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A periodontist is a dentist who specializes in the prevention, diagnosis, and treatment of periodontal disease, and in the placement of dental implants.  Periodontists are also experts in the treatment of oral inflammation.  Periodontists receive extensive training in these areas, including three additional years of education beyond dental school. They are familiar with the latest techniques for diagnosing and treating periodontal disease, and are also trained in performing cosmetic periodontal procedures.

During your first visit, the periodontist usually reviews your complete medical and dental histories. It’s extremely important for the periodontist to know if you’re taking any medications or being treated for any condition that can affect periodontal care, such as heart disease, diabetes, or pregnancy.

Your periodontist will then examine your gums for any gum line recession, assess how your teeth come into contact with each other when biting, and check to see if any of your teeth are loose. Your periodontist will further evaluate the health of your gums by placing a small measuring instrument (called a probe) in the spaces between your teeth and gums (called periodontal pockets) to measure the depth of those spaces. X-rays may also be taken to observe the health of the bone below your gum line.  In most instances your dental condition will be determined at this visit and a suitable treatment plan will be discussed with you.

Our emphasis is on maintaining compromised teeth and/or restoring esthetics and function using dental implants.  Arresting periodontal disease and preventing recurrence is our goal for every patient.  This involves daily dental hygiene, proper nutrition, periodic cleanings and check-ups.  It may not be where we start with every new patient, but that is what we want to attain and maintain, especially with all the evidence linking dental health to overall health.

New River Periodontics and Dental Implant Center provides a variety of surgical services. We pride ourselves on the fact that we are very conservative in our treatment recommendations and limit surgery to the areas where it is absolutely necessary.

Many times, the early stages of periodontal disease are best treated with non-surgical periodontal therapy. Even in severe cases, non-surgical periodontal therapy often precedes surgical therapy. This is done to improve the overall tissue quality prior to surgery and also to help limit the areas requiring surgery.

In scaling and root planing, your periodontist will perform a deep cleaning of your tooth root surfaces. First, your periodontist will scale beneath the gumline to remove plaque and other bacterial toxins from periodontal pockets. Root planing allows your periodontist to smooth the tooth root to prevent future plaque or toxins from adhering.

Many patients do not require additional treatment after scaling and root planing. However, the majority of patients will require ongoing maintenance therapy to sustain periodontal health.

Your bone and gum tissue should fit snugly around your teeth like a turtleneck around your neck. When you have periodontal disease, this supporting tissue and bone is destroyed, forming “pockets” around the teeth.

Over time, these pockets become deeper, providing a larger space for bacteria to live accumulate and advance under the gum tissue. These pockets can result in bone and tissue loss. Eventually, if too much bone is lost, the teeth will need to be extracted.

During a periodontal pocket procedure, your periodontist folds back the gum tissue and removes the disease-causing bacteria before securing the tissue into place. In some cases, irregular surfaces of the damaged bone are smoothed to limit areas where disease-causing bacteria can hide. This allows the gum tissue to better reattach to healthy bone.

ImplantDental implants are designed to provide a foundation for replacement teeth that look, feel, and function like natural teeth. The person who has lost teeth regains the ability to eat virtually anything and can smile with confidence, knowing that teeth appear natural and that facial contours will be preserved. The implants themselves are tiny titanium posts that are placed into the jawbone where teeth are missing. The bone bonds with the titanium, creating a strong foundation for artificial teeth. In addition, implants can help preserve facial structure, preventing the bone deterioration that occurs when teeth are missing.

Depending on your specific condition and the type of implant chosen, your periodontist will create a treatment plan tailored to meet your needs.

Here are some of the possible treatment plans depending on your situation:

  • Single Tooth Dental Implants – If you’re missing a single tooth, one dental implant can replace it.
  • Multiple Tooth Dental Implants – If you’re missing several teeth, they can be replaced by multiple dental implants.
  • Full Mouth Dental Implants – If you’re missing all of your teeth, they can be replaced by full mouth dental implants.
  • Sinus Augmentation – A key to implant success is the quantity and quality of the bone where the implant is to be placed. The upper back jaw has traditionally been one of the most difficult areas to successfully place dental implants due to insufficient bone quantity and quality and the close proximity to the sinus. Sinus augmentation can help correct this problem by raising the sinus floor and developing bone for the placement of dental implants.
  • Ridge Modification – Deformities in the upper or lower jaw can leave you with and inadequate amount of bone in which to place dental implants. To correct the problem, the gum is lifted away from the ridge to expose the void where bone is missing. The void is then filled with bone or bone substitute to build up the ridge. Ridge modification has been shown to greatly improve the jaw’s appearance and increase the chances of successful implants.

Just like natural teeth, dental implants require conscientious at-home oral care and regular dental visits to preserve function and prevent peri-implant disease. In order to keep your implant clean and plaque-free, brushing and flossing are still necessary.

After you’ve received your implant, your periodontist will work closely with you and your general dentist to develop the best care plan for you. Periodic follow-up visits will be scheduled to monitor your implant, teeth and gums to make sure they are healthy.

These procedures are a predictable way to cover unsightly, sensitive, or exposed root surfaces and to prevent future gum recession. If you are unhappy with the appearance of short unsightly teeth this can be greatly improved by a combination of periodontal procedures by our periodontists, Dr. Buyer and Dr. Maryam and cosmetic dentistry by your dentist.

