Welcome to Total Dental Care of Middle Island.

Specialty Care

Periodontal Disease

Periodontal Disease Middle IslandPeriodontal or gum disease is an infection of the tissues that surround and support your teeth. It is a leading cause of tooth loss in American adults. It has also been linked to heart disease, stroke, diabetes and other health problems.

Plaque is the sticky film of bacteria that is brushed and flossed away with proper oral care. When left on the teeth, plaque produces toxins that attack below the gum line in the sulcus, a shallow v-shaped crevice between the tooth and gums. This causes the bond between teeth and gums to break down. In the early stage of gum disease (gingivitis), gums may become red and swollen and bleed easily. In the more advanced stage (periodontal disease), teeth can loosen and fall out.

Good oral hygiene and regular dental examinations are essential in the prevention and early detection of gum disease especially since you can have it without experiencing any warning signs.

Signs that you may have gum disease include:

  • Gums that are red, swollen, tender, bleed easily or pull away from the teeth
  • Persistent bad breath or bad taste
  • Loose or separating teeth
  • A change in the way your teeth fit together
  • A change in the fit of partial dentures



Arestin® is an antibiotic treatment that fights periodontal disease used during scaling and root planning (SRP) procedures. Arestin is inserted in powder form into infected areas of the gums to treat any areas that SRP may have missed. SRP used with Arestin is proven to be more effective than SRP performed alone.


Osseous Surgery

Osseous Surgery Middle IslandOsseous surgery involves reshaping the jawbone beneath the gums to remove bacteria and the holes or pockets caused by periodontitis. This is commonly performed to treat bone loss that has occurred around multiple teeth and requires local anesthesia.

Reducing pocket depth and eliminating existing bacteria is important to prevent damage caused by the progression of periodontal disease and to help maintain a healthy smile.


Laser Gum Treatment

Laser gum treatment is a noninvasive, painless procedure that can treat a wide range of gum conditions with advanced laser technology. This safe and affordable treatment can be used to treat gum disease; repair deep gum pockets, sore gums and tooth damage; and improve a gummy smile.

During laser gum treatment, no damage or changes are made to healthy teeth and gums. The laser is aimed directly at the targeted area without cutting any gum tissue and seals the area as it treats. There is no need for stitches and minimal risk of infection or bleeding with this conservative yet effective treatment.


Bone Grafts

Bone can be removed from one area and replaced, or grafted, into another to correct cosmetic or functional defects in the mouth, or to aid in the placement of dental implants. One or more types of bone graft may be recommended depending on the patient’s condition.

  • In a sinus lift, bone is grafted to the bottom of the sinus so that a dental implant may be placed in the upper back jaw.
  • Ridge augmentation replaces bone in the oral ridge that has been absorbed by the body.
  • Nerve repositioning procedures move the inferior alveolar nerve (the nerve that gives us feeling in our lower lip and chin) before placement of dental implants in the lower jaw.

Bone for a graft is often taken from within the mouth while preparing for the implant placement. The bone may also be taken from the chin, third molar (wisdom tooth) region, or upper jaw. For more extensive procedures, the hip or knee may serve as donor sites. Although bone is usually taken from the patient’s own body, alternate sources may be recommended such as synthetic bone material.


Oral Surgery

Oral Surgery Middle IslandOral surgery may be required to diagnose or treat injuries and diseases in the mouth. Biopsies can determine the presence of oral cancer or tumors, which may then be surgically removed (excised). Tooth extractions prevent or treat damage caused by impacted wisdom teeth or crowding. Surgical contouring of the jaw or gum line can correct jaw alignment problems, TMJ, malocclusion (“bad bite”) or other problems.



Tooth Extraction

Extraction is recommended when a tooth becomes loose from gum disease, when teeth are crowded, when one tooth is preventing another from erupting, or when a tooth is so damaged or decayed that root canal therapy would be ineffective.

Because missing teeth can cause health problems ranging from tooth shifting to difficulty chewing, restorative procedures are recommended following extraction. These may take the form of dental implants, bridges or dentures.

The procedure itself may require removal of soft or hard tissue, depending on whether the tooth is fully erupted. A local anesthetic is usually all that is needed to eliminate discomfort, although general anesthetic may be used for sensitive patients or children.


Wisdom Teeth

When they are correctly aligned, wisdom teeth pose no threat to the mouth and may even be helpful. Often, though, problems develop that necessitate their removal. When the jaw is too small to accommodate the extra teeth, they may erupt sideways (impacted), part of the way, or not at all. Improperly erupted wisdom teeth have the potential to damage nearby teeth, bone and roots, and invite bacterial infection, which in turn leads to pain, swelling, jaw stiffness and other problems. Removal by an oral surgeon is swift and effective.



Apicoectomy, or surgical root canal retreatment, is performed when a traditional root canal treatment was unsuccessful. It may correct unresolved space around the tooth, fistula in the gum, or persistent inflammation or infection in the area around the root tip. During the procedure, the root tip (apex) of the tooth and the surrounding infected tissue is removed under local anesthesia. The root is often sealed with a root-end filling, and the gingiva is repositioned with sutures.


Sedation Dentistry

Wisdom Teeth Middle IslandPatients who are uncomfortable with needles and drills, who have sensitive teeth or gums, or who have a strong gag reflex can be helped with dental sedation. After one pill or injection, many patients feel no discomfort whatsoever during and after treatment. They often have little or no memory of the visit. Another benefit is that extensive treatment can be done in one or two appointments, including whitening yellow or stained teeth, replacing crowns or dentures, fixing chipped or damaged teeth, and restoring sore gums to good health.


Laser Dentistry

Lasers allow many dental procedures to be performed with no noise and very little pain. They are versatile tools that can be used in oral surgery, curing of restorative materials, and removal of hard and soft tissue. Other benefits of laser dentistry over traditional methods can include:

  • Reduced heat and vibration
  • High precision
  • Little or no need for anesthetic
  • Little or no bleeding
  • Faster treatment time
  • Increased rate of curing/bleaching
  • Less post-operative pain and swelling
  • Fewer pain medications/antibiotics

Many patients find that laser dentistry is far more comfortable than traditional methods using drills. The only noise comes from air as it cools the area being treated. Laser technology also allows several procedures to be performed during a single appointment by your own dentist, so you can be in and out of the office faster.


Contact us for more information on Specialty Care


How we can help…

We offer a wide range of procedures to help you get the perfect smile.





Total Dental Care
Right Menu Icon