The Apex of Periodontal Care
Through specialized expertise, advanced technology, and minimally invasive surgical techniques, Dr. Miriam Ting of Think Oral Implants and Periodontics excels at restoring patients’ smiles.Â
Miriam Ting, D.M.D., M.S., cannot imagine having a more fulfilling career. As one of the area’s leading periodontists and implantologists, she devotes her days to improving patients’ health and quality of life in a challenging field that blends art and science.
Dr. Ting is the founder of Think Oral Implants and Periodontics, which has offices in Paoli, Swarthmore, and Philadelphia’s Fox Chase neighborhood. She specializes in the prevention, diagnosis, and treatment of periodontal disease, a significant health issue with potentially lethal implications. In addition, she performs soft-tissue grafting, dental implants, and other highly specialized procedures.
We spoke with Dr. Ting about the serious nature of the conditions she treats, how minimally invasive surgery and technology have reshaped the patient experience, and the many ways in which her practice can restore a smile’s aesthetics, function, and overall health.
Q&A
Let’s start with periodontal disease, which affects almost half of all U.S. adults over the age of 30. Why is it so important to seek expert treatment for periodontal disease?
Because most people want to keep their teeth. People will experience bone loss as periodontal disease progresses, and as a result, their tooth—or even multiple teeth—can become loose and fall out. If that weren’t enough, periodontal disease is tied directly to systemic health. It has been linked to stroke, cardiovascular disease, diabetes, and some cancers. As the bacteria enters the bloodstream, it becomes more pathogenic. We’re also seeing the inhalation of the bacteria being linked to respiratory conditions such as pneumonia. The good news is that we can completely remove the aggressive periodontal pathogens with advanced forms of treatment.
Let’s start with periodontal disease, which affects almost half of all U.S. adults over the age of 30. Why is it so important to seek expert treatment for periodontal disease?
Because most people want to keep their teeth. People will experience bone loss as periodontal disease progresses, and as a result, their tooth—or even multiple teeth—can become loose and fall out. If that weren’t enough, periodontal disease is tied directly to systemic health. It has been linked to stroke, cardiovascular disease, diabetes, and some cancers. As the bacteria enters the bloodstream, it becomes more pathogenic. We’re also seeing the inhalation of the bacteria being linked to respiratory conditions such as pneumonia. The good news is that we can completely remove the aggressive periodontal pathogens with advanced forms of treatment.
What treatment options do patients have to address periodontal disease?
Periodontal disease has traditionally been addressed through invasive surgery, and in some practices that is the only option. My goal is to remove the periodontal pathogens from the body with a combination of laser therapy and antimicrobial therapy. Laser therapy kills the bacteria, removes the diseased lining of the periodontal pocket, and stimulates bone regeneration. It also preserves as much tissue as possible, which is a significant difference compared with the scalpels and sutures needed for a surgical approach.
Periodontal disease has traditionally been addressed through invasive surgery, and in some practices that is the only option. My goal is to remove the periodontal pathogens from the body with a combination of laser therapy and antimicrobial therapy. Laser therapy kills the bacteria, removes the diseased lining of the periodontal pocket, and stimulates bone regeneration. It also preserves as much tissue as possible, which is a significant difference compared with the scalpels and sutures needed for a surgical approach.
The laser my practice uses to treat periodontal disease is FDA cleared for periodontal regeneration. Some people might be familiar with the acronym LANAP, which stands for laser-assisted new attachment procedure. In my practice, we not only customize treatment to the patient’s needs, but we also customize the tools we use for their care.
Most patients are fearful of pain during and after treatment for periodontal disease. When you use laser therapy, patients will have no pain during the procedure other than a pinprick [from local anesthetic] to numb the area. Post-procedure, patients tend to have minimal discomfort, and some report having no pain at all. For patients who are phobic or very nervous, we have nitrous gas available to make the procedure as relaxing as possible.
Most patients are fearful of pain during and after treatment for periodontal disease. When you use laser therapy, patients will have no pain during the procedure other than a pinprick [from local anesthetic] to numb the area. Post-procedure, patients tend to have minimal discomfort, and some report having no pain at all. For patients who are phobic or very nervous, we have nitrous gas available to make the procedure as relaxing as possible.
Dental implants represent another area of specialty for your practice. Implants have come a long way in the past 10 or 15 years. What can patients expect in terms of their options and outcomes?
We now have a lot of good, long-lasting solutions for people who have lost one or more teeth. In many cases, these implants last a lifetime. We can do a single tooth or multiple teeth, and we also do full-arch implants through All-on-X, which is a denture-less fixed prosthesis that attaches to the jaw with multiple implants. As part of the process, we will also take care of the periodontium, or the tissues and structures surrounding the implant, so we might recommend a bone graft or a sinus lift to ensure a positive outcome. We carefully evaluate each patient’s needs and make sure we understand what they are willing to go through and what is within their budget so we can help them figure out the best option for them.
We now have a lot of good, long-lasting solutions for people who have lost one or more teeth. In many cases, these implants last a lifetime. We can do a single tooth or multiple teeth, and we also do full-arch implants through All-on-X, which is a denture-less fixed prosthesis that attaches to the jaw with multiple implants. As part of the process, we will also take care of the periodontium, or the tissues and structures surrounding the implant, so we might recommend a bone graft or a sinus lift to ensure a positive outcome. We carefully evaluate each patient’s needs and make sure we understand what they are willing to go through and what is within their budget so we can help them figure out the best option for them.
