DEFINITIONS, CAUSES & SYMPTOMS
The word "periodontal" literally means "around the tooth."
Periodontal diseases are serious bacterial infections that destroy
the attachment fibers and supporting bone that hold your teeth in
your mouth. Left untreated, these diseases can lead to tooth loss.
There are many forms of periodontal disease: Gingivitis
Moderate to advanced periodontitis
Is there a relationship between tobacco use and periodontal
Studies have shown that tobacco use may be one of the most
significant risk factors in the development and progression of
periodontal disease. Smokers are much more likely than non-smokers
to have calculus form on their teeth, have deeper pockets between
the teeth and gums and lose more of the bone and tissue that support
Is it normal for my gums to bleed when I brush my teeth?
Bleeding gums are one of the signs of gum disease. Think of gum
tissue as the skin on your hand. If your hands bled every time you
washed them, you would know something was wrong. There are a number
of other warning signs of gum disease. Do you have warning signs of
What are pockets?
Your bone and gum tissue should fit snugly around your teeth like
a turtleneck around your neck. When you have periodontal disease,
this supporting tissue and bone is destroyed, forming "pockets"
around the teeth. Over time, these pockets become deeper, providing
a larger space for bacteria to live. As bacteria develop around the
teeth, they can accumulate and advance under the gum tissue. These
deep pockets collect even more bacteria, resulting in further bone
and tissue loss. Eventually, if too much bone is lost, the teeth
will need to be extracted.
Could my periodontal disease be genetic?
Research proves that up to 30% of the population may be
genetically susceptible to gum disease. Despite aggressive oral care
habits, these people may be six times more likely to develop
periodontal disease. Identifying these people with a genetic test
before they even show signs of the disease and getting them into
early interventive treatment may help them keep their teeth for a
lifetime. Request a free AAP brochure on the causes and symptoms of
Can I pass my periodontal disease to others?
Periodontal disease may be passed from parents to children and
between couples, according to an article in the September 1997 issue
of the Journal of the American Dental Association. Researchers
suggest bacteria that cause periodontal disease pass though saliva.
This means that the common contact of saliva in families puts
children and couples at risk for contracting the periodontal disease
of another family member. Periodontal disease can lead to tooth
loss. Based on this research, The American Academy of Periodontology
recognizes that treatment of gum disease may involve entire
families. If one family member has periodontal disease, the AAP
recommends that all family members see a dental professional for a
periodontal disease screening. More about the spread of periodontal
disease within families
What can I do to try and avoid periodontal disease?
To keep your teeth for a lifetime, you must remove the plaque
from your teeth and gums every day with proper brushing and
flossing. Regular dental visits are also important. Daily cleaning
will help keep calculus formation to a minimum, but it won't
completely prevent it. A professional cleaning at least twice a year
is necessary to remove calculus from places your toothbrush and
floss may have missed. Other factors can affect the health of your
We will be happy to give you a brochure on proper brushing and
What can I expect the first time I visit the office
During your first visit, your we will review your complete
medical and dental history with you. It's extremely important for us
to know if you are taking any medications or are being treated for
any condition that can affect your periodontal care. You will be
given a complete oral and periodontal exam. Dr Allen will examine
your gums, check to see if there is any gum line recession, assess
how your teeth fit together when you bite and check your teeth to
see if any are loose. He will will also take a small measuring
instrument and place it between your teeth and gums to determine the
depth of those spaces, known as periodontal pockets. This helps us
assess the health of your gums. Radiographs (x-rays) may be used to
show the bone levels between your teeth to check for possible bone
ORAL CARE PRODUCTS
What kinds of oral care products should I use?
Here are some guidelines for choosing dental care products – what
works for most patients most of the time. To find out what is best
for your particular needs, ask us.
Begin with the right equipment – a soft bristled toothbrush that
allows you to reach every surface of each tooth. If the bristles on
your toothbrush are bent or frayed, buy a new one. A worn-out brush
will not clean your teeth properly.
In addition to manual toothbrushes, your choices include
automatic tooth brushes and "high tech" electronic toothbrushes.
These are safe and effective for the majority of patients.
Oral irrigators (water spraying devices) will not remove plaque
from your teeth unless used in conjunction with brushing and
Another aid is the rubber tip, often found on the handle end of a
toothbrush used to massage the gums after brushing and flossing.
Other options include interproximal toothbrushes (tiny brushes that
clean plaque between teeth) and interdental cleaners (small sticks
or picks that remove plaque between teeth). If used improperly,
these dental aids can injure the gums, so it is important to discuss
proper use with us.
How should I choose toothpaste and mouth rinses?
Fluoride toothpaste and mouth rinse used in conjunction with
brushing and flossing can reduce tooth decay as much as 40 percent.
So, using products with fluoride is a good idea. However, mouth
rinses are not recommended for children under six. Children should
use only a pea-size dab of fluoride toothpaste on the brush to avoid
fluoride overdosing. Tartar control toothpaste will reduce tartar (a
buildup of hardened plaque) above the gum line. Anti-plaque rinses
approved by the American Dental Association contain chemical agents
that may help bring early gum disease under control. These rinses
can be a helpful addition to brushing and flossing.
What are the advantages of dental implants?
