Patients

How do I know if I need a periodontist?

If you ever experience bleeding gums, noticed that your teeth seem loose or have spaces that weren’t previously there, you may benefit from a periodontal evaluation. Since there is a recently discovered genetic link to periodontal disease, you or your children could consider a visit to the periodontist if your parents have missing teeth or wear dentures. Gum disease is also one of the leading causes of bad breath. If this has been a problem, a periodontal screening could give you the solution. If you are beginning extensive dental work including crowns or bridgework your dentist may refer you to a periodontist to ensure the long-term stability of your new restorations. I work with your dentist to give you the most comprehensive care available.

How do you get gum disease?

While periodontal disease is caused by bacteria, it is not strictly “caught” in the same ways that colds and flu are caught. There are hundreds of bacteria that live in your mouth. Under normal health circumstances they are kept in balance. When a person is susceptible to gum disease, these bacteria get out of balance and cause the damage known as “pyorrhea” or periodontal disease. Genetics, systemic disease and sometimes infrequent dental care influence the course of the disease. Available now is the a genetic test that can tell you from a drop of blood whether you have a familial tendency towards periodontal disease. If a parent has lost teeth from gum disease their children should consider the benefits of the new genetic testing procedure. This will enable treatment decisions to be made much earlier for a better lifetime dental outcome.

Since you are a specialist, do I need a referral to come to your office?

No, as a specialist I can still evaluate your oral health, determine with your what your dental needs may be and refer you to a general dentist to work with us for the best result. I do not do bridgework or fillings, so you will eventually need a dentist.

Do I still need a dentist if I don’t have any teeth?

Most definitely! There are still a number of things that will require dental guidance even with dentures. Your oral tissue should be examined at least every two years for any changes that can occur under the dentures and often goes unnoticed by the wearer. The bone also deteriorates at a much greater rate without the stress of teeth to keep it in place. If your dentures feel loose after several years, it is because the bone is thinning and not providing the support it originally had. There are a number of dental implant options available to increase stability of “floating” dentures. As an added benefit, dental implants provide the needed stress to prevent further collapse of the jaws and face.

My gums are receding, is this gum disease?

Recession in a single site is not necessarily caused by periodontal disease. The most common gum surgery in children is the gingival graft where tissue is placed over an area of recession usually exposed by eruption patterns. In adults, recession can be caused by long term over brushing with a hard toothbrush or scrubbing techniques. These areas are most often noticed at the upper cuspids and bicuspids, since they are at the corners and subject to the extra pressure. The term “long in the tooth” refers to old age, but is also an indicator of periodontal disease. Since gum tissue will often follow bone loss, if your recession is generalized you might consider a periodontal evaluation for a definitive diagnosis.

My gums bled when I was pregnant, does this mean that I have gum disease?

The hormonal changes taking place during pregnancy often cause inflammation and bleeding gums. While this is a sign of periodontal disease, it can be only temporary with pregnancy. If your oral hygiene is good and you have had regular cleanings up to that point, you probably have nothing to worry about with a little bleeding. There are, however, new studies out that point out an incredible link to periodontal disease and premature, low birth weight in newborns. Your risk is 7.5 times greater that you will give birth to a premature or low birth weight baby if you have periodontal disease. This statistic is far larger than smoking or alcohol consumption. Given the increase mortality, health problems, and possible learning disability with prematurely born babies, a check-up with your dentist or periodontist should be a part of your prenatal routine.

How does diabetes affect periodontal disease?

Diabetes changes a patient’s response to infection and inflammation. Given the same genetic tendency toward periodontal disease, a diabetic individual will have more frequent and more severe problems. Since periodontal disease is an infection and inflammation is one of the results, diabetics often have multiple abscesses, heavier bleeding an earlier tooth loss. Studies show that well maintained and well controlled diabetics can have the same risks as non-diabetics. With close monitoring from you and your physician, and guidance from your dentist and periodontist, diabetes may only have a minimal effect on your oral health.

Why do I have bad breath?

There are several causes of bad breath. Mouth breathing from sinus problems, infection in the throat or tonsils, bacteria on the tongue or diseases of the lung or stomach can affect your breath. By far, the most prevalent cause of bad breath is periodontal disease. Bacteria living in the pockets around the teeth produce by products that give off a strong odor. Often people mask these effects with mouthwashes or mints. It is much more effective, however, to treat the periodontal infection and see your dentist for regular cleanings. The benefits of healing a mouth free of odor will make you more confident in your business and social interactions.

How bad is snuff or chewing tobacco to my gums?

