For more information, please choose a topic:

1. Why is my General Dentist referring me to a Periodontist?
2. What will happen during my initial visit to the Periodontist?
3. Does periodontal treatment hurt?
4. How much will periodontal treatment cost?
5. How can I help prevent periodontal disease?
6. Can I pass my periodontal disease to others?
7. What makes my periodontal condition worse?
8. Can periodontal disease be a potential risk factor in the development of other health problems?
9. Once my gums have been treated, am I finished with the periodontist forever?

1. Why is my General Dentist referring me to a Periodontist?

Your General Dentist has determined that your gums require the special care of a Periodontist. In addition to dental school, Periodontists have had two to three years of extensive advanced training in the treatment of periodontal disease. By referring you to a periodontist, your General Dentist is showing a strong commitment to your optimal dental care.

2. What will happen during my initial visit to the Periodontist?

After reviewing your medical and dental history, the periodontist will examine your gums, teeth and mouth. The examination to diagnose periodontal disease will include inspection of the color and firmness of your gums, studying which teeth are loose, checking for gum pockets, checking for gum recession and evaluating your bite. Additional radiographs (x-rays) may be taken to evaluate the bone supporting the teeth.

After gathering this information, the Periodontist will discuss the results of your examination with you and your General Dentist and decide upon the best possible treatment for your dental health.

3. Does periodontal treatment hurt?

Modern equipment, local anesthetics and state-of-the-art techniques make periodontal treatment more comfortable now than ever before. Effective medications are available and conscious sedation anesthesia can be utilized for your comfort during the treatment. As with other aspects of periodontal treatment, considerations for your comfort during and after treatment will be tailored to best suit your individual needs.

4. How much will periodontal treatment cost?

The cost of periodontal treatment will vary depending upon your needs. The fees in our office are based on the care, skill, time and judgment necessary to help treat your condition. After your initial examination, the fee for a particular treatment will be discussed fully prior to treatment. If you have a dental insurance plan, this may provide partial coverage for your treatment. We will do all we can to help patients derive maximum benefits from their insurance company. Please understand that every insurance policy is different and we have no way of knowing the exact amount a particular policy will pay.

As you consider this health investment, keep in mind that treating gum disease is less costly -and better for your health- than replacing teeth lost to untreated gum disease.

5. How can I help prevent periodontal disease?

The main cause of periodontal disease is bacterial plaque. Plaque is a sticky, colorless film that constantly forms on your teeth. Conscientious removal of plaque by brushing and flossing can minimize the risks of gum disease.

Supplemental intake of vitamins such as Vitamin C or calcium does not appear to help prevent periodontal disease. A well-balanced diet in conjunction with good oral hygiene and regular dental visits are the best prevention possible.

6. Can I pass my periodontal disease to others?

Researchers suggest that 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, bacteria that cause periodontal disease can pass through saliva. This means that the common contact of saliva in families puts children and couples at risk for contracting the periodontal disease of another family member. If one family member has periodontal disease, The American Academy of Periodontology recommends that all family members see a dental professional for a periodontal examination.

7. What makes my periodontal condition worse?

Although plaque is the primary cause of periodontal disease, other factors can affect the health of your gums and the bone supporting your teeth. Smoking, diabetes, heredity, hormonal fluctuations, stress and certain medications can increase your chances of getting certain kinds of periodontal disease; speed up the progression of the disease; and decrease treatment effectiveness.

Smoking: Recent studies have shown that smoking may be one of the most significant risk factors in the development and progression of periodontal disease. Smokers are up to 6 times more likely to exhibit periodontal disease than non-smokers. Stop smoking!

Diabetes: Many systemic disease states affect the gums. The most notable is diabetes. Diabetes has a significant impact on all tissues throughout the body, including the gum tissues. Research indicates that diabetes, especially when poorly controlled, increases the risk of periodontitis. Diabetics need to take especially good care of their teeth and gums. They are far more prone to periodontal infection than non-diabetics.

Hereditary factors: As in any infectious disease, host susceptibility plays a major role in determining whether or not the presence of an infectious agent will ultimately lead to expression of disease. Genetic risks, one aspect of such host susceptibility, continue to be examined for periodontal disease. Emerging data indicate that individual susceptibility to some forms of periodontal disease may be heritable. Research has shown that up to 30% of the population may be genetically susceptible to gum disease.

Hormonal factors: Hormonal fluctuations throughout ones life can also affect the gum tissues. These changes may increase ones susceptibility to periodontal disease and may require you to take special care of your oral health. For many women, the increased production of the hormones progesterone and estrogen during pregnancy cause significant swelling, bleeding or tenderness of the gum tissues. These changes usually begin in the second or third month and last through the eighth month of pregnancy. This condition is called pregnancy gingivitis and usually disappears after pregnancy, but may require professional treatment. Similar gum tissue changes (swelling, redness and tenderness) may also occur as a young woman's system matures during puberty or right before a menstrual cycle begins. These changes also occur as a result of the increase in the progesterone and estrogen hormones. These conditions and symptoms tend to lessen as the amount of sex hormones decrease. However, it is important to maintain oral health during these hormonal fluctuations, including at-home oral hygiene and regular professional dental care.

