At Auburn Periodontics & Implantology, we perform a wide variety of services to help you get the smile you deserve. By leveraging today's advanced techniques and technology, your periodontist Dr. Joseph Haynes can restore your beautiful smile to help you maintain your youthful appearance.

Read about our services in the pages below.
•  Bone Grafting
•  Esthetic Crown Lengthening
•  Functional Crown Lengthening
•  Gingivectomy
•  Guided Tissue Regeneration (GTR)
•  Gum Grafting
•  Occlusal Adjustment
•  Oral Cancer Screening
•  Periodontal Maintenance
•  Ridge Augmentation
•  Sinus Lift
Tap the links below to read more about dental implants. (Tap again to close.)

► Bone Grafting
Man smiling about his new smile after a successful bone graft.Bone loss in the jawbone is common when one or more teeth have been lost. Bone around a missing tooth begins to deteriorate when the jaw is not stimulated. Over time, there may be enough deterioration in the jawbone to prevent placement of dental implants. In such cases, Dr. Haynes will likely recommend having a bone grafting procedure. This is the replacement or augmentation of missing bone around your teeth.

There are three types of bone graft procedures: autogenous, allograft, and xenograft:

Autogenous grafts take bone from one area of the patient's body and transplant it to the location in the mouth being restored. The bone is usually taken from non-essential bones such as the chin area. The benefit of an autogenous bone graft is that the bone used comes solely from the patient thus reducing the likelihood of rejection and infection. The bone is also still "live," meaning it still has active cellular material.

Allografts also use human bone transplanted to the area in the mouth being restored. However, allografts do not use the patient's own bone. Instead, the bone usually comes from cadavers who have donated their bone to bone-banks. All allograft bone material is carefully screened and is considered very safe.

Xenografts also replace bone in the area requiring treatment, however the bone comes from a non-human source. Usually the non-human source is bovine (cow). Allografts and Xenografts are used because they do not require a second surgical site to harvest bone and ample amounts of bone can be easily attained.

The Procedure

Anesthesia is used to numb the area where the procedure will take place. An incision is made in the gums around where the bone will be augmented. This is done so that Dr. Haynes can see exactly how much bone will be needed before harvesting it from the patient (if an autogenous graft is being performed).

Next, Dr. Haynes will make a cut in the gums below the lower front teeth to expose the chin bone. Dr. Haynes will remove a part of the bone along with any bone marrow. This incision is closed with stitches. The bone removed from the chin will then be anchored in place in the jawbone with small titanium screws. Dr. Haynes may place a mixture of your bone marrow and some bone-grafting material around the bone graft to help speed healing. This incision is also closed with stitches.

After the procedure you will likely be given antibiotics as well as pain medication. You'll be asked to follow a restricted diet of soft foods, such as pastas and Jell-O. Bone grafts usually take between six to nine months to fully heal. Dental implants will not be placed until your mouth has healed completely.

► Esthetic Crown Lengthening
Young man smiling and showing his esthetically lengthened crowns.Those who feel that they have a "gummy" smile can greatly benefit from esthetic crown lengthening. This relatively simple procedure usually takes about an hour to perform and is essentially a "gum lift". During the procedure, Dr. Haynes removes excess gum and bone tissue and reshapes the smile to expose more of the natural tooth. While the procedure can be performed on just one tooth, it is most often done to the entire smile. The end result is that more of the natural tooth is exposed creating a wider, more beautiful smile.

Esthetic crown lengthening can also be done to preserve the health of the smile. Removing excess gum tissue can help control and prevent periodontal disease. Increasing the exposed surface area of the tooth will decrease the depth of pockets between teeth where bacteria can grow and harm your teeth and gums.

Prior to the procedure a local anesthetic will be administered by Dr. Haynes to prevent pain and discomfort. Small incisions in the gum tissue will be needed to separate the gums from the teeth. In some cases, a small amount of bone will also need to be removed to create a natural smile. Once the procedure is completed, Dr. Haynes will clean the incisions with sterile water and place sutures and a protective bandage over the area to encourage the teeth and newly contoured gums to re-attach to each other. A follow up appointment will be needed one to two weeks after the procedure to evaluate healing.

► Functional Crown Lengthening
Woman smiling after successful functional crown lengthening that restored her tooth and gums.Functional crown lengthening is sometimes needed to perform a cosmetic or restorative procedure. This may be the case if a tooth is too far decayed, broken below the gum line, or has insufficient structure for a restoration like a crown or bridge. In cases like this, Dr. Haynes may be required to lower the gum and bone levels to expose more of the root surface so it can be restored. However, simply trimming back the gum line is not sufficient. Instead, Dr. Haynes will need to reshape the gums and supporting bone to allow for adequate room to place a high quality restoration.

The procedure is similar to esthetic crown lengthening in that a local anesthetic will be administered. Small incisions are required to remove the gum tissue and reshape the area. When the procedure has been completed, Dr. Haynes will place sutures that will need to be removed in one to two weeks. After the area has completely healed (6–8 weeks), the final restorative dentistry such as a crown or bridge can be placed.

► Gingivectomy
Woman with flowers behind her smiling about her healed gingivectomy treatment.A gingivectomy is typically performed when severe periodontal disease is present that cannot be cured with other periodontal procedures. Gingivectomies are performed to remove and reshape loose, diseased gum tissue and to reduce the depth of pockets between the teeth and gums.

The Procedure

Before the procedure begins, Dr. Haynes will ensure you are completely numbed using a local anesthetic. Small incisions are then made and excess gum tissue is carefully removed. After all areas of diseased tissue are removed, a putty-like substance is then placed over the gums. This substance is designed to protect your gums as they heal.

After the Procedure

After the procedure, it is important to eat only soft foods and to drink only cool or slightly warm liquids while the putty is in place and your gums are healing. It is important to keep the mouth clean after the procedure. While it is important not to brush in the area where the procedure was performed, it may be possible to brush and floss the rest of the mouth. After a few weeks the gums will be completely healed and it will be possible to resume brushing and flossing, though this should be done gently at first.

► Guided Tissue Regeneration (GTR)
Retired man with tennis racket smiling about his healed periodontal disease through guided tissue regeneration.Teeth are held in place by surrounding gums, bone, and other tissues, but periodontal disease can cause the bone to break down. New bone growth can be achieved using techniques known as regenerative procedures. This growth increases the height of the bone around the tooth, giving the tooth more support, and increases the amount of attachment around the root of the tooth. Getting back even half the lost bone height extends the life of the tooth. One type of regenerative procedure is called guided tissue regeneration (GTR).

How GTR Works

A special membrane is placed between the gum and bone. In certain cases, the gap in the bone that allowed the bacteria responsible for causing gum disease is filled with a material used as a substitute for the original bone known as "Bone Graft". This prevents fast growing gum tissue from filling the space where bone was lost. This way, new bone has time to grow where it is needed.

Here Is How GTR Is Done:

Surgery on gum and bone: The gum is opened. The area under the gums is cleaned out to remove all bacterial deposits. Then a membrane (with or without the bone graft material) is placed over the damaged bone.

Separating tissues: Once in place between bone and gum, the membrane provides necessary space and time for the bone to heal and start regenerating itself.

After healing: The stitches and membrane dissolve or are removed. In about six months, the bone regenerates to support the tooth and new attachment forms around the root of the tooth.

To decrease your chances of other health problems associated with periodontal disease, it is important to continue with your daily oral hygiene routine, along with professional maintenance care.

► Gum Grafting
Woman smiling about her successful gum grafting treatment.Gum recession happens when the gum line moves toward the root of the tooth, leaving a larger portion of tooth enamel exposed. It is one of the most noticeable and damaging results of gum disease. Unfortunately, many patients do not seek treatment because they are unaware of their gum recession. Gum recession often happens gradually and is not noticeable until the symptoms become severe. These symptoms include sensitivity to extreme temperatures, exposure of the roots, and teeth that appear "long". Without gum tissue surrounding the tooth and its root, the risk of cavity and decay is severely increased. This makes it important to fix receding gums very quickly.

Gum grafting is the procedure in which receding gums are repaired by taking tissue from another area and attaching it to the gum line. In addition to health benefits, gum grafting can help patients who are unhappy with the esthetic appearance of their teeth. It can help to reduce the amount of tooth shown and increase the gum line to a level considered more attractive by you.

There Are Currently Three Types of Gum Grafts Available:

Connective Tissue Grafts: This is considered the most common form of gum grafting surgery. It involves cutting a flap of skin from the roof of the mouth and removing a small amount of tissue from beneath the flap. The borrowed tissue is then stitched to the gum line and given time to attach itself.

Free Gingival Grafts: This type of gum grafting is similar to connective tissue grafts. Instead of borrowing from beneath a flap of skin, tissue is removed directly from the roof of the mouth.

Pedicle Grafts: This type of gum grafting borrows tissue directly from the gum line. A flap of skin is cut from the gum tissue and pulled over the tooth, then stitched in place. This gum grafting method is usually reserved for those with plenty of gum tissue.

► Occlusal Adjustment
Young woman closing her eyes while smiling with her bite that has been corrected through occlusal adjustment.Occlusal, or bite, adjustment is a procedure performed to help teeth come together properly by removing interference. Bite interference can prevent the jaw from closing in its anatomically correct position. Interference can develop as teeth develop, can occur following an accident, or can accumulate over time with wear. Dental work such as fillings, crowns, bridges and extractions can also cause interference.

Bite interference often prevents the jaw from fully sliding into correct position because the jaw and neck are never able to fully relax. This may result in severe headaches and neck aches. Many people may begin to grind their teeth as their jaw seeks its natural position. Teeth grinding can cause bone loss, tooth loss and receding gums. Over time, patients may develop temporomandibular joint issues, or TMJ, if untreated.

During your examination, Dr. Haynes will examine your jaw closely and may notice symptoms that your bite may be off. Some symptoms include if the jaw does not open evenly on both sides, if the jaw makes a clicking noise as it opens, if the enamel has been ground away in certain areas, or if there are fractured teeth. Chronic symptoms of teeth grinding, headaches or neck aches, are also clues that the bite may be off.