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Although your teeth appear short, they may actually be the proper length. The teeth may be covered with too much gum tissue. We can correct this by performing the periodontal plastic surgery procedure, crown lengthening.

Exposed tooth roots are the result of gum recession. Gum graft surgery will cover the exposed root and help prevent additional recession and bone loss.

During gum graft surgery, your periodontist takes gum tissue from your palate or another donor source to cover the exposed root. Gum graft surgery can be performed on one tooth or multiple teeth, and may help reduce tooth sensitivity and improve the aesthetics of your smile.

When the 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.

Some individuals may have a “gummy” smile because the teeth appear short. In fact, the teeth may actually be the proper lengths, but they’re covered with too much gum tissue. To correct this, your periodontist performs a dental crown lengthening procedure.

During the dental crown lengthening 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 dental crown lengthening to make a restorative or cosmetic dental procedure possible. Crown lengthening adjusts the gum and bone level to expose more of the tooth so it can be restored.

Crown lengthening (or crown exposure) is required when your tooth needs a new crown or other restoration. The edge of that restoration is deep below the gum tissue and not accessible. It is also usually too close to the bone or below the bone.

The procedure involves adjusting the level of the gum tissue and bone around the tooth in question to create a new gum-totooth relationship. This allows us to reach the edge of the restoration, ensuring a proper fit to the tooth. It should also provide enough tooth structure so the new restoration will not come loose in the future. This allows you to clean the edge of the restoration when you brush and floss to prevent decay and gum disease. The procedure takes approximately one hour.

SURGERYTraditionally, gum disease is treated by eliminating the gum pockets. The infected gum tissue is trimmed away and uneven bone tissue re-contoured. Although this is still an effective way of treating gum disease, new and more sophisticated procedures are used routinely today.

Your periodontist may recommend a regenerative procedure when the bone supporting your teeth has been destroyed due to periodontal disease. These procedures can reverse some of the damage by regenerating lost bone and tissue.

During this procedure, your periodontist folds back the gum tissue and removes the disease-causing bacteria. Membranes (filters), bone grafts or tissue-stimulating proteins can be used to encourage your body’s natural ability to regenerate bone and tissue.

Guided tissue bone regeneration regenerates the previously lost gum and bone tissue. Most techniques utilize membranes that are inserted over the bone defects. Some of these membranes are bio-absorbable and some require removal. Other regenerative procedures involve the use of bioactive gels.

Bone grafting can repair implant sites with inadequate bone structure due to previous extractions, gum disease, or injuries. The bone is either obtained from a tissue bank or your own bone is taken from the jaw, hip, or tibia (below the knee.) Sinus bone grafts are also performed to replace bone in the posterior upper jaw. In addition, special membranes may be utilized that dissolve under the gum and protect the bone graft and encourage bone regeneration. This is called guided bone regeneration or guided tissue regeneration.

Major bone grafts are typically performed to repair defects of the jaws. These defects may arise as a result of traumatic injuries, tumor surgery, or congenital defects. Large defects are repaired using the patients own bone. This bone is harvested from a number of different sites depending on the size of he defect. The skull (cranium), hip (iliac crest), and lateral knee (tibia) are common donor sites. These procedures are routinely performed in an operating room and require a hospital stay.

Careful management of extraction sockets after tooth extraction prevents unsightly bone loss and provides a better cosmetic outcome for tooth replacement.

Laser Assisted New Attachment Procedure is an FDA approved alternative to traditional gum surgery. This approach minimizes the appearance of longer looking teeth, eliminates sutures, reduces after treatment temperature sensitivity and is more comfortable than traditional approaches to therapy. The laser kills the causative bacteria in the sulcus and in the tissues surrounding the teeth. Recent studies show new attachment is regenerated with this protocol. It is an alternative to traditional scalpel and suture gum surgery. New River Periodontics and Dental Implant Center has over 14 years of experience with this procedure.

This is a less invasive procedure to create more bone volume in the posterior maxilla for dental implants. The sinus membrane is hydraulically lifted to allow for bone augmentation and implant placement under local anesthesia. Often times, the lift and implant can be placed at the same time which eliminates a second procedure.

Cone beam computerized tomography (CBCT) gives a very precise picture of the bone volume and density to support dental implants. This technology delivers more predictable restorative solutions to missing teeth and images pathology to allow for more precise operative plan. CBCT is significantly less radiation exposure (1/5 to 1/10) than traditional medical CAT scans. New River Periodontics  was the first periodontal practice  in Southwest Virginia to routinely use CBCT. New River Periodontics has  CBCT technology in both  Blacksburg and Roanoke offices.

Sedation allows for patients with anxiety or patients requiring long and/or complicated dental surgical procedures to be treated in a comfortable manner. Our providers  completed  rotations in medicine and general anesthesia. They comply with all required federal and state credentialing requirements to deliver IV sedation to patients in an outpatient surgery center.

Sedation allows for patients with anxiety or patients requiring long and/or complicated dental surgical procedures to be treated in a comfortable manner. Our providers completed  rotations in medicine and general anesthesia. They  comply with all required federal and state credentialing requirements to deliver IV sedation to patients in an outpatient surgery center.

Advanced surgical approach to accelerate orthodontic therapy and manage cases when tooth and supporting bone will not allow for safe and effective tooth movement. These cases are coordinated with the patient’s orthodontist.

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