A perfect smile is
about more than just teeth. The supporting structures of your teeth, including the gums, also play an
essential role in your overall appearance and wellbeing. A periodontist can prevent, diagnose and treat
conditions that affect these structures.
Dr. Kenneth Lee has been practicing dentistry for 44 years and is a certified specialist in periodontics and
prosthodontics (aesthetic and reconstructive dentistry). In addition to running his practice, he is the
director and organizer of a dental study club for dentists, holds faculty appointments at three universities
— the University of Washington in Seattle, the University of British Colombia in Vancouver and McGill
University in Montreal — and is invited to lecture internationally in Europe, Asia, and North America.
Dr. Michelle Lee has been practicisng dentistry for eight years and is a certified specialist in
periodontics. She also has faculty appointments at the University of Washington, and teaches weekly at the
University of British Colombia as a clinical assistant professor.
We spoke with the father-daughter team about their practice and what a periodontist can do for you.
Q:
How did
the two of you come to be working together?
KL:
I
currently practice with my daughter, Michelle, who is in fact a third-generation dentist in our family!
My father was also a dentist and I used to practice with him before he retired in 1977. Some of
his patients are now being treated by Michelle and I feel they are fortunate to have such excellent
continuity of care. In fact, I am very proud to say that Michelle is not the only third-generation
dentist in our family. I have twin daughters, and Melissa, Michelle’s identical twin sister, is also a
periodontist. Melissa, however, recently got married and has moved to Waterford, Ireland to practice with her
husband.
Q: What part of the business do you each deal with?
KL: Michelle followed the same education as I did, graduating from McGill University with
her dental degree and then specializing in periodontics at the University of Washington. Because of this we
have similar philosophies of treatment and Michelle and I share the care of our patients. She will be
continuing the practice when I retire. We provide periodontal care and dental implant treatment to replace
missing teeth.
Q: Why is it important to see a periodontist?
KL: It is important to see a periodontist in order to make sure that the teeth and gums are
healthy. If the gums are not healthy, bone loss around the teeth can occur, resulting in loosening of the
teeth and eventual tooth loss.
Q:
Who
should be concerned with gum disease?
ML: Gum disease can occur in anyone and especially in patients who have risk factors for the
development of gum disease, such as those who smoke, who are diabetic, or who may have an underlying medical
condition making the immune system weak. Gum disease may be localized to a small area or generalized,
affecting the whole mouth.
Q: What is periodontal therapy?
ML: Periodontal therapy is treatment aimed at improving the health of the dental supporting
structures, reducing inflammed gum tissue, and reducing the bad bacteria.
Q: Who would need it?
KL: Everyone who would like to preserve their teeth and good health! Sound dentition
is required to maintain good health because people have to eat and enjoy food.
Q: What would periodontal therapy involve?
ML: Initial periodontal treatment usually involves deep cleaning, where the roots of the
teeth are cleaned very well and in more involved cases, periodontal surgery would follow. Often times, people
have lost teeth as a result of advanced periodontal disease or trauma and we replace these teeth with dental
implants. Because of our training and background, our practice provides treatment related to the
placement of dental implants. Especially if placed in the visible front region, bone or soft tissue grafting
may be required in order to achieve an ideal natural aesthetic result.
Q: How long would it take for results to be seen?
ML: Initial improvements in gum tissue health from the deep cleanings can be seen within a
few weeks, but any bone healing or changes will take a few months.
Q: Tell me about bone grafting. Why would a patient need it?
ML: A patient may need a bone graft if they have lost bone around teeth or, quite commonly,
if they have lost a tooth and we are planning to place dental implants. A dental implant must be placed into
bone and if there is not enough bone, we need to grow the bone first.
Q: What would the procedure be like?
ML: Bone grafting around a tooth involves cleaning the root surface well, placing the bone
graft into the bony defect, covering the area with a membrane and allowing time for healing. When performing
a bone graft prior to the placement of a dental implant, this would involve placing the graft material where
the bony ridge is deficient, covering the graft with a membrane and closing the gum tissue back over. Bone
healing would take approximately six months.
Q: What is gingival recession?
KL: Gingival recession is when the gum tissue has receded or disappeared from the tooth,
exposing the root surface and making the tooth appear longer. Often times, these teeth will experience
more sensitivity and be at risk for developing abrasion, cavities and further recession, not to mention it is
unaesthetic. The root surface is usually darker than the crown so it is quite noticeable.
ML: [Recession is] commonly caused by aggressive toothbrushing, bite problems, having thin
gum tissue, and periodontal disease.
Q: Who does it most commonly affect?
KL: It most commonly affects patients with thin gum tissue and those who brush very
aggressively with medium-hard bristle toothbrushes.
Q: Tell me how dental aesthetics relates to gum health and gingival harmony.
ML: An aesthetic smile is not only related to the teeth itself, but how they fit in the
mouth and the frame around it, [for example] the gum tissue. Our eyes appreciate symmetry between the right
and left sides and if there is a discrepancy in gum tissue height, it will be very noticeable. For example,
if one front tooth has gum recession making it look a lot longer than the other side, making a new crown for
it will not change the proportion, only the colour or shape of the crown. But if a gum graft was performed to
cover the exposed root surface and to restore the normal tooth proportion, it will look much more natural and
will fit the smile better.
Q: Tell me about your work with trauma cases.
KL: We often see trauma cases from motor vehicle accidents, bicycle accidents or sport
accidents where teeth have been knocked out or fractured. Often, these teeth will be so badly damaged that
they are no longer restorable and will need to be removed and replaced with dental implants. Because of
the damage, rebuilding of the bone and soft tissue can be required prior to or at the time of dental implant
placement. Because of the healing time involved, this can take several months before the final result is
achieved. Dental implants are currently considered the standard of care to replace lost teeth either for
cosmetic reasons or chewing purposes.
Q: What is important to look for in a good periodontist?
KL: Someone who is properly qualified, experienced, recognized by their professional peers,
who is up to date in treatment and someone you feel comfortable with. •
For more information visit Dr. Kenneth Lee and Dr. Michelle Lee at vancouverperiodontics.com.
