Periodontal FAQs

A periodontist is a dental specialist who focuses on preventing, diagnosing, and treating periodontal diseases. They also specialize in the placement, repair, and maintenance of dental implants. Periodontists receive three additional years of training after dental school to gain knowledge in these areas.

They are familiar with the most recent techniques for diagnosing and treating periodontal disease and are also trained in performing cosmetic periodontal procedures. Although they offer a wide range of periodontic treatments, they often deal with more problematic cases, such as those with a complex medical history or severe gum disease.

Periodontists often work with general dentists and patients to develop comprehensive and customized plans for overall oral care. For example, they will offer treatment such as root debridement (removing damaged tissue) or scaling and root planing (cleaning the infected surface of the tooth). Periodontists can also use a range of surgical procedures to treat patients with severe gum problems.

Periodontal (gum) disease is a severe infection of the gums and bones surrounding and supporting the teeth. Gum disease results from poor oral hygiene, resulting in the buildup and hardening of plaque on the teeth—tooth plaque forms when bacteria, acids, and carbohydrates combine into a sticky, colorless film.

Periodontal disease is common but largely preventable. Without treatment, gum disease can attack your gums, the cementum covering the teeth roots, the periodontal ligament, and the bone that supports the teeth. More advanced stages of the disease can cause the teeth to loosen or lead to tooth loss.

Periodontal disease is often silent, meaning symptoms such as pain may not always appear until the disease is more advanced. However, you should still lookout for some of the most common signs and symptoms, which include:

• Gingivitis (inflammation of the gums)
• Persistent bad breath
• Bleeding when eating certain foods, brushing, or flossing
• Gum pockets
• Gum recession
• Difficulty eating/tooth loss
• Abscess formation
• Bone loss
• A change in the way your teeth fit together when you bite
• Mouth sores
• Chronic halitosis
• A change in the fit of partial dentures

Healthy gums do not bleed easily and fit snugly around the roots of your teeth. If you notice any of the symptoms above, contact your dentist or periodontist right away. Seek treatment as early as possible to increase the possibility of reducing or preventing complications associated with gum disease.

Both dentists and periodontists must attend dental school after earning an undergraduate degree. While dental school is a four-year program, a periodontist must complete the same program plus three additional years of additional post-doctoral training beyond dental school.

In simpler terms, a general dentist can diagnose and treat a wide range of oral health issues. Periodontists, therefore, receive specialist training that allows them to see severe, complex cases that would be beyond the scope and training of a general dentist. At the same time, periodontists specialize in diagnosing, treating, and preventing periodontal disease and the placement of dental implants.

Studies have shown that people with poor oral health (such as periodontal disease or tooth loss) have more serious cardiovascular problems such as stroke and heart attack than people with good oral health. As a result, some research suggests that gum disease and poor oral hygiene may increase your risk of developing heart disease. But there may not be a direct link.

Not everyone with periodontal disease develops heart problems, and many people with heart disease have healthy gums. Still, there’s a growing suspicion that gum disease may be an independent risk factor for heart disease. Shared risk factors, such as an unhealthy diet or smoking, may explain the connection.

Researchers have probed the link between cardiovascular health and gum disease for decades and proposed several theories. Unfortunately, a single study will rarely answer the question definitively, so we’ll likely need additional research better to understand the relationship between oral health and heart disease. Nonetheless, your dentist will recommend regular brushing and flossing for your overall wellbeing.

Unfortunately, Medicare typically only covers medical treatments and doesn’t cover any dental treatments, procedures, or supplies. In addition, Medicaid programs are run by each state individually, so coverage will vary depending on the state in which you live.

The majority of people on Medicare have no dental coverage at all. Limited or no dental coverage can result in relatively high out-of-pocket costs for some and foregone oral health care for others. Always check with your dental care provider to determine if the periodontal treatment you need is in your plan.

Periodontal treatments can vary depending on the type and severity of the disease. If caught early (when it is gingivitis) and no damage has been done to the supporting gums and bone around the teeth, a professional cleaning from your dental practitioner should suffice.

If your gum disease is beyond gingivitis, the first step in treating the disease usually involves scaling or root planning. Scaling is where your dentist or hygienist removes plaque or tartar down to the bottom of each periodontal pocket. Root planing involves smoothing the root surfaces of your teeth to allow the gum tissue to heal and reattach to the teeth.

Your dentist may recommend certain medicines to aid healing and help control discomfort and infection. If pockets don’t heal enough after scaling and root planning, you may need gum surgery. Surgery allows your dental practitioner to remove plaque and tartar from hard-to-reach areas.

Your dentist will then stitch your gums into place to tightly hug your teeth. Periodontal surgery can also make it easier to keep your teeth clean and help to shrink pocket depth.