Before the procedure begins, Dr. Haynes will have you bite on a thin piece of special paper. The paper transfers color to the areas where contact occurs. The doctor will then smooth the area where the marks have been left removing just enough of the tooth or restoration to eliminate the interference. This process will be done on all areas where the mylar paper left color on the tooth until the jaw is able to get into its normal position.

► Oral Cancer Screening
Mature woman seated in an exam chair receiving an oral cancer screening from her periodontist.Oral cancer screening involves diagnosing and treating diseases of the mouth such as cysts, tumors, and precancerous and cancerous lesions. Many patients experience unusual changes in the mouth, teeth, gums, tongue, or throat that may be due to disease. Early diagnosis of diseases in the mouth is very important. The earlier a disease is diagnosed, the faster treatment and healing can begin.

Dr. Haynes may perform a number of tests or exams to determine what is causing the symptoms you are experiencing and diagnose the disease. Usually, biopsy or tissue removal is the best way to determine a diagnosis as the sample is sent to a laboratory for analysis.

Treatments vary depending on the type of disease that is present. Each patient's needs will be addressed on a case-by-case basis in order to achieve the best results. Dr. Haynes is dedicated to making any procedure performed as comfortable as possible.

► Periodontal Maintenance
Man smiling about his preventive periodontal maintenance that healed his gums.Periodontal maintenance is an ongoing service Dr. Haynes provides to help you prevent periodontal disease in the gum tissue and bone. Periodontal maintenance is usually necessary for patients who are susceptible to periodontal disease or who have been treated for gum disease. Maintenance visits to the periodontist will help prevent additional dental problems in the future. Most importantly, preventing disease and treating it in its early stages keeps you healthy but also saves you money!

Why should I care about periodontal maintenance?

Gum disease is caused by the bacteria found in plaque. The toxins produced by the bacteria attack your gums and teeth. If the plaque is not removed, it will harden and form calculus. Even someone dedicated to good oral hygiene will be unable to completely prevent the formation of calculus on the teeth. Flossing and brushing will keep the calculus to a minimum but regular, professional maintenance is needed to remove what has been missed. During your maintenance cleaning, the hygienist will also check for hidden periodontal problems.

How often should I visit your office for periodontal maintenance?

Dr. Haynes will recommend how often you should have a periodontal maintenance visit. The frequency will be determined by the type of periodontal disease you have, the type of periodontal treatment you have had in the past, how you've responded to those treatments, and how quickly you develop plaque. Of course, the most important factor is how dedicated you are to oral hygiene at home.

► Ridge Augmentation
Man smiling about his new implants after receiving ridge augmentation treatment.Ridge augmentation is a common procedure performed to help recreate the natural contour of the gums. After a tooth is removed, the bone in the jaw will often begin to deteriorate and recede. The height and width of the socket, which was supported by the tooth, will begin to shrink after the tooth is removed. Sometimes patients will eventually develop an indentation in the gums or jawbone where the tooth used to be.

It may be necessary in order to place a dental implant or for esthetic purposes. If a person's bone has deteriorated too much, placing a dental implant may not be possible.

The Procedure

There are two types of ridge augmentation procedures: soft tissue and hard tissue. Occasionally, both types of ridge augmentation are performed at once.

Soft tissue grafts are usually done to improve the esthetics and cleansability of the site. Prior to the procedure, the area will be numbed. An incision is made to expose the site and a soft tissue graft is then obtained either from the palate (roof of the mouth) or a soft tissue substitute. The graft is then inserted into the area receiving the graft, which is then secured with stitches.

Hard tissue grafts are done to recreate adequate bone contouring prior to dental implant placement. Prior to the procedure, the area will be numbed. An incision is made and the gum lifted away to expose the bone defect. A bone graft obtained either from another site within the mouth or cadaver bone is placed in the area receiving the graft and secured using titanium screws. The area is then closed with stitches.

Healing time varies but usually lasts no longer than 6 months.

► Sinus Lift
Woman smiling about her new dental implants after a successful sinus lift treatment.Patients who have lost teeth in their upper jaw often need a sinus lift prior to having dental implants placed. This is due to natural shrinking over an extended period of time. As a result, the sinuses expand to occupy the empty space where the bone used to be. With insufficient bone to securely place the dental implant, a sinus lift is necessary to move the sinus back to its proper position and place additional bone in the area.

The Procedure

There are two types of sinus lift procedures. The procedure you receive will depend on your specific needs and the amount of bone remaining. Dr. Haynes will discuss your options with you prior to the sinus lift.

Before the sinus lift begins, an anesthetic is applied. Dr. Haynes will create a small opening in the bone to access the sinus cavity. He will then gently lift the sinus back to its original position. A grafting material is placed beneath the newly raised sinus cavity along the existing bone. This grafting material will then mesh with your bone, thus creating more bone.

Joseph Haynes
925 East Main Street
Auburn, WA 98002

(253) 275-0413
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