What is periodontal (gum) disease?

Periodontal disease is a chronic inflammatory response to dental plaque. It can lead to weakened gums and ultimately tooth loss.

Over time, bone loss occurs, causing pockets (spaces around the teeth, below the gum line) to appear that need professional cleaning. This loss of bone leads to loosening and possible loss of teeth.

How can my dentist tell if I need a periodontist?

A diagnosis of periodontitis is made by inspecting the soft gum tissues around the teeth and by evaluating the patient's x-ray films to determine the amount of bone loss around the teeth. Ask your dentist if they are regularly performing peroidontal probings.

Who's at risk for gum disease?

Here are some of the most common causes of gum disease:

• poor oral hygiene

• tobacco use

• genetic predisposition for gum disease

• pregnancy and menopause

• chronic stress and poor diet

• systemic diseases like diabetes, leukemia, thrombocytopenia
  

• certain medications
  

What signs of periodontal disease can I detect myself?

• red, swollen or tender gums

• bleeding while brushing, flossing, or eating hard food

• hereditary-did your parents loose their teeth?

• persistent bad breath

• a change in the fit of partial dentures

• signs and symptoms may go unnoticed, especially in smokers

Can periodontal disease be cured?

Periodontal disease is the primary cause of adult tooth loss, but with prompt treatment this
outcome can be avoided. For patients who are susceptible to periodontal disease; however, treatment is a lifelong process. The two most effective ways to ward off periodontal disease after successful initial treatment are:

1. good oral hygiene

2. regular cleanings by a dental hygienist

Can periodontal disease affect my overall health?

Researchers have discovered a strong link between periodontal disease and higher instances of systemic conditions, such as heart disease and stroke. In return, poor overall health from smoking and diabetes can make a person more susceptible to periodontal disease.

About your visit

Can I book an appointment myself or will my dentist have to send in a referral first?

A referral from your dentist or physician isn't necessary to be seen by Dr. Tillmanns. Please contact us and we'd be happy to book a consultation for you.

How soon can I get in to see Dr. Tillmanns?

We strive to book patients' appointments at their earliest convenience and accommodate patients travelling from out of town. For those with flexible schedules, we have a short-notice cancellation list that you can place your name on, and we will call you as an earlier appointment becomes available.

How will I pay for the treatment I receive? Will my insurance cover the costs of a periodontist?

Payment for your treatment is discussed during your consultation. Each patient's care is considered individually. Pre-authorization will be sent to your insurance prior to commencement of treatment, if you wish.

Is there communication between Dr. Tillmanns' office and my dentist's office?

Generally there is a very close relationship between our office and your family dentist to ensure that your oral care is optimized. However, privacy legislation doesn't allow us to communicate with your dentist without your specific consent.

Multidisciplinary Cases

Complex situations often require a multidisciplinary approach, meaning help from different areas of specialty in dentistry. We pride ourselves on having excellent working relationships with certified specialists in Orthodontics (movement of teeth through braces), Oral Surgery, Endodontics (root canals) and Prosthodontics (crowns, bridges, dentures).

My periodontal (gum) disease was treated by Dr. Tillmanns. Will my cleanings be done at his office from now on?

Most patients transfer back to their family dentist for regular cleanings after treatment is completed, health is re-established and stability is demonstrated. However, some patients will benefit from alternating visits between their regular dentist and Dr. Tillmanns. A few patients with more advanced gum disease may benefit from having their regular cleanings exclusively in Dr. Tillmanns’ office.

Why would I go to Dr. Tillmanns' for a cleaning instead of my general dentist's office?

Your cleaning appointments at Dr. Tillmanns’ and your dentist’s office are both performed by a Registered Dental Hygienist. However, because of their extensive periodontal experience, hygienists at Dr. Tillmanns’ can help identify potential deterioration early and have Dr. Tillmanns recommend possible interceptive treatment immediately. Scientific research has established that susceptible patients' oral health is better maintained long-term in a specialized periodontics practice.