Stress: Although the study of how stress affects the periodontal tissues is ongoing, it is clear that stress is a main concern. When individuals suffer any sort of crisis such as job loss, marital problems, a debilitating disease affecting a loved one or death to a family member stress related hormones (adrenaline, cortisone) are increased. When this occurs, especially in the presence of an already existing periodontal condition, chances are that the problem will worsen.

Medications: Certain medications can affect the gums. One group of drugs that concerns periodontists are the calcium channel-blockers. These medications that are used to treat certain heart conditions include Cardizem, Procardia, Verapamil and others. Though they don't affect every person the same way, calcium channel-blockers sometimes cause significant gum swelling. Other drugs that can have the same effect on the gums include the antiepileptic drug Dilantin (phenytoin), and the immunosuppressive drug cyclosporin. These gum swellings occur between the teeth, and make brushing and flossing extremely difficult. In some instances, the gums swell so large they can only be managed with resective surgery. If you take any drugs in these categories and are experiencing swollen and bleeding gums, you may want to seek professional help.

It is important that you inform your dentist or periodontist of any factors that may put you at increased risk for periodontal disease so that the subtle changes in your periodontal health that may occur can be identified and treated appropriately.

8. Can periodontal disease be a potential risk factor in the development of other health problems?

The most recent scientific research indicates that periodontal diseases may, in fact, be a significant risk factor for a number of systemic diseases. Periodontal disease is caused by pathogenic bacterial organisms. These periodontal pathogens have the potential to escape from the confines of the infected gum tissues, travel in the blood stream and become widespread throughout the body.

Some of the health problems that have been linked to periodontal disease include:

Heart Disease: When bacteria from the periodontal pocket enters the blood stream, it appears that the heart is one of the most susceptible organs. The periodontal bacteria cause small blood clots and contribute to the buildup of fatty deposits inside the coronary (heart) arteries. Researchers have found that the risk of coronary artery disease is twice as high in people who have periodontal disease compared to those who do not have periodontal disease. If you know that you have heart disease or currently receive treatment for a cardiovascular complication, it is especially important for you to have good periodontal health.

Diabetes: For years we've known that people with diabetes are more likely to have periodontal disease than people without diabetes. Recently, research has emerged suggesting that the relationship goes both ways - periodontal disease may make it more difficult for people who have diabetes to control their blood sugar. We now know that severe periodontal disease in diabetics contributes to increased periods of time when your body functions with high blood sugar. This puts the diabetic at increased risk for more severe complications such as involvement of the blood vessels, eyes, kidneys and nerves. In other words, controlling your periodontal disease will help you control your diabetes. If you are among the 16-18 million Americans in the U.S. who live with diabetes it is especially important for you to practice good oral hygiene and to have a complete periodontal evaluation. Having healthy gums will lead to a healthier body.

Respiratory Disease: People who suffer with periodontitis may be more susceptible to pneumonia, bronchitis and other respiratory problems. More research is needed to confirm exactly how periodontal disease may put people at increased risk for respiratory disease. What we do know is that infections in the mouth, like periodontal disease, are associated with increased risk of respiratory infection.

Premature Birth: If you have periodontal disease and are pregnant, one recent study found that you are 7-8 times more likely to deliver a pre-term low birth weight baby than do mothers without periodontal disease. More research is needed to confirm how periodontal disease may affect pregnancy outcomes. What we do know is that periodontal disease is an infection and all infections are cause for concern among pregnant women because they pose a risk to the health of the baby. If you are planning to become pregnant, be sure to include a periodontal evaluation as part of your prenatal care.

Fascinating new research has eroded the tradition-bound concept that oral infections such as periodontitis are simple local entities whose effects are limited to only the mouth. Existing evidence supports and strengthens the association and relationship between periodontal diseases and systemic diseases/conditions. It is now clear that prevention and treatment of periodontal diseases are not only necessary to maintain dental health, but overall health as well. Without periodontal health, general health is often compromised.

9. Once my gums have been treated, am I finished with the periodontist forever?

Not in most cases. As mentioned earlier, periodontal disease is a chronic condition that is not cured but can be stabilized and maintained. Periodontists have a great track record when it comes to getting periodontal conditions under control. Once the initial treatment has been completed, maintenance care is essential for future good oral health. Your periodontist may see you periodically for maintenance visits to help ensure your continued periodontal health, but you will also still need to see your General Dentist regularly for new or recurrent cavities, changes in fillings, crowns, bridges and many other conditions in which your General Dentist specializes.