Our Services

Following are some of the procedures that Dr. Layport uses to treat patients diagnosed with a periodontal (gum) disease. A periodontist is a dentist who specializes in the prevention, diagnosis and treatment of periodontal disease. Dr. Layport has received extensive training in these areas, including up to three additional years of education beyond dental school.

Contact us with any questions about our services.

Scaling and Root Planing
There are several methods of non-surgical periodontal therapy that are available. During your consultation with Dr. Layport, she will recommend the best course of treatment for you based upon your individual diagnosis.

Scaling is a cleaning procedure that removes plaque and calculus from the teeth at or slightly below the gumline. Root Planing removes deposits to the bottom of the pocket. The root surfaces are also smoothed which allows for tightening of the gum tissue and reduces the pocket depth.

At Dr. Layport's office, Scaling and Root Planing (SRP) is typically done in two 1-1/2 hour appointments by Dr. Layport or by one of her hygienists. The deep areas will be numbed with local anesthetic. An ultrasonic scaler (Cavitron) is used as well as hand instruments (scalers).

This type of treatment may be all that's needed, especially when periodontal disease is caught early.

Occlusal Therapy
An imbalanced bite may increase or speed up bone destruction. Adjusting the bite (carefully grinding a thin layer of the teeth that are hitting too hard) allows the teeth to meet properly and distributes stress to stronger teeth.

A biteguard (also called a nightguard) is a removable appliance that is typically worn at night to protect the teeth and to relax the jaw muscles. These are usually needed by people who clench or grind their teeth (bruxism), which is a common habit associated with stress or TMJ problems.

Splinting is occasionally needed to attach loose teeth together, making you feel more comfortable.

Antibiotic Placement
Because bacteria cause periodontal disease, antibiotics are used if scaling and root planing alone are not enough to control the disease.

Systemic antibiotics are used by Dr. Layport primarily for Early-Onset Periodontitis (bone loss before age 35) and for Refractory Cases (disease that is only slowed and not stopped by our usual treatments).

Typically Doxycycline, a tetracycline type of antibiotic, is used. Metronidazole (Flagyl) and Amoxicillin or Augmentin are commonly used together in aggressive cases. Periostat is a low-dose form of Doxycycline which is primarily used for long-term use in Refractory patients. The dosage is low enough that the bacteria are not killed, and do not form resistance to the antibiotic. The beneficial effect derives from a side effect that helps prevent collagen (gum tissue fibers) breakdown by enzyme suppression.

Localized antibiotic placement is an actively changing part of periodontal therapy. Currently Dr. Layport uses Arestin, which is Minocycline in a powder form, in localized problem areas. A Metronidazole chip is expected to be approved for use soon. Chlorhexidine is an antibacterial mouthwash which can be used for irrigation in localized problem pockets as well as a general mouthwash in certain circumstances.

Crown Lengthening
If you're not happy with your smile, there are cosmetic periodontal and dental procedures available now that could help you achieve the look and smile you want.

Do you have a "gummy smile"? Are your teeth too long? Periodontists today can help you reshape your gum-line to expose your ideal smile. In addition, they can work with your dentist to create the foundation for beautiful crowns, veneers, etc. to be constructed on your front teeth.

If you feel that your teeth are too short and your smile is too "gummy" or that your gum-line is uneven, covering too much of some teeth, while leaving others the right length, a simple cosmetic treatment might be just right for you.

Crown lengthening and gingivectomy procedures remove the excess gum tissue to expose more of the visible "crown" of the tooth.

Long teeth or exposed roots:
Soft tissue grafts and other root coverage procedures are designed to cover exposed roots, to reduce the chance for further gum recession, and to protect your vulnerable roots from decay.

When a tooth is fractured or decay extends below the gumline, this area must be uncovered before it can be restored, for several reasons:

•  In order for the gum to heal against the tooth in a healthy manner, there must be 3 millimeters of healthy tooth between the margin of a filling or crown (cap) and the crest of the bone which supports the tooth. This is called biologic width.
•  A tooth that is broken or decayed below the gumline is difficult, if not impossible, for your dentist to restore correctly since access and visibility are compromised.
•  Inadequate retention form means there is not enough tooth structure left above the gumline to firmly hold a crown.
•  In addition, even the best filling or crown will trap bacteria where it meets the tooth. If this area is below the gumline where you cannot properly clean it, the bacterial accumulation can result in both periodontal problems and new decay.

A crown lengthening procedure reshapes the gum and bone to solve these problems.

Dental Implants
Missing teeth:
Dental implants are replacement teeth that feel and look just like your own. An artificial tooth root made of titanium is placed into your jaw, and after a healing period, an artificial tooth is attached to the post. Dental implants can be more tooth-saving than traditional bridgework, since neighboring teeth do not have to be ground down to support the replacement.

