Frequently Asked Questions

Seeing a Periodontist

When should I see a Periodontist?

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:

  • Gums that bleed easily.
  • Red, swollen or tender gums.
  • Persistent bad breath.
  • Loose or separating teeth.
  • A change in the way your teeth fit together when you bite.
  • A sore or irritation in your mouth that does not get better within two weeks.
  • If you are thinking of becoming pregnant.
  • If you have a family member with periodontal disease.
  • If you have heart disease, diabetes, respiratory disease or osteoporosis.

Periodontal Diseases

What are periodontal diseases?

The word periodontal literally means "around the tooth." Periodontal diseases are serious bacterial infections that destroy the attachment fibers and supporting bone that holds your teeth in your mouth. Left untreated, these diseases can lead to tooth loss. There are many forms of periodontal disease:

I'm over 55. Does this mean I'm more likely to get periodontal disease?

Your chances of developing periodontal disease increase considerably as you get older. More than half of people aged 55 and older have Periodontist. The good news is that research suggests 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 stress.

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.

What is the relationship of periodontal diseases to other diseases?

Evidence suggests a possible link between periodontal diseases and other systemic conditions that can negatively affect a person's overall wellness, such as diabetes and heart disease.

Bacteria associated with periodontal diseases have been linked to heart disease, diabetes, stroke and preterm or low weight births. The bacteria travel through the body's veins and arteries using them as a highway system to link to other parts of the body. Periodontal bacteria can also spread from the oral cavity to the rest of the body, including the lungs and can cause respiratory diseases associated with chronic obstructive pulmonary disease, the sixth leading cause of mortality in the United States. Researchers have found that people with periodontal disease are almost twice as likely to suffer from coronary artery disease as those without periodontal disease.

No matter where bacteria travel in the body, the immune system will respond by sending white blood cells to battle the bacteria. These white blood cells release chemicals that create an inflammatory response. Inflammation can damage tissues. Scientists now understand that inflammation causes or complicates many diseases, including pancreatic cancer and Alzheimer's disease. For example, inflammation can damage tissues in the brain which can increase a patient's risk of developing Alzheimer's. Inflammation from gum disease has also been linked to arthritis. Many scientists believe that inflammation is responsible for the development of rheumatoid arthritis in some of the estimated 2.1 million people suffering from the condition. Today, the level of inflammation in your body can be evaluated with a Creative protein test from a blood sample.

Autoimmune diseases can have side effects related to oral health. Maintaining good oral health can impact your quality of life. Good oral health provides the ability to eat and speak with confidence and contributes to your overall well being.


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 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.


What is plaque?

Plaque is a clear, sticky film that adheres to the surfaces of teeth, gum tissues, dental restorations, and even the tongue. It is so adherent, that it can not be washed or rinsed off, but must be mechanically removed. Plaque is neither food stuck on the teeth, nor food debris. It contains a variety of bacteria that can cause dental decay, contribute to calculus (tartar) formation, and initiate the inflammatory response associated with periodontal disease.

Research has shown that plaque must be controlled in order to combat periodontal (gum) disease. Furthermore, by reducing plaque, decay can be kept to a minimum. Couple a lifetime of good plaque control with fluoride supplements (which are most effective when added to developing teeth during childhood), and dental decay becomes almost non‑existent.

How quickly does plaque form?

Unfortunately, plaque forms soon after it is removed. Some studies report that it starts forming as soon as five minutes after it is removed. Other reports state that it can take up to four hours. Regardless of how quickly it begins reforming, effective plaque control will keep it at a minimum. That's why we encourage brushing your teeth twice a day, plus daily flossing and regular professional cleanings.

First signs of plaque affecting the gums:

A frequent warning sign is when the edge of the gums next to the teeth, become reddened, inflamed and bleed when touched. This early stage is known as gingivitis and takes three weeks to form when all oral hygiene measures are suspended. Gingivitis is a reversible condition. With diligent flossing and tooth brushing, gingivitis usually disappears. Left untreated, it can progress into periodontal disease. Periodontal disease is defined as the formation of pockets (loss of gum attachment to the teeth) and the loss of bone that supports the teeth. Periodontal disease is a chronic disease that can result in tooth loss. In fact, periodontal disease is the main reason adults have teeth removed.

Bad Breath

What is bad breath?

Many cases of bad breath, or halitosis, are due to protein breakdown caused by the bacteria in the mouth. These odor-producing organisms can lurk anywhere: around the necks of the teeth, in pockets, next to fillings and crown margins, on the tongue, and in various other recesses in the mouth. Consider how prone the mouth is to grow these bacteria. It has all the ingredients of a successful incubator: it's dark, moist, warm, and has all the "food" necessary that the bacteria need to metabolize. Left to their own devices, these odor‑causing bacteria can thrive to the extent of causing bad breath.

What can I do to overcome bad breath?

Practice good oral hygiene. This includes brushing and flossing regularly and effectively, so that as much of the plaque is removed by you as possible. If your mouth feels dry, drink plenty of liquids during the day. If necessary, use sugar-free mints or breath‑freshening products found in health and drug stores. Brush your tongue and the roof of your mouth. Bacteria in this area can contribute to bad breath.

Some things you can do to help combat bad breath:
  • Visit your dentist regularly.
  • Have your teeth cleaned periodically by a professional.
  • Brush your teeth and gums and floss properly. Clean your tongue all the way back gently.
  • Drink plenty of liquids.
  • Chew sugar‑free gum, especially if your mouth feels dry.
  • Clean your mouth after eating or drinking milk.
  • Maintain a properly balanced diet.