Periodontal maintenance (deep cleaning) is very similar to regular dental cleanings, but there are a few differences. While you’ll need regular cleanings for preventative care, periodontal maintenance appointments help keep your teeth and gums healthy after undergoing scaling and root planning. Periodontal maintenance visits are also more often than regular cleanings. You will need to return every three to four months.

Periodontal maintenance appointments involve cleaning and removing surface stains from your teeth, removing plaque and tartar that may have formed on the surface of the tooth’s root, and flushing out any deep pockets that may have formed around the gum line.

Osteoporosis is a common metabolic bone disease characterized by bone fragility, decreased bone mineral density, and low bone mass. It commonly occurs in postmenopausal women and less frequently in men. 

A study conducted in 1995 by the University of New York concluded that postmenopausal women with osteoporosis were 86% more likely to develop periodontal disease. In addition, estrogen deficiency following menopause also speeds up the progression of bone loss.

Recent research studies have linked periodontal disease to respiratory complications. Researchers have concluded that periodontal disease can worsen respiratory conditions such as chronic obstructive pulmonary disease (COPD).

Bacteria and plaque mainly cause gum disease. The bacteria causing gum disease can travel down to the lungs and harm them. Healthy lungs have protective defenses to deal with bacteria from the mouth. Still, damaged lungs may have trouble defending themselves, increasing the risk that the bacteria will make lung problems worse or cause infections.

Bacteria that cause respiratory problems like pneumonia and bronchitis may also come from periodontal disease or an oral cavity. Poor oral hygiene can also allow the bacteria to increase before it spreads past the mouth. In other words, proper dental health contributes to healthier lungs.

Pregnancy can affect your entire body – including your oral health. Because of hormonal changes, pregnancy can accelerate the accumulation of dental plaque. In addition, changes in a pregnant woman’s oral microbiome may also increase the likelihood of developing periodontal disease. Signs of periodontal disease that can get worse in pregnancy include:

• Formation of pockets between the teeth and gums
• Bleeding from the gums

An increasing body of evidence shows that periodontal disease can increase the incidence of an adverse pregnancy. In a study by the Journal of Obstetrics and Gynecology Research, such adverse outcomes may include:

• Restriction of the baby’s growth
• Preterm labor
• Low birth weight

It’s crucial to maintain good oral hygiene throughout your pregnancy. Follow good oral hygiene habits such as brushing and flossing and maintaining regular dental visits during pregnancy to prevent periodontal disease.

Except in unusual cases, you can help prevent periodontal disease by practicing good oral habits. For example, brush your teeth twice a day and clean between your teeth with floss or an interdental cleaner once a day. Regular dental checkups are also crucial.

Even if you brush and floss regularly, you may not remove all the plaque that builds up in your mouth, especially around the gumline. A dental examination allows your dentist to look at many things, including the color and firmness of your gums. They will use a periodontal probe to gently measure the space between your teeth and gums to check if you have periodontal pockets.

Your dentist may provide additional instructions on cleaning products or methods you can use at home. Avoiding tobacco use and other healthy measures, such as eating a balanced diet, are also crucial in preventing periodontal disease.

Research suggests that there’s a relationship between diabetes and periodontal disease and that it goes both ways. Diabetics patients have a high risk of developing gum disease. Diabetes causes thickened blood vessels that can reduce the flow of nutrients and the removal of wastes from body tissues. This reduced flow weakens the gums and bone, putting them at greater risk of infection.

Poor diabetic control encourages bacterial growth by increasing the glucose levels in saliva. As with any infections in diabetic patients, periodontal disease may make it more difficult for people who have diabetes to control their blood sugar.

Diabetic patients should be vigilant about their oral health by brushing and flossing regularly and seeing their dentist regularly for checkups.

Involuntary teeth grinding, gnashing, or clenching is a common condition that affects most humans at some point in their life. This involuntary grinding of the teeth is known as bruxism. It can happen while awake or asleep, but people are much less likely to know that they grind their teeth when sleeping.

Because of the force applied when grinding teeth, bruxism can pose severe problems for the teeth and jaw and may require treatment to reduce its impact. There are several reasons why you could be grinding your teeth, but here are the most common.

• Misaligned teeth problems
• Medical causes such as sleep apnea or Parkinson’s
• Stress or anxiety

Symptoms of bruxism may vary depending on how severe the grinding or clenching is. Common symptoms of bruxism that you may notice include a tight jaw, headaches, or a sore face. The effects of grinding on the teeth can consist of tooth sensitivity, broken or cracked teeth, and temporomandibular joint syndrome (TMJ).

Bruxism is sometimes not diagnosed because it is only one of several potential causes of tooth wear.

