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 hold your teeth in your mouth. Left untreated, these diseases can lead to tooth loss.

There are many forms of periodontal disease:
Gingivitis
Aggressive periodontitis
Chronic periodontitis
Periodontitis as a manifestation of systemic diseases
Necrotizing periodontal diseases

Who is a periodontist?
A periodontist is a dentist who specializes in the prevention, diagnosis and treatment of periodontal disease and in the placement of dental implants. Periodontists receive extensive training in these areas, including three additional years of education beyond dental school. Periodontists are familiar with the latest techniques for diagnosing and treating periodontal disease. In addition, they can perform cosmetic periodontal procedures to help you achieve the smile you desire. Often, dentists refer their patients to a periodontist when their periodontal disease is advanced. However, you don't need a referral to see a periodontist. In fact, there are occasions when you may choose to go directly to a periodontist or to refer a family member or friend to your own periodontist.

Is there a relationship between tobacco use and periodontal disease?
Studies have shown that tobacco use may be one of the most significant risk factors in the development and progression of periodontal disease. Smokers are much more likely than non-smokers to have calculus form on their teeth, have deeper pockets between the teeth and gums and lose more of the bone and tissue that support the teeth.
More about tobacco use and periodontal disease

Is it normal for my gums to bleed when I brush my teeth?
Bleeding gums are one of the signs of gum disease. Think of gum tissue as the skin on your hand. If your hands bled every time you washed them, you would know something was wrong. There are a number of other warning signs of gum disease.

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.

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.

Can I pass my periodontal disease to others?
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. Researchers suggest that bacteria causing periodontal disease are passed though saliva. This means that when a family or couple come into contact with each other's saliva, they're at risk for contracting the periodontal disease of another family member. Based on this research, the American Academy of Periodontology recognizes that treatment of gum disease may involve entire families. If one family member has periodontal disease, the AAP recommends that all family members see a dental professional for a periodontal disease screening.

What can I do to avoid periodontal disease?
To keep your teeth for a lifetime, you must remove the plaque from your teeth and gums every day with proper brushing and flossing. Regular dental visits are also important. Daily cleaning will help keep calculus formation to a minimum, but it won't completely prevent it. A professional cleaning at least twice a year is necessary to remove calculus from places your toothbrush and floss may have missed.

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 periodontitis. The good news is that research suggests that 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 change in financial status.

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:

If you notice any symptoms of periodontal disease, including:
gums that bleed easily, such as during brushing or flossing
red, swollen or tender gums
gums that have pulled away from the teeth
persistent bad breath
pus between the teeth and gums
loose or separating teeth
a change in the way your teeth fit together when you bite

What kinds of oral care products should I use?
Here are some guidelines for choosing dental care products – what works for most patients most of the time. To find out what is best for your particular needs, talk to your periodontist. Begin with the right equipment – a soft bristled toothbrush that allows you to reach every surface of each tooth. If the bristles on your toothbrush are bent or frayed, buy a new one. A worn-out brush will not clean your teeth properly. In addition to manual toothbrushes, your choices include automatic toothbrushes and "high tech" electronic toothbrushes. These are safe and effective for the majority of patients. Oral irrigators (water spraying devices) will not remove plaque from your teeth unless used in conjunction with brushing and flossing. Another aid is the rubber tip, often found on the handle end of a toothbrush used to massage the gums after brushing and flossing. Other options include interproximal toothbrushes (tiny brushes that clean plaque between teeth) and interdental cleaners (small sticks or picks that remove plaque between teeth). If used improperly, these dental aids can injure the gums, so it is important to discuss proper use with your periodontist.