Dental implants look and feel like your own teeth. They can help
prevent the bone loss and gum recession that often accompanies
bridgework or dentures. In addition, they don't sacrifice they
quality of your adjacent teeth like a bridge because neighboring
teeth are not altered to support the implant. Implants are secure
and offer freedom from the clicks and wobbles of dentures and the
success rate of implants is highly predictable. More about dental
How do I care for my dental implants?
Dental implants are like your own teeth and will require the same
care. In order to keep your implant clean and plaque-free, brushing
and flossing still apply. Request a free brochure on dental
How can I avoid surgery for my periodontal disease?
Depending on how far your periodontal disease has progressed,
treatment can vary widely. If caught in the early stages, simple
procedures are done that will remove the plaque and calculus from
below the gum line and eliminate the infection-causing bacteria. If
these diseases have advanced to the point where the periodontal
pockets are deep and the supporting bone is lost, surgery might be
necessary. You may have heard about new products on the market that
claim to cure periodontal disease. Oftentimes, they do not replace
traditional periodontal therapy. Rather, the intent of these
products is to improve the effectiveness of traditional therapies.
Will periodontal surgery hurt?
New treatment options using refined techniques can be performed
comfortably as office procedures. Improvements in medications, local
anesthesia, anxiety and pain control, and, in some cases, conscious
sedation, are available to make your treatment more pleasant and
What is maintenance therapy?
Maintenance or supportive periodontal therapy is an ongoing
program designed to prevent periodontal disease from recurring for
patients who have undergone periodontal treatment. This ongoing
phase of treatment will allow us to assess your periodontal health
and make sure infection stays under control. During maintenance
therapy, your mouth is examined, new calculus and plaque are
removed, and, if necessary your teeth are polished and your bite is
How often do I need maintenance therapy?
The answer varies from person to person. We will tailor a
schedule that best helps to protect your periodontal health. The
intervals between visits may range from every few weeks to four
times per year, in addition to check ups by your general dentist.
What is root scaling and planing?
This is a non-surgical procedure where we remove plaque and
tartar from below the gum line. Tooth root surfaces are cleaned and
smoothed with specially designed instruments. It is important to
remove the plaque and tartar from the pockets, because aside from
the bacterial toxins that irritate the gums, plaque and the rough
surfaces of tartar make it easier for bacteria to get a foothold.
COSMETIC PERIODONTAL PROCEDURES
What can be done to improve the look of my "gummy" smile?
Crown lengthening (link from new procedures section) is a
procedure to remove excess gum tissue to expose more of the "crown"
of the tooth. Your gumline can be sculpted to give your new smile
just the right look.
What can be done to correct my "long" teeth or receding gums?
Soft tissue grafts (link from new procedures section) and other
root coverage procedures are designed to cover exposed roots, to
reduce further gum recession and to protect your vulnerable roots
from decay. During this procedure, Dr. Allen takes gum tissue from
your palate or another donor source to cover the exposed root. This
can be done for one tooth or several teeth to even your gum line and
Periodontal Disease and General Health
LINKS TO OTHER DISEASES
What is the relationship between periodontal disease and
More research is needed to confirm how periodontal disease may
put people at increased risk for respiratory disease. What we do
know is that infections in the mouth, like periodontal disease, are
associated with increased risk of respiratory infection. An analysis
of research has revealed that periodontal (gum) disease may be a far
more serious threat to your health than previously realized. Healthy
gums, healthy body
How does periodontal disease increase my risk for heart
Several theories exist to explain the link between periodontal
disease and heart disease. One theory is that oral bacteria can
affect the heart when they enter the blood stream, attaching to
fatty plaques in the coronary arteries (heart blood vessels) and
contributing to clot formation. Coronary artery disease is
characterized by a thickening of the walls of the coronary arteries
due to the buildup of fatty proteins. Blood clots can obstruct
normal blood flow, restricting the amount of nutrients and oxygen
required for the heart to function properly. This may lead to heart
attacks. Researchers have found that people with periodontal disease
are almost twice as likely to suffer from coronary artery disease as
those without periodontal disease. Periodontal disease and heart
Can periodontal disease increase my risk for having a
Pregnant women who have periodontal disease may be seven times
more likely to have a baby that is born too early and too small.
More research is needed to confirm how periodontal disease may
affect pregnancy outcomes. What we do know is that periodontal
disease is an infection and all infections are cause for concern
among pregnant women because they pose a risk to the health of the
baby. If you are thinking about becoming pregnant, be sure to
include a periodontal evaluation with a periodontist as part of your
prenatal care. Pregnancy and periodontal disease
Women and Periodontal Disease
What is the relationship between periodontal disease and
For years we've known that people with diabetes are more likely
to have periodontal disease than people without diabetes. Recently,
research has emerged that suggests that the relationship goes both
ways – periodontal disease may make it more difficult for people who
have diabetes to control their blood sugar. More research is needed
to confirm how periodontal disease can make it more difficult to
control blood sugar. What we do know is that severe periodontal
disease can increase blood sugar, contributing to increased periods
of time when the body functions with a high blood sugar. This puts
diabetics at increased risk for diabetic complications. If you are
among the 16 million Americans in the US who live with diabetes, or
are at risk for diabetes or periodontal disease, see a periodontist
for a periodontal evaluation. Periodontal disease and diabetes