Picture 2 | Bonomo Periodontics


Click on the headings below to learn more about each topic.


What is Recession?
Recession is a common biologic process in which the protective gum tissue around the tooth migrates away from the top of the tooth. This results in exposure of the root surface and a narrowing of the protective band of tissue. The tooth may become sensitive to hot, cold and sweet foods and appears longer than the adjacent teeth.

What causes recession to happen?
Recession can be caused by many different factors but the most common cause is related to ones genetics. Individuals who have thin gum tissues are more susceptible to recession. These thin tissues do not tolerate the typical "wear and tear," as well as thick tissues and as a result they break down (recede). It is not uncommon for a patient to discover one or more family members who have recession or have been treated for it. There are several known factors that contribute to this condition. Some of them include: aggressive tooth brushing, inflammation from plaque, tooth grinding/clenching, oral piercings and direct trauma.

Why should I treat it?
In health, a tooth is surrounded by two types of tissue. The tissue immediately next to the tooth is gingiva (gums). It is thick fibrous and pink in color. This tissue is important because it provides a tight seal around the tooth to prevent penetration of bacteria to the underlying supporting bone. It also helps to prevent against trauma from tooth brushing, food impaction, etc. Just below the gingiva is the mucosal tissue. This tissue is red, thin and loose. It does not seal tightly around the tooth and is easily susceptible to bacterial inflammation and trauma.

When recession occurs, the band of protective tissue gets narrower and the body begins to lose it's natural defense against bacterial invasion. Failure to treat this condition can result in continued recession, gingival infection, tooth sensitivity, unsightly appearance and even tooth loss. Early intervention is key to keeping the cost, surgical trauma and post operative discomfort to a minimum.

The greater the recession the bigger the surgery!

Gum Grafting

Your dentist may have informed you that you have recession and need a gum graft. While there are several different types of grafts and techniques they all serve to make the tooth and surrounding gums stronger and more stable.

What is a gum graft?
A gum graft is a minor procedure in which we reinforce week gum tissues and in some cases, replace missing gum tissues to improve the appearance, function, stability and comfort of the teeth. The grafted tissue is usually taken from the patient at the time of the procedure and in some cases a donor tissue can be used.

Does it hurt?
A patient undergoing a gum graft should anticipate a healing period of 7 to 10 days. During this time a level of tenderness is perfectly normal and expected. Pain medications are always prescribed to keep the tenderness at a minimum, and can be supplemented to keep the patient comfortable. If a patient experiences pain it is typically due to over activity on the patients part or improper/insufficient use of the pain medication. A phone call to Dr. Bonomo's office is usually all that is required to get the patient back on the right regimen.

How much does it cost and will my insurance pay for it?
Since treatment needs differ from patient to patient and the various techniques differ in their price, it is impossible to estimate cost without an examination. However, we do provide each patient with a detailed treatment plan after their initial consultation which outlines the cost of their treatment.

The majority of insurance companies do cover gum grafting procedures. Unfortunately, finding out what is covered and how much can be very frustrating and confusing for the inexperienced patient. Our experienced staff is happy to assist in the processing of our patients claims, and can often give helpful advice on how to approach treatment while maximizing your benefits.

Gum Grafting Techniques
This is not an all encompassing description but rather a brief overview of the different grafts. Each graft has certain advantages and disadvantages and you should consult with Dr. Bonomo to discuss which type of graft is best suited for your situation.

Epithelial Soft Tissue Graft (free gingival graft)
This graft utilizes the patient's own tissue to reinforce and strengthen the band of gingiva around the tooth. The graft is sutured into place utilizing resorbable stitches that will dissolve naturally within a few days. Healing time is 7-10 days.

Subepithelial Tissue Graft (connective tissue graft)
This graft utilizes the patient's own tissue to cover exposed root surfaces that may be sensitive or unsightly. The graft is sutured into place utilizing resorbable stitches that will dissolve naturally within a few days. Healing time is 7-10 days.

Donor Graft (acellular dermal graft)
This graft is identical to the subepithelial tissue graft except it utilizes a donor tissue instead of the patients tissue to cover the exposed root surface. These materials are a safe and FDA approved. They are also widely used in both dentistry and medicine.

Dental Implants

What is a dental implant?
It is the most advanced means of replacing a missing tooth (teeth). It is similar in appearance to a screw and is made of surgical grade titanium, the same material that is used in artificial joints. The implant or fixture replaces the root portion of the tooth, and is positioned even with or just below the gums. Most patients do not even notice it is there. Once the bone is adequately healed to the implant, the restorative dentist can make a tooth to secure to this new, artificial root.

Does it hurt?
Dental implants are typically associated with very little post operative discomfort. Pain medications are always prescribed, but the majority of patients need them only for the first day or two.

How long does it take?
The implant procedure typically takes about 40 minutes to 1 hour. During that time, the patient is comfortable and numb. Most procedures are performed under conscious sedation and are completed within the office. Dental implants are the most advanced, and most permanent means of replacing missing teeth. The success rate of these devices is in the range of 96% to 98%.

Gum Disease Treatment

What is Gum Disease?
Gum disease is typically, but not exclusively, an inherited condition which caused by the build-up of bacterial plaque and results in the loss of bone support around the teeth. The term Gum Disease is somewhat misleading because it implies that only the gums are being affected. It undoubtedly originated because the gums often appear red, inflamed and can bleed easily. The truth is that this is a disease of the bone. The current medical name for this disease is periodontitis or periodontal disease, but some people know it by it's original name piorea.

What causes Gum Disease?
Gum Disease is caused by the buildup of bacteria (plaque) on and around the teeth. Certain types of bacteria within this plaque cause an aggressive immune response in the gums. The interplay between the bacteria and the patients immune response result in the destruction of the adjacent bone structure.

Why should I treat it?
The disease is innately progressive and, if left untreated, will eventually result in tooth loss. For some patients this is not enough of a deterrent to seek treatment. Unfortunately for those individuals, the progression of the disease typically has some unpleasant side effects.

Most patients with moderate and severe disease complain of having noticeably bad breath, bleeding gums, loose teeth and temperature sensitivity. Diet is commonly modified by patients suffering from this condition and some foods become prohibitive.

Probably the strongest reason for seeking treatment is that gum disease has been linked to heart disease, heart attacks and strokes. It has also been shown to contribute to diabetic instability, and preterm-low birth weight babies.

How do you treat it?
There are several adjunctive treatments available but most are used in combination with either non surgical (deep cleaning) or surgical therapies. After initial diagnosis of periodontal disease most patients are set up with an appointment for a deep cleaning. If residual disease is still present after this first phase of treatment, surgical therapy is often indicated. With treatment, regular cleanings and proper home care, most patients can experience decades or even permanent inactivity of the disease.

Deep Cleaning

Your dentist or Dr. Bonomo may have informed you that you need a deep cleaning.
The purpose of this procedure is to remove bacteria that has accumulated below the gums. The treatment can last up to 4 hours depending on the severity of the condition. Special medications are typically given to the patient, and are taken 1 hour before the scheduled appointment. These medications relax and mildly sedate the patient for the duration of the cleaning appointment. Local anesthetics are also used to ensure the patient is comfortable and enable the hygienist to effectively access all structures below the gums.

This procedure is non surgical and associated with little discomfort.


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