Soft Tissue Grafts
Periodontal procedures are available to stop further dental problems and gum recession. Exposed tooth roots are the result of gum recession. Maybe you are sensitive to hot or cold foods and liquids because of exposed roots.  If so, your gums may have receded. This occurs for a variety of reasons, including aggressive tooth brushing or periodontal disease. You may not be in control of what caused the recession, but prior to treatment, your periodontist will help you identify the factors contributing to the problem. Once these contributing factors are controlled, a soft tissue graft procedure will repair the defect and help to prevent additional recession and bone loss. Soft Tissue grafts can be used to cover roots or develop gum tissue which is absent due to excessive gingival recession. During this procedure, your periodontist takes gums tissue from your palate or another donor source to cover the exposed root. This can be done for one tooth or several teeth to even your gum line and reduce sensitivity. A soft tissue graft can reduce further recession and bone loss. In some cases, it can cover exposed roots to protect them from decay and may reduce tooth sensitivity.

Aesthetic Crown Lengthening
Periodontal procedures are available to lay the groundwork for restorative and cosmetic dentistry and/or to improve the esthetics of your gum line. You may have asked your dentist about procedures to improve your smile because your teeth appear short. Your teeth may actually be the proper length, but they're covered with too much gum tissue. To correct this, your periodontist performs a 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.

Functional Crown Lengthening
Functional crown lengthening is a periodontal procedure available to lay the groundwork for restorative and cosmetic dentistry.  Crown Lengthening is a surgical procedure that recontours the gum tissue and often the underlying bone surrounding one or more teeth so that an adequate amount of healthy tooth is exposed. Crown lengthening is often used as part of a treatment plan for a tooth that is to be fitted with a crown. This procedure provides the necessary space between the supporting bone and crown, preventing the new crown from damaging gum tissues and bone. Your dentist may also recommend crown lengthening in order to make a restorative procedure possible. If a tooth is badly worn, decayed or fractured below the gum line, crown lengthening adjusts the gum and bone levels to gain access to more of the tooth so it can be restored.

Periodontal/Osseous Surgery
Many factors can cause periodontal disease or influence its progression. The main cause of periodontal disease is bacteria in the form of a sticky, colorless plaque that constantly forms on your teeth. Your bone and gum tissue should fit snugly around your teeth like a turtleneck fits around you 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.  As bacteria develops around the teeth, they can accumulate and advance under the gum tissue. These deep pockets collect even more bacteria, resulting in further bone and tissue loss. Eventually too much bone is lost and the teeth need to be extracted. Your periodontist has measured the depth of your pockets. If you have pockets that are too deep to clean with daily at-home oral hygiene and a professional care routine, a pocket reduction procedure will be recommended. During this procedure, your periodontist folds back the gum tissue and removes disease-causing bacteria before securing the tissue back 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.

Dental Implants
If you are missing one or more teeth and would like to restore your ability to smile, speak and eat with comfort and confidence, then dental implants may be right for you. Perhaps your dentures don't fit as securely or as comfortably as they once did. Dental implants provide an alternative to a denture that wobbles, clicks or causes pain.  Perhaps you have loose teeth that need to be stabilized after treatment of advanced gum disease. Or, maybe you hide your smile because of spaces from missing teeth. Dental implants are artificial substitutes for natural tooth roots. The implants- small anchors shaped like screws, cylinders or blades- are placed into the jawbone. Replacement teeth are attached to the part of the implant that projects through the gums. Although dental implants have brought a comfortable, confident smile to many patients, they are not for everyone. The ideal candidate has good general health, good oral health and adequate bone in the jaw to support the implant. Equally important, the ideal candidate is willing to commit to conscientious oral hygiene and regular dental visits. Essential to the decision is a comprehensive dental examination. The dentist will review your medical and dental history, thoroughly examine your oral tissues and supporting bone in the jaw, and check the way your teeth fit together when you bite. After this examination, your dentist will talk with you about dental implant options, benefits, risks and possible alternative treatments. When tested dental implant systems are placed by trained dentists, they can have a success rate of over 90%. In fact, with effective oral care at home and regular dental visits, dental implants have lasted as long as 20 years and may last a lifetime.

IV Conscious Sedation
is available to our patients.   Dr. Betancourt has been on Medical Staff at Indian River Medical Center in the Department of Surgery since 1998.

Anxiety and fear concerning dental care and treatment is normal.  However, sometimes this anxiety can prevent us from seeking the care we know we need.  Our office provides multiple options to help you go through the necessary procedures as comfortably as possible.  We offer oral sedation, nitrous oxide (laughing gas) and intravenous conscious sedation (Monitored Anesthesia Care).  Dr. Betancourt trained at the University of Kentucky Hospital Operating rooms supervised by the Division of Anesthesiology.  Patients with ASA classes greater than II or other medical concerns can be treated as outpatients at  Indian River Medical Center under general anesthesia.

Extractions / Socket - Ridge  Preservation
Although our goal is to save teeth through periodontal therapy, some teeth may be hopeless due to bone loss, infection, pain or fractured beyond repair and need to be extracted (removed).  The bone that holds the tooth in place can cause a deformity when the tooth is extracted after healing has taken place.  This deformity can cause problems with replacement for this missing tooth whether it is a bridge, dental implants or a removable denture.   These deformities in the bone whether due to disease or extraction can be removed or greatly improved with the procedure called socket preservation.  Socket preservation involves filling the defect with bone or a bone substitute and sometimes using a biocompatible barrier to encourage your natural ability to regenerate lost bone and tissue.  The length of healing depends on your individual needs, but usually is between 2-4 months before implant placement or restorative treatment can begin.   In some cases, your dentist can provide temporary partials or bridges to replace the missing teeth while the bone grafting heals.

Bone Grafting / Sinus Augmentation
In certain patients with bone atrophy or deficiencies it is necessary to increase the available bone for implant placement or for more ideal prosthetic restoration.  We work closely as a team with referring doctors to achieve the most ideal result for our mutual patients.  These procedures can include moving the maxillary sinus to allow for implant placement, bone block grafting to increase the width of bone necessary and socket augmentation when needed.

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Vero Beach Periodontist Dr. James Betancourt - Dental Implants - Periodontal Surgeries
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