Patient Frequently Asked Questions Periodontal

Basic Information

  1. What are periodontal diseases?

    Periodontal diseases are disorders that affect the supporting structures of the teeth - the gum tissue, bone support and ligaments that hold the teeth in place.
  2. What is a periodontist?

    A periodontist is a dentist who has received extra training to allow them to specialize in periodontics. After completion of dental education, most periodontists have three or more years of postdoctoral education, including hospital experience.
  3. Why do dentists refer patients to periodontists?

    Dentists refer patients to periodontists to assure they receive the best care for conditions that are beyond their scope of treatment.
  4. How do my general dentist and periodontist work together to help me?

    Your dentist and periodontist communicate with each other throughout your care, from the initial development of treatment plans, to any reconstructive considerations, to completion of care when your oral health has been re-established, through ongoing maintenance care.

Gingivitis, Periodontitis, Recession

  1. What is gingivitis?

    Gingivitis is inflammation of the gums, usually caused by a reaction to the bacterial biofilm, sometimes referred to as plaque that grows around the teeth.
  2. What are symptoms of gingivitis?

    Red, puffy, swollen, bleeding gums are signs of gingivitis.
  3. How is gingivitis detected?

    Simple visual examination can reveal the signs of gingivitis. Rubbing on the gums may also elicit bleeding.
  4. What is periodontitis?

    When inflammation moves deeper, causing loss of tooth supporting bone, the disease is called periodontitis.
  5. Does gingivitis lead to periodontitis?

    While it is possible to have gingivitis that does not progress to periodontitis, it is very rare for periodontitis not to be preceded by gingivitis.
  6. What are symptoms of periodontitis?

    Early periodontitis can have no symptoms. Eventually bad breath, increasing space between the teeth, tooth mobility or deep aching pain around the teeth may be experienced. In advanced cases, abscess can form between the roots and gums or bone support.
  7. How is periodontitis detected?

    Your periodontist will examine your gums, check for recession, evaluate how your teeth come together in biting positions and check for any loose teeth. A small measuring instrument will be placed between the teeth and gums to determine the depth of those spaces. X-rays may also be taken.
  8. How does periodontitis cause tooth loss?

    Periodontitis causes loss of tooth supporting bone. Without treatment, teeth may become unbearably painful, uncomfortably loose, or abscessed.
  9. What is recession?

    Recession is a condition characterized by movement of the gumline away from the tooth crown.
  10. What are symptoms of recession?

    Exposed roots, roots that are sensitive to temperature, sweets or touch, increased build up of debris or calculus on the roots, or root decay all are symptoms of recession.
  11. How is recession detected?

    Direct measurements of recession can be made in the mouth.
  12. How does recession affect teeth?

    The resulting root exposure increases susceptibility to decay and periodontal disease. It also causes loss of bone support.
  13. Do bite problems have anything to do with periodontal disease?

    Bite problems can cause loss of bone support and, if periodontitis is present, they can speed it up.
  14. How are bite problems treated?

    Usually, selective tooth reshaping is performed. Sometimes, full coverage restoration is used to develop proper tooth relationships.

Causes of Periodontal Diseases

  1. What causes periodontal diseases?

    In most cases, periodontal diseases are caused by inadequate personal care for the mouth, allowing growth of harmful bacteria and inflammation of the tooth supporting structures.
  2. What is plaque?

    Plaque is a soft biofilm of bacteria that adheres to tooth and root surfaces.
  3. What is calculus?

    Calculus is plaque that has mineralized, becoming hard and sometimes dark as it firmly adheres to tooth surfaces above and below the gumline.
  4. How can I prevent periodontal disease?

    By cleaning your teeth properly and seeing a dentist for regular preventive cleaning of the teeth. Smoking also increases the risk for periodontal disease.
  5. What x-rays are best for diagnosing periodontitis?

    Individual x-rays of two or three teeth at a time, called periapical x-rays, provide better definition of periodontal structures than a single x-ray scan of the whole mouth, called a panoramic x-ray.

Treatment of Periodontal Diseases

  1. How is gingivitis treated?

    Gingivitis is largely reversible with removal of tooth deposits and institution of good oral hygiene.
  2. How is periodontitis treated?

    Individual treatment depends to a great extent on the particular features of each case. It generally can involve home care instruction, cleaning and smoothing of root surfaces, and a minor office surgical procedure that involves repositioning of gum tissues and reshaping of tooth support.
  3. How is recession treated?