The effects of tobacco still exist no matter how it is ingested. Smoking does not only increase your risk of coronary artery disease and stroke, but reduces your immune response to viruses and bacteria. The use of tobacco products therefore opens the door to overgrowth of bad bacteria involved in periodontal disease. The type of periodontal infection seen with cigarette smoking is very specific to certain teeth and more difficult to address than others simply because one source of inflammation is so constant. Similarly, with oral tobacco use, you have the direct application of an irritant to the tissues. You can see pre-cancerous changes within several weeks of tobacco use. It is in the best interest of your oral health and overall physical health to discontinue any type of tobacco use.

Is gum disease as strong a risk factor for heart attack as smoking?

Gum disease is often a chronic, painless condition that gives off few warning signals. You may notice bleeding gums when your brush or floss vigorously. The bacteria which develop in the pockets around the teeth by the billions, can cause serious health problems. Recent research has shown an increase in clotting of the blood when one of the most common of these bacterial species enters the bloodstream. In the study on rabbits, electrocardiograms showed the clotting of blood was bad enough to slow the flow of blood through the coronary arteries, depriving the heart of all the oxygen it needed. Large studies indicate that those with gum disease have twice the usual risk of dying prematurely from heart disease.

I heard you put bone grafts around teeth to regenerate new bone tissue, does that work and is it safe?

The bone grafting techniques used today can be very successful in helping you maintain your teeth. We use both synthetic and human bone grafting materials to stimulate new bone growth. The amount of new bone growth will depend on the location and type of defect or pattern of bone loss. The human bone graft material is demineralized and sterilized at the tissue bank. It has been used millions of times without any transmission of disease because it is not a living tissue. Your bone cells migrate to the graft material and the defect is actually repaired with the patient’s own bone. The graft greatly facilitates the new bone growth.

What are dental implants?

Dental implants are a unique, reconstructive procedure to restore your natural smile. Your dentist may have recommended dental implants for several reasons:

  • Tooth loss due to disease
  • Root canal failure
  • Cracked tooth
  • Loss of a bridge
  • Painful and/or loose dentures or partials

Your new teeth will look, feel and function as close as possible to your natural teeth. Clinical studies over 30 years have shown this procedure is one of the most predictable in dentistry, with success rates as high as 95%. For specific case planning, please give us a call.

Are there different kinds of gum disease?

The most prevalent information on gum disease involves gingivitis. This is the earliest stage of periodontal involvement. Most people have some form of gingivitis in their lifetime. Early periodontal disease is the next level from gingivitis. The difference in the phases is the degree of bone loss, from early to advanced. Careful measurements will determine what treatment is warranted. There are several types of periodontal disease that are relatively rare, including localized juvenile periodontal disease that generally strikes in late adolescence and is noted by the very specific sites the bacteria targets. Rapidly progressive or refractory periodontal disease is a form that is very difficult to treat due to the immediate and severe response the patient makes to any level of the bacteria in tissue. All of these diseases are caused by the bacteria but how your body reacts, and what level is determined by your family history and genetic profile.

How do braces straighten crooked teeth?

Braces use steady, gentle pressure over time to move teeth into their proper positions. They don’t look like they’re doing much just sitting there. But in fact, every moment of your orthodontic treatment, there’s something happening in your mouth. Something good for you. The brackets we place on your teeth and the main wire that connects them are the two main components. The bracket is a piece of specially shaped metal or ceramic that we affix to each tooth. Then we bend the arch wire to reflect your “ideal” bite – what we want you to look like after treatment. The wire threads through the brackets and, as the wire tries to return to its original shape, it applies pressure to actually move your teeth. Picture your tooth resting in your jaw bone. With pressure on one side from the arch wire, the bone on the other side gives way. The tooth moves. New bone grows in behind. It may look like nothing is happening–but we’re making a new smile here. Thanks to new materials and procedures, all this happens much quicker than ever before. It’s kind of an engineering feat.

What is osteocrenosis of the jaw and How medication (ex: Fosamax, Bisphosphonates etc.) can affect your health?

Bone is a living tissue with living cells and a blood supply. Osteocrenosis means death of the bone which can occur from the loss of blood supply of by some other means very rarely, individuals taking bisphosphonates as a part of their cancer treatment have developed osteocrenosis of the jawbone has occurred in individuals taking bisphosphonates for treatment of osteoporosis or Paget’s disease. Dental treatments that involve the bone can make the condition worse.

The risk for developing osteocrenosis of the jaw is very small (estimated at less than one person per 100,000 person-years of exposure to the drugs (Fosamax, Actonel or Boniva): but, if it does occur, It is a serious condition with no known treatment so you should be aware of this complication. At this time, the percentage of people who will develop the disease cannot be predicted, because the condition is rare and has just recently been associated with the use of bisphosphonates. It is important for you to understand that other factors may play a role in the development of osteocrenosis, such as other medications you are taking and health problems that you may have.

Although the risk is low with any procedure, it is higher with procedures involving the bone and associated tissues, such as tooth extractions. Your dentist will be able to tell you if the procedure will involve these tissues.