General Treatment

smiling womanOur practice provides the highest-quality services for restoring mouths that have been damaged by periodontal disease and common problems that require periodontal treatment. Our primary goal for our patients is to achieve and maintain optimum oral health through advances in techniques, technologies and by maintaining their scheduled dental exams.


Your third molars are more commonly called "wisdom teeth." Usually appearing in the late teens or early twenties, third molars often lack the proper space in the jaw to erupt fully or even at all. This common condition is called impaction. When any tooth lacks the space to come through or simply develops in the wrong place of your jaw and becomes impacted, problems can arise. Primarily, damage to adjacent teeth and crowding occur.

In certain cases, the wisdom tooth that cannot come through becomes inflamed under the gums and in the jawbone, causing a sac to develop around the root of the tooth that then fills with liquid. This can cause a cyst or an abscess if it becomes infected. If either of these situations goes untreated, serious damage to the underlying bone and surrounding teeth and tissues can result.

To potentially stave off this result, an extraction of one, several or all of the wisdom teeth may be advised. If that is the case, we have the equipment and training needed to perform such extractions, with an absolute minimum of discomfort. Ask our staff for more information regarding tooth extractions if you feel you may need one.

Scaling and Root Planing

This is a deep-cleaning, nonsurgical procedure, done under a local anesthetic, whereby plaque and tartar from above and below the gum line are scraped away (scaling) and rough spots on the tooth root are made smooth (planing). Smoothing the rough spots removes bacteria and provides a clean surface for the gums to reattach to the teeth. Scaling and root planing is done if your dentist or periodontist determines that you have plaque and calculus (hardened plaque, also called tartar) under the gums that needs to be removed.

Flap Surgery/Pocket Reduction Surgery

During this procedure the gums are lifted back and the tarter is removed. In some cases, irregular surfaces of the damaged bone are smoothed to limit areas where disease-causing bacteria can hide. The gums are then placed so that the tissue fits snugly around the tooth. This method reduces the size of the space between the gum and tooth, thereby decreasing the areas where harmful bacteria can grow and decreasing the chance of serious health problems associated with periodontal disease.

Bone Grafts

Involves using fragments of your own bone, synthetic bone, or donated bone to replace bone destroyed by gum disease. The grafts serve as a platform for the regrowth of bone, which restores stability to teeth. New technology, called tissue engineering, encourages your own body to regenerate bone and tissue at an accelerated rate.

Soft Tissue Grafts

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 option. When there is only minor recession, some healthy gingiva often remains and protects the tooth, so that no treatment other than modifying home care practices is necessary. However, when recession reaches the mucosa, the first line of defense against bacterial penetration is lost. In addition, gum recession often results in root sensitivity to hot and cold foods as well as an unsightly appearance of the gum and tooth. When significant, gum recession can predispose to worsening recession and expose the root surface, which is softer than enamel, leading to root caries and root gouging.

Before and After Gum Grafting

A gingival graft is designed to solve these problems. A thin piece of tissue is taken from the roof 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 root. The gingival graft procedure is highly predictable and results in a stable, healthy band of attached tissue around the tooth.

Regrow Receding Gums with AlloDerm Grafting

A receding gum line is one of the visible signs of periodontal disease and has the ability to encourage further damage by allowing greater access to the bacteria that causes it. Traditionally, it has been not feasible to treat receding gums. AlloDerm is a major breakthrough for cosmetic dentistry. While it is not possible to regrow receding gums, Alloderm allows for the predictable treatment of receding gums, essentially reversing this sign of aging and giving patients back a beautiful smile.

Gum Grafting

Grafting works by repairing damaged tissue by providing a foundation for new tissue regeneration. You’ve probably heard the term associated with skin grafting. Your gums are structured the same way. Traditionally, the foundation gum tissue is harvested from somewhere else in the patients mouth and then transplanted where needed. Soon after placement, blood flows from the natural gum tissue into the graft. The patient’s own cells move into the AlloDerm and begin the process of tissue regeneration. Over time, healthy gum tissue will regrow and transform into tissue that looks and functions naturally. Alloderm spares the patient a second surgical site where the tissue would have been taken.


AlloDerm® is derived from donated human skin tissue. Human skin is composed two parts, the epidermis and the dermis. AlloDerm uses only the dermis, which does not contain DNA. The dermis is used for grafts because it contains a framework of structural components that allow regeneration and replacement throughout life.

AlloDerm is safe. All tissue donors are screened and tested for transmissible diseases before tissue is processed. Before AlloDerm is deemed fit for human use, additional tests are performed to assure patient safety. AlloDerm allows doctors the ability to treat multiple areas of recession in one procedure, thus avoiding the cost and pain of multiple surgeries.

Crown Lengthening

During this procedure, excess gum and bone tissue is reshaped to expose more of the natural tooth. This can be done to one tooth, to even your gum line, or to several teeth to expose a natural, broad smile. Your dentist or periodontist may also recommend crown lengthening to make a restorative or cosmetic dental procedure possible. Perhaps your tooth is decayed, broken below the gum line, or has insufficient tooth structure for a restoration, such as a crown or bridge. Crown lengthening adjusts the gum and bone level to expose more of the tooth so it can be restored.

Michaud Periodontics & Dental Implants