Adjunctive treatment is additional treatment that is needed before or after orthodontic treatment in order to ensure the success of overall periodontic procedures. The goals of orthodontic treatment are to help patients achieve a functional bite and teeth that are esthetically appealing and free from abnormalities that make dental care difficult. When adjunctive treatment is needed, orthodontists may refer patients to dentists, periodontists, prosthodontists, or oral surgeons as needed. Orthodontists will typically work one on one with other professionals to ensure that all adjunctive treatments are geared towards achieving the same goals.
Mild surgical procedures may be helpful in achieving optimal results when patients have issues such large frenums, highly rotated teeth, or excess gum tissue creating the look of a gummy smile. A frenectomy will remove or reposition a portion of the frenum to relieve pressure and help close gaps between the front teeth. A fiberotomy releases the elastic fibers that hold crooked teeth in place and help those teeth return to their original positions after orthodontic treatment. Gigivoplasty is a procedure done to sculpt the gum tissue to correct uneven gum heights or make a smile less gummy. These procedures may be performed before or after orthodontic treatment, depending on the case.
If teeth are missing or must be removed due to decay, it may be helpful to use prosthetic teeth or to have dental implants put in before beginning orthodontic treatment. The implants or prosthetics may be necessary to hold the place where teeth were so that the remaining teeth can be adjusted to the desired positions. A dentist or a periodontist may be able to perform the procedure. Dental implants can help patients to achieve a healthier and more beautiful smile than would be possible with only the remaining teeth.
If patients have periodontal disease, it is important to treat the infection before placing braces or performing any other type of orthodontic treatment. Periodontists may treat the infection using antibiotics, which may be taken orally or placed directly into the gap between the gums and teeth. Patients will also have to take good care of teeth at home and possibly undergo root scaling to clear up periodontal infection. After the infection has been taken care of, it may sometimes be necessary to perform bone grafts before beginning orthodontic treatment.
Medications that may be prescribed to treat periodontal infections include: