Gum disease treatment and laser periodontal therapy.
From the earliest signs of gingivitis to advanced bone loss, Drs. Engen and Pizzini treat every stage of gum disease with surgical precision and, when appropriate, FDA-cleared laser therapy.
The leading cause of adult tooth loss, and highly treatable when caught.
Periodontal disease is a bacterial infection of the gum tissue and the bone that holds your teeth in place. It progresses from gingivitis (reversible gum inflammation) through mild, moderate, and advanced periodontitis, with increasing pocket depth, bone loss, and ultimately tooth mobility if untreated.
Because it is often painless in early stages, many patients don't know they have it until their dentist spots it at a routine visit. When a general dentist sees pocket depths, bone loss on X-rays, or tissue recession that needs surgical intervention, they refer to a periodontist.
Drs. Engen and Pizzini are among only a few board-certified periodontists in the Inland Northwest, meaning they have the specialty training and credentials to manage every stage of the disease.
Warning signs
- Gums that bleed when brushing or flossing
- Persistent bad breath
- Receding gums or teeth that look longer
- Loose or shifting teeth
- Pus between the teeth and gums
- A change in your bite
Every stage of disease, every level of treatment.
All procedures performed by a board-certified periodontist; no delegation to assistants for surgical steps.
Periodontal Exam & Evaluation
Comprehensive periodontal charting, pocket-depth measurements, bone assessment via X-ray, and a full-mouth evaluation to stage your disease and plan treatment.
Scaling & Root Planing
Deep cleaning below the gumline to remove calculus and bacterial deposits from root surfaces, allowing gum tissue to reattach and pockets to shrink.
Pocket Reduction Surgery
When non-surgical therapy is insufficient, osseous surgery reshapes the bone and gum tissue to reduce pocket depth and eliminate areas where bacteria can hide.
Gum Grafting
Connective tissue grafts to cover exposed roots, stop further recession, and restore both the protective gum line and the aesthetics of your smile.
Crown Lengthening
Reshaping of gum and bone to expose more of the tooth surface, required before certain crown restorations and to correct a "gummy smile."
Periodontal Maintenance
Ongoing supportive therapy at 3- to 4-month intervals to maintain the results of treatment and prevent recurrence of disease.
Periodontal Emergencies
Acute periodontal abscess, severe pain, swelling, or sudden tooth mobility. Call the office; urgent cases are seen promptly.
Laser-assisted gum therapy: less cutting, faster healing.
The LANAP protocol uses the PerioLase MPV-7, the first and only laser FDA-cleared to regenerate new periodontal attachment and bone. Dr. Engen is one of only three dentists in Spokane offering this treatment.
"The fiber is about the width of three human hairs, a precision you cannot achieve with a scalpel."Full PerioLase overview →
How LANAP works
- Step 1. The laser fiber removes infected tissue lining the pocket without cutting healthy gum.
- Step 2. Ultrasonic instruments clean root surfaces of calculus deposits.
- Step 3. A second laser pass sterilizes the pocket and stimulates a stable blood clot.
- Step 4. The clot forms a natural biologic seal, allowing new bone and attachment to regenerate.
Restore coverage, stop recession, improve aesthetics.
Connective tissue grafts
The most common grafting technique for recession. Tissue is harvested from the palate (or a donor source) and placed over exposed root surfaces to rebuild the gum line, reduce sensitivity, and improve the appearance of the teeth.
Periodontal plastic surgery
Cosmetic reshaping of the gumline, correcting uneven tissue, a "gummy smile," or asymmetrical gum levels, to improve the proportion and symmetry of your smile.
Crown lengthening
Surgical reshaping of gum and underlying bone to expose more tooth structure before a crown, veneer, or other restoration, and to achieve a balanced gum-to-tooth ratio.
Why treat recession?
Exposed root surfaces are at much higher risk for decay, are sensitive to temperature, and , without intervention, will continue to recede. Grafting halts further loss and restores both function and appearance.
Recovery
Most graft procedures are performed under local anesthesia with sedation available. Patients typically return to desk work within a day or two and resume normal diet within a few weeks as tissue heals.
Ready to move forward?
Whether you were referred by your dentist or are seeking a specialist on your own, we welcome self-referrals and referrals alike. Contact us to schedule a comprehensive periodontal evaluation.