About Periodontal Surgery

How long is the initial consultation?

The consultation can last from 1 to 1.5 hours, depending on your individual situation. During the consultation, we perform a physical examination of the mouth and teeth, may take x-rays, explain the necessary proceedures, talk about the risks/benefits of treatment, discuss pre- and post-op patient care, choices for pain management, cost of treatment(s), and book your treatment date(s).

I'm from out of town. Do I still have to travel for the consultation?

Yes. It's necessary for us to assess the condition of the mouth first-hand in order to give you an accurate diagnosis and treatment options.

How much will my treatment(s) cost?

Payment for your treatment is discussed during your consultation and will vary depending on your needs and wishes.

Does Dr. Tillmanns use 3D X-ray imaging in his diagnoses?

Yes. Dr. Tillmanns' uses 3D imaging. Our state-of-the-art Sirona Galileos x-ray machine provides patients extremely detailed three dimensional imaging, low radiation dosage, and is routinely used for complex situations and advanced diagnosing requirements.

How long will my surgery take?

The duration of the surgery varies for each patient, and is dependent on the severity of the disease.

Does Dr. Tillmanns use lasers to treat periodontal disease?

Since Dr. Tillmanns only uses clinically proven treatment methods, he does not use lasers at this time. Despite the hype by many laser manufacturers, none have demonstrated clinically significant benefits in the treatment of periodontal disease over traditional methods. Such laser treatments include PDT (photo-dynamic therapy, i.e. Periowave®). If the current situation changes and reliable, research based clinical evidence supporting the use of lasers in the treatment of periodontal disease becomes available, Dr. Tillmanns will re-evaluate his position. For further information see the Position Statement of the American Academy of Periodontology.

What sedation techniques does Dr. Tillmanns use?

There are many different levels of conscious sedation available in dentistry, ranging from inhalation of nitrious oxide (laughing gas), to oral sedation, to IV (intravenous) sedation. Dr. Tillmanns is qualified to perform each of these. Dr. Tillmanns and his staff are also certified in basic life support (BLS), and he has completed the Advanced Cardiac Life Support (ACLS) course numerous times.

Will I be able to drive myself home after surgery?

In most cases, our patients can drive themselves home. However, if you were sedated, you will be considered legally impaired for 24 hours and will not be able to operate a vehicle. We ask that you have someone who can care for you after surgery. If you're from out-of-town, please consult with our office staff when you're making your travel arrangements.

What kind of after-care does the office provide?

All of our patients are contacted within two days of surgery to see how their recovery is progressing. Dr. Tillmanns also provides his home phone number to patients and encourages them to call if there are any complications or concerns. Patients are usually booked for a post-operation visit 7-10 days after surgery. For out-of-town patients, we are usually able to arrange for your regular dentist to perform the post-op procedures.

About Implants

Will I need an implant for each missing tooth?

Not necessarily. Occassionaly, up to six missing teeth can be replaced with restoration supported by only two implants. Individual situations vary; recommendations are based on a thorough analysis of each patient.

How long does implant surgery usually take?

The average implant surgery takes about 1 hour. However, depending on the patient's individual situation, it could take longer and may include multiple surgeries. This will be discussed during your initial consultation.

Will my implants match the rest of my teeth?

We strive to create beautiful and symmetrical smiles. This involves not only the restoration on the implant(s), but also the supporting tissues (bone, gums). Whether you have one tooth or many that need replacement, our goal is to ensure that you are thrilled with the end result.

What if my implant fails?

It is very rare for implants to fail when placed properly. Our success rate exceeds 98% in non-smokers. Our policy in non-smokers is to replace implants should the implants fail within the first three years and if the patient has not been negligent. We do this at no extra cost to our patients. This is case-specific and patients must have followed all recommendations for post-operative implant care. Success rate of smokers in gerneral is lower than that of non-smokers, but it is still a very predictable treatment.