You also specialize in soft-tissue grafting. Can you describe the scenarios in which soft-tissue grafting would be helpful or necessary?
A lot of factors can contribute to gingival recession, which can be unsightly, increase sensitivity, and lead to decay. I use a minimally invasive technique in which I make a small incision to release the keratinized tissue gently, place a graft material, and reposition it to cover the receded area. In most cases, we would supplement the result by drawing out platelet-rich fibrin (PRF) from the recipient’s blood, which has leukocytes and antibacterial properties. Soaking the graft in the liquid PRF before it is sutured helps to increase healing, stimulate tissue regeneration, and reduce pain.
A lot of factors can contribute to gingival recession, which can be unsightly, increase sensitivity, and lead to decay. I use a minimally invasive technique in which I make a small incision to release the keratinized tissue gently, place a graft material, and reposition it to cover the receded area. In most cases, we would supplement the result by drawing out platelet-rich fibrin (PRF) from the recipient’s blood, which has leukocytes and antibacterial properties. Soaking the graft in the liquid PRF before it is sutured helps to increase healing, stimulate tissue regeneration, and reduce pain.
Snoring is a quality-of-life issue that affects not only the snorer, but also the snorer’s family. What options does your practice offer to address the problem?
One of the most common causes of snoring is loose or enlarged tissue in the soft palate and surrounding areas. When you’re relaxed and sleeping, the tissue vibrates and worsens a person’s snoring habit. I use a CO2 laser to tighten the collagen fibers in the loose tissue, which can open up the airway and reduce the vibrations that disrupt sleep. It’s a gentle, quick, and effective way to resolve a snoring issue without invasive surgery.
One of the most common causes of snoring is loose or enlarged tissue in the soft palate and surrounding areas. When you’re relaxed and sleeping, the tissue vibrates and worsens a person’s snoring habit. I use a CO2 laser to tighten the collagen fibers in the loose tissue, which can open up the airway and reduce the vibrations that disrupt sleep. It’s a gentle, quick, and effective way to resolve a snoring issue without invasive surgery.
Speaking of lasers, advanced technology seems like a big part of your practice.
There are different kinds of lasers for different purposes, and our practice utilizes many of them. We use an Nd:YAG laser to treat periodontal disease, a CO2 or Er:YSSG laser for soft-tissue and hard-tissue procedures like frenectomies, gingivectomies, and crown lengthening which require precise cuts and minimal charring.
There are different kinds of lasers for different purposes, and our practice utilizes many of them. We use an Nd:YAG laser to treat periodontal disease, a CO2 or Er:YSSG laser for soft-tissue and hard-tissue procedures like frenectomies, gingivectomies, and crown lengthening which require precise cuts and minimal charring.
In addition, we have a special laser for biostimulation to accelerate healing after certain procedures or to address postoperative complications. Laser biostimulation is an option, without which the body will still heal, but the body may have to work harder to contend with the pain and inflammation that can accompany a surgical procedure. It is most beneficial for patients who are medically compromised and need that extra boost.
With everything we do, our intention is to make sure our patients leave the office better off than when they came in. Technology has a big role in that.
About Dr. Ting
Dr. Ting earned a Bachelor of Dental Surgery degree from the Faculty of Dentistry at the National University of Singapore, and later earned her D.M.D. with Magna Cum Laude from the Temple University Kornberg School of Dentistry. She also completed specialist training in advanced periodontology and implantology, and received a M.S. in craniofacial biology at the University of Southern California.
Dr. Ting earned a Bachelor of Dental Surgery degree from the Faculty of Dentistry at the National University of Singapore, and later earned her D.M.D. with Magna Cum Laude from the Temple University Kornberg School of Dentistry. She also completed specialist training in advanced periodontology and implantology, and received a M.S. in craniofacial biology at the University of Southern California.
Dr. Ting is a diplomate of both the American Board of Periodontology (ABP) and the International Congress of Oral Implantologists (ICOI). She is board-certified by the ABP and the ICOI as an expert in the field of periodontology and implantology.
Not only is Dr. Ting a skilled clinician, but she’s also a respected educator who enjoys imparting her knowledge to others. She has a faculty appointment at the Department of Periodontics at the University of Pennsylvania School of Dental Medicine. She is also the attending periodontist for the Graduate Program Residency at Einstein-Jefferson Hospital. In addition, she is the founder and director of the Think Dental Learning Institute, which provides evidence-based continuing education to dental clinicians who are devoted to high-quality care.
Think Oral Implants and Periodontics
(610) 550-3333
thebestdentaloralcare.com | youtube.com/@AskDrTing | thinkdentallearninginstitute.com
250 W. Lancaster Ave., Suite 215
Paoli, PA 19301
7500 Central Ave., Suite 101
Philadelphia, PA 19111
801 Yale Ave., Suite G6A
Swarthmore, PA 19081
(610) 550-3333
thebestdentaloralcare.com | youtube.com/@AskDrTing | thinkdentallearninginstitute.com
250 W. Lancaster Ave., Suite 215
Paoli, PA 19301
7500 Central Ave., Suite 101
Philadelphia, PA 19111
801 Yale Ave., Suite G6A
Swarthmore, PA 19081
Photo by Jeff Anderson
Published (and copyrighted) in Suburban Life magazine, January 2024.