    Minor office procedures involving grafting of soft tissues can restore root coverage and establish adequate gum tissue to prevent further recession.
  4. What is scaling and root planing?

    Scaling and root planing involves removal of harmful deposits from tooth and root surfaces and smoothing of root surfaces. It can be a first stage treatment for periodontitis or definitive treatment for early cases.
  5. What is pocket reduction surgery?

    Pocket reduction surgery involves repositioning of gum tissues and reshaping of tooth support.
  6. Is it possible to regenerate lost periodontal structures?

    In some cases, regenerative procedures can be employed, that help replace lost gum tissue or bone structure.
  7. How can teeth lost to periodontitis be replaced?

    While teeth can be replaced with removable complete dentures, removable partial dentures or fixed partial dentures (bridges), the best value is achieved with implant supported replacement. Implant supported replacements are the longest lasting, most comfortable, conservative and natural replacements available.

Periodontal Disease and other Diseases

  1. Is periodontitis linked to other diseases?

    Recent studies suggest that having periodontitis may increase the risk for heart disease, stroke, diabetes, pneumonia, preterm low birth weight delivery, and other health problems.
  2. How are periodontitis and heart disease linked?

    Recent studies suggest that having periodontal disease may nearly double the risk for having a fatal heart attack. One theory is that white blood cells become altered in people with periodontal disease, causing increased build up of the coronary artery deposits that constrict blood flow to the heart.
  3. How are periodontitis and stroke linked?

    Recent studies suggest that having periodontal disease increases the risk for stroke. The mechanism is believed to be similar to that which increases risk for coronary artery disease.
  4. How are periodontitis and diabetes linked?

    People with diabetes battle infections poorly, and periodontitis is an infection of the supporting structures of the teeth. Studies show that for adults with late onset, or Type II diabetes, blood sugar is better controlled when periodontal health is present, and control of blood sugar also helps control of periodontal disease.
  5. How are periodontal disease and pneumonia linked?

    Recent studies suggest that people with severe periodontitis are at increased risk for pneumonia. It is believed that inhalation can transmit the very harmful bacteria that cause periodontitis into the lungs, where they can start serious infections.
  6. How are periodontitis and preterm low birth weight delivery linked?

    Recent studies suggest that mothers who have severe periodontitis are at significantly increased risk for preterm delivery of low birth weight babies. It is believed that the increased gum inflammation leads to inflammation and irritation of other membranes in the body, such as the sac that protects a baby. Irritation of these membranes can cause preterm delivery.
  7. Can some medications contribute to periodontal disease?

    There are medications that suppress the immune response or reduce the secretion of protective saliva; these can make people more at risk for periodontal infections. Other medications can increase growth of the gums, leading to the formation of periodontal pockets and gum infection.

Maintaining Health after Treatment

  1. Can I get periodontitis back, after I have been treated?

    Yes, Periodontitis is a chronic disease caused by bacteria. It must be maintained once under control.
  2. How can I keep from getting periodontitis back again?

    You can maintain your periodontal health with good daily homecare and regular professional care.
  3. What is Periodontal Maintenance Care?

    It is the phase of care preformed after completing treatment of periodontitis.
  4. What is done during a periodontal maintenance care appointment?

    Your gums and bone support are examined, deposits are removed from tooth surfaces and the teeth are polished. Antibacterial agents may be applied to any periodontal pockets. Home care is evaluated and special procedures or assistance with technique is offered.
  5. How are my dental and periodontal maintenance care appointments coordinated?

    Usually patients alternate between their general dentist's office and the periodontist's office.
  6. How often should I be seen for periodontal maintenance care?

    Most patients who have completed treatment for periodontitis are seen every three to four months on an alternating basis between their referring dentist's office and their periodontist's office.
  7. How often should I have x-rays?

    While individual x-rays may be indicated at anytime depending on the particular condition, in general, x-rays to find cavities between the teeth are taken every year to year and a half and x-rays to evaluate bone support are taken every three to five years.
  8. What is a Dental Hygienist?

    A Dental Hygienist is a licensed oral health care professional whose focus is on prevention and treatment of dental disease. Dental Hygienists are graduates of accredited dental hygiene education programs. They are required to pass written and clinical exams before obtaining a license to practice. Dental Hygienists are key members of the Dental Team.
  9. What role do Dental Hygienists play in the treatment of periodontal disease?

    Dental Hygienists provide initial periodontal therapy as well as maintenance care. They also provide education on home care instruction.