cuts into the bone to facilitate the orthodontic movement, and the sites are then augmented with graft material.  After this treatment, orthodontic treatment begins.  PAOO decreases the treatment time (1 year to 6 months, 2 years to 6-8 months), enhances the range of movement, requires fewer permanent extractions, and less root resorption has been reported.

Cosmetic Periodontal Surgery

Cosmetic periodontal procedures are a conventional way to cover unsightly, sensitive or exposed root surfaces and to prevent further gum recession.  If you are not happy with the appearance of short, unsightly teeth, we can help with cosmetic periodontal surgery.  

Although your teeth appear short, they may in fact be the proper length.  The teeth may be covered with too much gum tissue.  Dr. John Miller can correct this by performing the periodontal plastic surgery, crown lengthening.  During this procedure, excess gum and bone tissue are reshaped to expose more of the natural tooth.  

Another cosmetic procedure performed by Dr. John Miller is the soft tissue graft.  This procedure is used to cover unattractive tooth roots, reduce gum recession and protect the roots from decay and eventual loss.  Tooth loss causes the jawbone to recede and can lead to unnatural looking indentation in a patients gums and jaw, and appearance of general aging.  The original look of your mouth may not be recaptured because of the spaces remaining under and between replacement teeth.  They may appear too long compared to nearby teeth.