Questions and answers

During your first visit, your periodontist will review your complete medical and dental history with you. It's extremely important for your periodontist to know if you are taking any medications or being treated for any condition that can affect your periodontal care. You will be given a complete oral and periodontal exam. Your periodontist 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. Your periodontist 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 your periodontist 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 loss.

Your chances of developing periodontal disease increase considerably as you get older. More than half of people aged 55 and older have periodontitis. The good news is that research suggests that these higher rates may be related to risk factors other than age. So, periodontal disease is not an inevitable part of aging. Risk factors that may make older people more susceptible include general health status, diminished immune status, medications, depression, worsening memory, diminished salivary flow, functional impairments and change in financial status.

If you value your oral as well as overall health, anytime is a good time to see a periodontist for a periodontal evaluation. 

Sometimes the only way to detect periodontal disease is through a periodontal evaluation. A periodontal evaluation may be especially important in the following situations: 
•    If you notice any symptoms of periodontal disease, including: 
o    gums that bleed easily, such as during brushing or flossing 
o    red, swollen or tender gums 
o    gums that have pulled away from the teeth 
o    persistent bad breath 
o    pus between the teeth and gums 
o    loose or separating teeth 
o    a change in the way your teeth fit together when you bite
•    If you are thinking of becoming pregnant. Pregnant women who have periodontal disease may be seven times more likely to have a baby born too early and too small. In addition, about half of women experience "pregnancy gingivitis." However, women who have good oral hygiene and have no gingivitis before pregnancy are very unlikely to experience this condition. 
•    If you have a family member with periodontal disease. Research suggests that the bacteria that cause periodontal disease can pass through saliva. This means the common contact of saliva in families puts children and couples at risk for contracting the periodontal disease of another family member. 
•    If you have heart disease, diabetes, respiratory disease or osteoporosis. Ongoing research is showing that periodontal disease may be linked to these conditions. The bacteria associated with periodontal disease can travel into the blood stream and pose a threat to other parts of the body. Healthy gums may lead to a healthier body. 
•    If you feel that your teeth are too short or that your smile is too "gummy." Or, if you are missing one or more of your teeth and are interested in a long-lasting replacement option. 
•    If you are not satisfied with your current tooth replacement option, such as a bridge or dentures, and may be interested in dental implants. 
•    have a sore or irritation in your mouth that does not get better within two weeks.

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.

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 that bacteria causing periodontal disease are passed though saliva. This means that when a family or couple come into contact with each other's saliva, they're at risk for contracting the periodontal disease of another family member. 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.

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.

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.

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 in which bacteria can 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.

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 the teeth.

A periodontist is a dentist who specializes in the prevention, diagnosis and treatment of periodontal disease and in the placement of dental implants. Periodontists receive extensive training in these areas, including three additional years of education beyond dental school. Periodontists are familiar with the latest techniques for diagnosing and treating periodontal disease. In addition, they can perform cosmetic periodontal procedures to help you achieve the smile you desire. Often, dentists refer their patients to a periodontist when their periodontal disease is advanced. However, you don't need a referral to see a periodontist. In fact, there are occasions when you may choose to go directly to a periodontist or to refer a family member or friend to your own periodontist.

As you know, your own teeth require conscientious at-home oral care and regular dental visits. 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! 
After treatment, your periodontist will work closely with you and your dentist to develop the best care plan for you. Periodic follow-up visits will be scheduled to monitor your implant, teeth and gums to make sure they are healthy.

This procedure is a team effort between you, your dentist and your periodontist. Your periodontist and dentist will consult with you to determine where and how your implant should be placed. Depending on your specific condition and the type of implant chosen, your periodontist will create a treatment plan tailored to meet your needs. Click for more information about the treatment options described below. 
•    Replacing a Single Tooth   If you are missing a single tooth, one implant and a crown can replace it. A dental implant replaces both the lost natural tooth and its root. 
•    Replacing Several Teeth   If you are missing several teeth, implant-supported bridges can replace them. Dental implants will replace both your lost natural teeth and some of the roots. 
•    Replacing All of Your Teeth   If you are missing all of your teeth, an implant-supported full bridge or full denture can replace them. Dental implants will replace both your lost natural teeth and some of the roots. 
•    Sinus Augmentation   A key to implant success is the quantity and quality of the bone where the implant is to be placed. The upper back jaw has traditionally been one of the most difficult areas to successfully place dental implants due to insufficient bone quantity and quality and the close proximity to the sinus. Sinus augmentation can help correct this problem by raising the sinus floor and developing bone for the placement of dental implants. 
•    Ridge Modification   Deformities in the upper or lower jaw can leave you with inadequate bone in which to place dental implants. To correct the problem, the gum is lifted away from the ridge to expose the bony defect. The defect is then filled with bone or bone substitute to build up the ridge. Ridge modification has been shown to greatly improve appearance and increase your chances for successful implants that can last for years to come.

The ideal candidate for a dental implant is in good general and oral health. Adequate bone in your jaw is needed to support the implant, and the best candidates have healthy gum tissues that are free of periodontal disease. 
Dental implants are intimately connected with the gum tissues and underlying bone in the mouth. Since periodontists are the dental experts who specialize in precisely these areas, they are ideal members of your dental implant team. Not only do periodontists have experience working with other dental professionals, they also have the special knowledge, training and facilities that you need to have teeth that look and feel just like your own.

Your dentist and periodontist will work together to make your dreams come true.

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 
•    Aggressive periodontitis 
•    Chronic periodontitis 
•    Periodontitis as a manifestation of systemic diseases 
•    Necrotizing periodontal diseases