Q. What symptoms are commonly associated with periodontal disease?
A. Unfortunately, it’s possible for periodontal disease to exist for quite a while before it presents any symptoms whatsoever. This underscores the importance of regular dental checkups, which might be the first place that periodontal disease is detected. With early detection, periodontal disease can sometimes be reversed and can be treated more successfully overall. When symptoms do appear, they usually include bleeding from the gums after flossing or brushing the teeth, chronic bad breath, swelling and tenderness in the gums, pain in the jaw or elsewhere in the mouth, and visibly receding or irritated gum tissue. If there is visible pus between the teeth and the gums, or if the teeth have begun to loosen and become mobile, see your dentist or periodontist right away to prevent the spread of infection and possibly preserve the natural teeth. If you have a fever that is accompanied by significant pain and visible infection, contact an emergency dentist or other emergency medical practitioner to stop infection from spreading from the periodontium to the body’s other tissues.
Q. What do periodontists do, exactly?
A. Periodontists are dental specialists who diagnose, treat, and prevent periodontal disease, which is a disease that affects the system of tissues that surround and support the teeth in the mouth. These tissues include the alveolar bone that lines the tooth sockets in the jaw, the periodontal ligament fibers that cushion and secure the teeth inside their sockets, the cementum layer that encases and shapes the root of the tooth and protects the living pulp tissues contained inside the tooth, and the gum tissue that shields the teeth from invasive elements and provides an added layer of protection to the roots, bone, and ligaments. Periodontists can place dental implants and monitor their healing and functioning, and they can also correct gum recession and abnormal gum tissue by sculpting and shaping gum tissue and using soft tissue grafts from other areas of the mouth. General dentists can diagnose and treat gum disease when it’s in its early stages, but when gum disease progresses and affects the other tissue of the periodontium, the best treatment will come from a periodontist. These dentists will work together, in a team with the patient, to implement a comprehensive plan for improving the oral health and maintaining these improvements over time.
Q. My periodontist is board certified. Does this matter?
A. All periodontists are required to complete an additional three years of training in residency, on top of their initial doctoral training, to become specialists in the field of periodontology. While it is not a requirement for the specialization, many periodontists choose to take board-certification exams to demonstrate their commitment to continued education and development in the field and their mastery of each aspect of diagnosing and treating periodontal disease, including their awareness of strategic techniques for dental implant placement. Successful completion of these exams is necessary for board certification with the American Board of Periodontology, which must be renewed every six years.
Q. I’ve heard that there’s a correlation between periodontal disease and cardiovascular disease. Should I be concerned?
A. Extensive, continued research suggests that periodontal disease can escalate the likelihood of developing cardiovascular disease. Both periodontal disease and cardiovascular disease are inflammatory conditions, and inflammation that is left unaddressed in one area of the body can encourage inflammation in other tissues. This means that the inflammation of periodontal disease could feed into the inflammation of cardiovascular disease and vice versa, though more research is needed to definitively confirm this link.
Q. I’ve recently noticed that I have some of the symptoms of periodontal disease. How do I find a good periodontist?
A. The best way to find a reputable periodontist near you is to ask your dentist for a recommendation. Most dentists have professional relationships with other specialists and clinicians and understand their areas of specialization, and they also have an understanding of your clinical needs. It can also be a good idea to ask trusted coworkers, friends, or family for a recommendation for a periodontist. These uncensored reviews can be biased, of course, but you’ll get firsthand information and generally honest feedback from people you’re close to. If these recommendations don’t pan out, or if you’d prefer a more solitary research approach, web searches can yield good results, and follow-up phone calls can help you gather more information and get a better feel for the practice to learn if they’d be a good fit for you.
Q. When I smile, my gums appear unusually long and cover my teeth, and it makes me feel self-conscious. Is there anything a periodontist could do to restore my ability to smile comfortably and freely?
A. When a person’s gums are longer than the average couple of millimeters, this creates what’s known as a gummy smile, and the effects of an unusual smile on a person’s self-esteem can be debilitating. It sounds like you have a gummy smile, and you should definitely talk to your periodontist to see if a crown lengthening procedure could work for you. In this procedure, the periodontist removes excessive gum tissue to restore the visual, spatial balance between the gums and teeth. If crown lengthening isn’t advisable for one reason or another, your periodontist might suggest a cosmetic treatment like dental crowns or dental veneers. Whatever the case, it’s likely that there’s a treatment option that will work for you, so visit your periodontist to learn about treatments for your gummy smile.
Q. Is periodontal disease contagious?
A. Periodontal disease is the inflammatory response to the accumulation of bacteria at and below the gum line. Because it is an inflammatory reaction, it is not contagious, but it’s generally a good idea to avoid sharing bacteria-ridden saliva with people who have periodontal disease to keep from introducing additional bacteria into your own oral cavity.