Indentations in the gums and jawbone:
Sometimes when you lose one or more teeth, you can get an indentation in your gums and jawbone where the tooth used to be. Your periodontist can fill in this "defect" with a procedure called ridge augmentation. A new tooth can then be created that is natural looking, easy to clean and beautiful.

Gingival Grafting
A tooth is surrounded by two types of tissue. The first is gingiva (gum), which is pink, thick and dense. It is also called keratinized tissue. Gingiva forms a tight seal around the tooth which serves as a barrier against the penetration of bacteria to the underlying bone. The gingiva also helps to withstand trauma from brushing, eating, etc. The other type of tissue, mucosa, found directly below the gingiva, is red, thin and loose or elastic. It does not seal tightly around the tooth, nor does it withstand trauma well (as shown by how easily you can "scratch" the floor of the mouth).

When gum recession occurs, the body loses a natural defense against both bacterial penetration and trauma. When there is only minor recession, some healthy gingiva often remains and protects the tooth, so that no treatment other than gentle oral hygiene is necessary. Recession can be caused by genetically thin bone and gum, overscrubbing or toothbrush bristles that are too stiff, or by clenching and grinding habits.

Before Gingival Graft

After Gingival Graft

When recession reaches the mucosa, the first line of defense against bacterial penetration is lost. No matter how meticulously the patient tries to control the bacteria, there is a greater chance of it penetrating and affecting the underlying supporting bone. In addition, gum recession may result in root sensitivity as well as an unsightly appearance to the gum and tooth.

Some people genetically have extremely thin gingiva and require grafting to prevent recession before it starts. This is quite common when orthodontic tooth movement is planned.

A gingival graft is designed to solve these problems. A thin piece of tissue is taken from the roof of the mouth, or moved over from adjacent areas, to provide a stable band of dense gingiva around the tooth. There is also a new skin graft product that eliminates taking gum from the roof of the mouth.

Before Gingival Graft

After Gingival Graft

A connective tissue graft is a newer technique used to help cover the exposed portion of the root. It offers more predictable root coverage and better color matching but is a more technically difficult procedure. It is the preferred technique for upper teeth and for severe recession.

Dr. Layport makes a stent, which looks like the older-style orthodontic retainer, to protect the roof of the mouth during healing greatly reducing soreness and complications after surgery.

The visit to perform a gingival graft is about 60 minutes long. The stitches are removed approximately one week later in a 5-10 minute visit. A 5 minute check-up verifies the final result 6 weeks later.

Gingival graft procedures are quite predictable. The color of the graft and the amount of root coverage is more variable.

Bone Grafting
Bone grafting is used to regenerate or "regrow" tissue (also known as guided tissue regeneration).These techniques restore and strengthen the support of the teeth so they can function longer. There are many new technologies available to enhance bone regeneration. Angular bone defects and pockets 8mm or deeper usually require regeneration therapy. Bone grafting is generally done in conjunction with osseous or flap surgery.

Osseous / Flap Surgery
Just as there are many types of periodontal diseases, there are many treatment options. Dr. Layport looks at you as an individual and develops a treatment plan that is tailored to your needs.

The following are some of the reasons why surgery might be necessary:

•  To clean and reduce periodontal pockets (flap surgery). You cannot keep deep pockets clean and free of plaque just by brushing and flossing alone. The pockets may also be too deep even for your dentist or hygienist to clean. Therefore, your periodontist may decide that surgery is necessary to remove plaque and calculus below the gum-line. The gums are lifted away from the teeth to allow access for cleaning and smoothing of the tooth roots. Your periodontist will reduce the pocket and reposition the gums with stitches to minimize areas where disease-causing bacteria can hide.

•  To reshape damaged bone (osseous surgery).This is done to smooth the uneven or irregular surface of the damaged bone and to promote proper healing of the gum tissue. This is done along with flap surgery.
•  To regenerate or "regrow" tissue (bone grafting or guided tissue regeneration).These techniques restore and strengthen the support of the teeth so they can function longer. There are many new technologies available to enhance bone regeneration. Angular bone defects and pockets 8mm or deeper usually require regeneration therapy. (These are often done together.)

Periodontal Maintenance
Sticking to a regular oral hygiene regimen is crucial for patients who want to sustain the results of therapy. Patients should visit the dentist every 3-4 months (or more, depending on the patient) for scaling, localized root planing and an overall exam.

Treating and preventing gum disease brings great health benefits. By retaining your natural teeth, you can chew more comfortably and enjoy better digestion. You can have a healthy smile, a natural asset to your appearance. You can save money and avoid discomfort by preventing future dental problems. For looking good and feeling good, nothing works better than your natural teeth.

Dr. Cynthia A. Layport
9900 SW Greenburg Road, Suite 230
Tigard, OR 97223-5473

Phone: 503-620-1117
Fax: 503-624-1547


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