Periodontal (or gum) inflammation is a response of the body to the onslaught of bacterial toxins and acids underneath the gums. Various factors such as diabetes, smoking, genetics, etc. can change the severity of the body’s response to these bacterial products. Inflammation results in redness and swelling of the gums. The body will send a lot of immune cells to try to remove the irritating substances that are residing in the gums. This immune response is essential for the body to ward off infections, however, in a situation where the oral hygiene is not good, the inflammatory response becomes chronic and the body is not able to return to normal health. This causes the eventual breakdown of the bone that holds the teeth in place. Symptoms of periodontal inflammation include bleeding and red gums. More advanced cases lead to loosening of the teeth and pus exuding from the gums. The by-products of inflammation eventually overtake the body’s system of repair resulting in permanent damage. The only way to break this cycle is by performing meticulous oral hygiene (simple brushing and flossing) on a daily basis.
To place an implant, there must be an adequate amount of bone to bear the brunt of the bite. In the upper molar area, it is very common to be short of bone for implants since the maxillary sinus is located right above it. Since the bone shrinks once a tooth is removed, it is not unusual to find only a few millimeters of bone remaining. In these cases, a procedure called a sinus lift bone graft is available. In a sinus lift, a flap of gum is retracted from the upper jaw in the molar area, and a small window is cut into the bone being careful to not lacerate the sinus membrane. The sinus membrane is gently “lifted” and a bone graft material is placed in the hollowed out space in between the lower part of the sinus bone and the membrane. The surgical site is closed and allowed to heal undisturbed for a number of months. At this point, the bone will be fully organized and ready for implant placement. A sinus lift procedure has over 90% success rate. The feedback that I have gotten from patients as far as the recovery from the procedure has been very favorable. The technique opens up many more opportunities to restore the upper jaw with implants instead of having to resort to dentures.