Q. If I have periodontal disease, does that mean that my children are more likely to get it as well?
A. Research indicates that there might be a genetic inclination toward periodontal disease, so if you have it, your children might also face an increased risk of developing it. However, there are multiple other contributing factors that play a more significant role than genetics, and periodontal disease in general is uncommon in children, though it can occur in certain cases. The best way to prevent your children from getting periodontal disease, regardless of your own periodontal health, is to make sure they establish effective oral hygiene habits early on and understand their continued importance. You and your pediatric dentist can work together to teach your children proper brushing and flossing and to make regular dental checkups and cleanings an enjoyable part of the routines of life. When these basic habits are established and enforced, there is an excellent chance that your children will avoid developing periodontal issues later on in life. If you notice any symptoms of periodontal disease in your children, including swelling or bleeding in the gums and chronic bad breath, contact your pediatric dentist and periodontist as soon as possible.
Q. How many kinds of periodontal disease are there, and what are they?
A. In its earliest form, inflammation in the periodontium occurs in the gingival tissue, or gums, and gingivitis develops. When the gum tissue becomes red and swollen and bleeds during brushing or flossing, these are the early signs of gingivitis, which is also called gum disease. With prompt treatment, gingivitis intercepted early on can be reversed and the periodontium and other oral tissues can be restored to health. When gingivitis remains untreated, it can advance and turn into periodontitis. In cases of periodontitis, or periodontal disease, the tissues of the periodontium become inflamed. When this inflammation spreads to the periodontal ligaments that attach the teeth in their sockets, the teeth can loosen. As they loosen, the pockets in the soft tissue surrounding them deepens, filling with gradually more and more bacteria and causing greater and greater damage to the attachment ligaments. If left unaddressed, advanced periodontitis commonly leads to tooth loss and to the gradual loss of the jawbone and deterioration of the structure and shape of the lower face. So, the two main manifestations of disease in the tissues of the periodontium are gingivitis and periodontitis. When in its mild or moderate stages, gingivitis can be treated by a general dentist. In more severe or complex cases, periodontitis should be assessed and treated in collaboration between a general dentist and a periodontist and with the cooperation of the patient.
Q. Periodontal disease sounds awful. How can I prevent it?
A. Periodontal disease forms when a proliferation of plaque and tartar accumulates on the teeth. Plaque is a sticky film that develops when starches and debris from food and beverages mix with saliva and adheres to the surfaces of the teeth. When plaque calcifies on the teeth, it turns into tartar, which is also called dental calculus, a hard substance that irritates the gums and encourages the accumulation of additional bacteria and plaque in the areas where it collects. Plaque can be removed with effective brushing and flossing, but invariably, some plaque will remain hidden on the teeth with even the best hygiene methods. Once plaque hardens and turns to tartar, it can only be removed in a clinical setting by a dental professional. If plaque and tartar are allowed to build up, the bacteria they harbor become trapped beneath the gum line, flourishing in the warm pockets they find there and releasing toxins that continue to encourage an inflammatory response throughout the periodontal tissues. This is just one of the reasons that routine professional cleanings are so important, and why skipping them can cause a domino effect of destruction to the oral cavity. Not only will professional cleanings help keep bacterial buildup at bay, professional exams can help catch gum disease early on, before it begins to destroy the oral tissues and compromise the teeth and with plenty of time for specialized periodontal treatment.
Q. My periodontist recommended a treatment that I can’t afford. Is there anything I can do?
A. In many cases, periodontists offer financing options, including payment plans, or they work with third-party financers who manage these plans for them. Periodontists are also more familiar with the various types of dental insurance plans and what procedures they might cover. If you live near a college or university that has an affiliated dental school, check with their main office to see if they offer dental care for a reduced cost. These treatments provide care by an advanced dental student who’s supervised by faculty, helping the student improve their technique and chairside manner while offering community members affordable dental care.
Q. People talk about missing teeth like they’re a big deal, but I don’t care what my smile looks like. Why should I worry about losing my teeth to periodontal disease?
A. When even a single tooth is missing, the consequences can spread far beyond the appearance of the smile. In the absence of a tooth root, the bone in the jaw begins to deteriorate, and, in the absence of a tooth, the skin around the mouth begins to sag. This leads to a dramatically aged and sunken appearance in the lower face. Missing teeth also affect a person’s ability to chew certain foods, preventing them from maintaining a balanced and enjoyable diet. If you have even one missing tooth, the remaining teeth are prone to migration in the mouth, which can affect the bite and alignment of the teeth and increase your likelihood of losing additional teeth. Combined with the natural reabsorption of bone that occurs when there is no tooth root present to keep it healthy, the complications of missing a tooth can speed up tooth loss and complicate treatment the longer the issue is left unaddressed. There are many options available for people missing one or more teeth, and a visit to the periodontist can help you learn more about the importance of prosthetic teeth in maintaining the enduring health of the periodontium.