A:

Four out of five people have periodontal disease and don’t know it!  Most people are not aware of it because the disease is usually painless in the early stages.  Unlike tooth decay, which often causes discomfort, it is possible to have periodontal disease without noticeable symptoms.  Having regular dental check-ups and periodontal examinations are very important and will help detect if periodontal problems exist.

Periodontal disease begins when plaque, a sticky, colorless, film of bacteria, food debris, and saliva, is left on the teeth and gums.  The bacteria produce toxins (acids) that inflame the gums and slowly destroy the bone.  Brushing and flossing regularly and properly will ensure that plaque is not left behind to do its damage.

Other than poor oral hygiene, there are several other factors that may increase the risk of developing periodontal disease:

• Smoking or chewing tobacco – Tobacco users are more likely than nonusers to form plaque and tartar on their teeth.

• Certain tooth or appliance conditions – Bridges that no longer fit properly, crowded teeth, or defective fillings that may trap plaque and bacteria.

• Many medications – Steroids, cancer therapy drugs, blood pressure meds, oral contraceptives.  Some medications have side affects that reduce saliva, making the mouth dry and plaque easier to adhere to the teeth and gums.

• Pregnancy, oral contraceptives, and puberty – Can cause changes in hormone levels, causing gum tissue to become more sensitive to bacteria toxins.

• Systemic diseases – Diabetes, blood cell disorders, HIV / AIDS, etc.

• Genetics may play role – Some patients may be predisposed to a more aggressive type of periodontitis.  Patients with a family history of tooth loss should pay particular attention to their gums.

Signs and Symptoms of Periodontal Disease

• Red and puffy gums – Gums should never be red or swollen.

• Bleeding gums – Gums should never bleed, even when you brush vigorously or use dental floss.

• Persistent bad breath – Caused by bacteria in the mouth.

• New spacing between teeth – Caused by bone loss.

• Loose teeth – Also caused by bone loss or weakened periodontal fibers (fibers that support the tooth to the bone).

• Pus around the teeth and gums – Sign that there is an infection present.

• Receding gums – Loss of gum around a tooth.

• Tenderness or Discomfort – Plaque, calculus, and bacteria irritate the gums and teeth.

Good oral hygiene, a balanced diet, and regular dental visits can help reduce your risk of developing periodontal disease.

A:

Many people are unaware that having periodontal disease (the destruction of gum tissue and bone that hold our teeth in place) can affect your overall health.  Periodontal disease is one of the most common infections; often more prevalent than the common cold!  Periodontal disease is not only the number one reason people lose teeth; it can also affect the health of your body!

Periodontal disease is a bacterial infection, and in its earliest stages, it’s called gingivitis.  It starts when an accumulation of plaque (a colony of bacteria, food debris, and saliva) is NOT regularly removed from the gums and teeth.  The bacteria in plaque produce toxins/acids that irritate and infect the gums and eventually destroy the jaw bone that supports the teeth.  When periodontal disease is not treated it can eventually lead to tooth loss!

There are numerous studies that have looked into the correlation between gum disease and major medical conditions.  These studies suggest people with periodontal disease are at a greater risk of systemic disease and indicate that periodontal disease may cause oral bacteria to enter the bloodstream and travel to major organs and begin new infections.  Research suggests that periodontal bacteria in the blood stream may:

• Contribute to the development of heart disease
• Increase the risk of stroke
• Compromise the health of those that have diabetes or respiratory diseases
• Increase a woman’s risk of having a preterm, low-birth weight baby

Researchers conclude there is still much research to be done to understand the link between periodontal disease and systemic diseases, but enough research has been done to support that infections in the mouth can play havoc elsewhere in the body.

To ensure a healthy, disease-free mouth, we recommend the importance of regular dental check-ups and cleanings, which include a periodontal evaluation.  Also, diligent home care and a proper diet can help reduce the plaque and bacteria in the mouth.

Remember….the mouth body connection!  Taking care of your oral health may contribute to your overall medical health!

A:

After your mouth is restored to health, you still require monitoring. Periodontal disease is controlled, not cured. Regular maintenance can ensure disease control by eliminating bacteria on a more frequent schedule.

Why do I have to alternate my maintenance between my general dentist and a periodontist?

The primary job of a periodontist is to monitor the health of your gums and assess your homecare to evaluate control of gum disease. Your general dentist is, in a sense, a specialist in detecting cavities and restoring diseased teeth. He or she will pay special attention to your restorative needs.

A: First and foremost, if you are a smoker, quit! Studies have shown that smoking does numerous things that increases your risk for gum disease and tooth loss. Uncontrolled diabetes will also put you at significant risk for gum disease and tooth loss. Coming in for regular maintenance and taking good care of your teeth at home are of significant benefit.

A:

Gingivitis is inflammation of the gums. Your gums may be swollen, reddened, and bleed when brushed or flossed. The difference between this and periodontal disease is that no bone has been lost around the teeth yet.

A: Guided tissue regeneration is a technique to restore structures that may have been lost due to disease. There are several ways to accomplish this. It is the preferred method of treating periodontal disease, but it is not possible in every case.

A:

Crown lengthening is simply making a tooth longer, so the crown will fit properly and the gums remain healthy. The top of the tooth is referred to as a crown, so making it longer is crown lengthening. This may be done to enhance your smile, or to allow a dentist to restore a tooth that has broken off or has a very deep cavity. Please refer to the case picture section for an example of a crown lengthening done to improve esthetics.

A:

A dental implant is a titanium root replacement that is placed into the bone. A healing phase follows, and during that time, the bone tightly "bonds" to the implant securing it in place. Following the healing phase, your restorative dentist can place a tooth on top of the dental implant which now acts as a titanium root. In some select instances, the implant can be placed at the time of the extraction to shorten the treatment time. Please refer to the case picture section for a before and after
photo of a single tooth restored with implants.

A:

A bridge is essentially two teeth that are holding an artificial one between them. These two teeth have crowns (caps) on them to hold the artificial one in place. If you get a cavity on one of them, you need to replace the whole bridge. In addition, all bridgework will eventually need to be replaced. A
dental implant does not require placing crowns on teeth that do not even need them. If the crown on the implant needs to be replaced for some reason, you are simply replacing one, not three, as you would with a bridge.

There are several other benefits that can be specific to the case. Ask your
dentist how they can benefit you.

A:

No, periodontal disease is typically a "silent" disease in that no pain may be noted until the disease has become advanced. Therefore, it is very important that radiographs and periodontal probing be completed regularly to identify disease early. Bleeding gums, shifting teeth and bad breath are all signs of disease.