Gum Specialist

Dr. Irit Shoval

Dr. Irit Shoval graduated with a Masters in Periodontology from the University of Toronto. She remains a clinical instructor at the Faculty of Dentistry in the fourth year undergraduate clinic and is involved in the admissions process for dental school candidates. Her practise is limited to Periodontics and Implant Dentistry. This includes flap surgery for periodontal disease, gum and bone grafting, pre-orthodontic procedures, dental implant placement as well as many other procedures. Irit lectures frequently to both dentists and laboratory technicians and is very active in continuing education seminars. Irit practises both at Dr. Kleins office as well as in her specialty practises.

Services

flap surgery for periontal disease treatment
scaling and root planing with and without subgingival placement of medicament
crown lengthening
soft tissue grafting
hard tissue grafting
dental implant placement
direct and indirect sinus lifts cuspid exposures
frenectomy/fibrotomy
biopsy
exploratory surgery

It is our goal to deliver comprehensive dental care. For this reason, we have equipped our office to provide you with a range of specialized periodontal services. Such procedures include treatment of gum disease, gum grafting, dental implants, bone grafting and other aesthetic gum procedures.

Treatment of Gum Disease

Figure 1

Periodontal disease, also known as “gum disease”, is a chronic bacterial infection that damages the gums and bone supporting the teeth. Left untreated, it can lead to tooth loss. More importantly, research links periodontal infection to more serious problems, such as cardiovascular disease, diabetes and pre-term low-birth weight babies.

There are several conservative options to treat periodontal disease. These include, deep scaling and root planing, local antibiotic delivery and systemic antibiotic prescriptions. If the gum disease is moderate to severe, periodontal pocket reduction surgery may be necessary.

The purpose of this procedure is to allow access for cleaning the roots of the teeth and the adjacent gum tissue and to eliminate defects in the bone surrounding the teeth. The goal of this procedure is to prolong the retention of the teeth by reducing infection and inflammation and decreasing pocket depths. A periodontal consultation will allow us to customize the proper treatment for you.

Gum Grafting

Figure 2

When the gums recede, the root(s) of the tooth/teeth becomes exposed. This can lead to tooth sensitivity (to hot, cold and sweets) or aesthetic concerns. Treatment for this condition may be necessary when there is a concern about the recession progressing and for aesthetic/tooth sensitivity concerns. Soft tissue or gum grafting will result in an increase in the thickness of the tissue surrounding the tooth/teeth which will prevent further recession and bone loss. See figure 1 and 2. There are several indications for gum grafting. These are 1) covering the roots of teeth that have had recession of the gums for aesthetic, tooth sensitivity or root decay concerns 2) thickening the tissue around the teeth to prevent further recession of the gums or as a preventive measure prior to orthodontic treatment. Many factors can contribute to gingival recession, including aggressive tooth brushing, periodontal disease, genetic predisposition as well as several others.

Dental Implants

Figure 3

Figure 4

The purpose of dental implants is to allow the patient to have more functional artificial teeth or improved appearance. Implants provide anchorage, support and retention for artificial teeth or crowns. A missing tooth (or teeth) can be replaced by a dental implant, conventional bridge or denture. A dental implant has the advantage over the other two mentioned approaches because it does not involve the adjacent teeth to the missing space (bridge) and it is a fixed prosthesis rather than having to remove it nightly (denture). In addition, once an implant is inserted into the jaw bone it acts to prevent further atrophy of this bone with time. There are two phases to this treatment option, a surgical and a prosthetic phase. It involves raising the gum tissue to expose the underlying bone. If during the surgery clinical conditions are unfavorable for placement of an implant, supplemental bone grafts may be required to build up the ridge (see below). Once the implant is secured in place in the jaw bone, the overlying gum tissue is then stitched closed and the area is allowed to heal for 3-6 months. After this healing stage, a second small surgical procedure may be necessary to expose and test the stability of the implant. Following this, the implant is ready to receive the crown and this stage will be done by your general dentist. In addition to replacing one tooth with an implant, implants can be placed to help retain a denture. This will provide you with a more secure denture that allows for easier and more effective chewing capabilities (figure 3 and 4).

Bone Grafting

This procedure is sometimes necessary prior to dental implant placement. Implants rely on an adequate amount of jaw bone of sufficient quality to heal properly. If there is insufficient bone, it is possible to build the bone to allow for subsequent implant placement. This bone can be harvested from another area in the mouth. If this is not possible or desirable there are other options available such as bone harvested from a cow or other human being. A healing period is necessary to allow for the supplemental bone to fuse to your existing jaw bone. Following this healing time we can continue with your dental implant treatment plan.