When your gums recede, the gum tissues around your teeth pull back towards the root of the teeth. Gum recession, or root exposure, exposes more of your tooth than usual. When exposed, your teeth roots accumulate food particles, by-products, and bacteria.

Gum disease is also a cosmetic issue. If not treated in the early stages, gum recession may damage surrounding tissues and body structures, resulting in tooth loss. When you laugh or smile, you should see a relatively equal gum-to-tooth ratio.

Gum recession can occur due to various causes. If you develop periodontal disease, this can irritate your gums and cause gum recession. Misaligned teeth, oral piercings, and brushing your teeth too aggressively can also contribute to problems with receding gums. Aging can cause minor gum recession to become more prominent.

If plaque is left undisturbed (not rinsed or brushed) on the teeth for too long, it builds up and becomes hard tartar(calculus). Unlike plaque, calculus is so hard that you can’t remove it from the teeth with regular brushing and flossing. So essentially, the better you brush and floss, the less plaque will build up.

Your dental practitioner will need to remove calculus through a process of dental scaling and root planning. Also known as deep cleaning, scaling, and planning is done below the gum line to treat gum disease.

If gum disease is caught early and hasn’t damaged structures below the gum line, then a regular dental cleaning will restore your oral health. However, if the pockets between the teeth and gums are too deep, you may need scaling and root planning

Pocket irrigation is a procedure that periodontists and dentists perform routinely as part of deep dental cleaning. During pocket irrigation, the dental practitioner will clean the “pockets” or spaces that form between the teeth and gums. These spaces form when your gums start to detach from your teeth after harmful bacteria release toxins that destroy the fibers attaching your teeth to the gums and jawbones.

During a pocket irrigation procedure, the dentist will inject a powerful stream of water into the dental pockets using a piece of handheld equipment. The water stream removes the plaque and tartar deposits from the teeth and in between teeth. Once your dentist removes the unwanted deposits from your teeth, they will apply an antibacterial to kill any remaining bacteria and prevent re-infection.

A dental prophylaxis is a professional cleaning procedure performed by your dentist to remove plaque buildup that regular brushing and flossing can’t reach. Although your home dental care might be effective, you require regular professional dental cleaning to stop decay and the progression of gum disease.

Since prophylaxis involves a thorough examination of the entire oral cavity, your dentist can evaluate the risk of periodontitis, screen for oral cancer, and often spot signs of medical problems like kidney issues or diabetes. Your dentist may also provide recommendations for altering your home care regimen.

Dental practitioners recommend prophylaxis twice annually as a preventative measure. Still, if you have a high risk of gum disease or suffer from periodontitis, you may need prophylaxis performed every 3-4 months.

People who smoke have a higher risk of developing gum problems, oral cancer, tooth decay, tooth loss, stained teeth, and complications after oral surgery and tooth removal. So if you smoke tobacco or vape, it is crucial to look after your oral health to prevent gum disease and dental problems.

Be sure to visit your dentist regularly. They can do regular health and oral checks and advise on keeping your teeth and gums healthy. You should also speak to your dentist and doctor about quitting.

Most general dentists have a working relationship with one or more periodontists. Although there is nothing wrong with choosing a periodontist based on your dentist’s recommendations, you can always do some research to ensure you are working with an expert who’s suitable for your particular needs. Consider several factors, such as payment options offered by clinics, specialized fields of care, and personality type.

Alternatively, you might want to ask family or friends for recommendations. Your coworkers can also be an invaluable resource, as they are likely to know financing options and whether or not the periodontist they recommend accepts your insurance. Finally, if you’re unable to get a recommendation from someone you know, you can conduct an online search for periodontists in your area.

Once you have narrowed down clinics in your area, you can research their websites to overview treatment options available, contact information, insurance, financing options, and more.

If you’re self-conscious about the ratio of your gums to teeth (gummy smile), talk to your periodontist about the options available to improve your smile. Depending on the nature of the problem, your periodontist may suggest a crown lengthening procedure, removing excess gum tissue, or lip lowering. They may also recommend alternative approaches such as crowns and veneers.

When it comes to dental issues, every individual case differs. Dental implants can help to prevent shifting of surrounding teeth, and they have a natural look. They are often preferred to bridges and dentures because they are more secure and can help to prevent bone loss.

After examining your teeth and gums, your periodontist can determine if dental implants are the best restoration option for your case.

Missing some or all your teeth can have several negative consequences. First, missing teeth can affect the aesthetics of your face. Second, gaps from missing teeth will affect your smile, and missing too many teeth will cause the skin around your mouth to sag from lack of proper support.

Moreover, missing teeth may affect the way you speak and make it more difficult to chew food properly. Finally, missing even a single tooth may have emotional consequences. Many people with missing teeth feel less confident about their smiles. If you are missing any of your teeth, consider replacing them with dental implants, which look and feel just like natural teeth.