FAQs for Dental Implants, Periodontal Disease & Treatments

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 - is the earliest stage of periodontal disease. It is characterized by red, swollen gums that bleed easily. Most common cause of gingivitis is inadequate oral hygiene causing plaque buildup. Plaque is characterized by bacterial colonies that irritate the gums by releasing toxins. The body in response launches an immune response causing inflammation of the gums. Gingivitis is associated with little or no discomfort.

Other factors that may contribute to gingivitis include, diabetes, smoking, aging, genetic predisposition, systemic diseases and conditions, stress, inadequate nutrition, puberty, hormonal fluctuations, pregnancy, substance abuse, HIV infection, and certain medication use.

Aggressive (refractory) periodontitis - A form of periodontitis that occurs in patients who are otherwise clinically healthy. Common features include rapid attachment loss and bone destruction and familial aggregation. This type is usually non-responsive to treatment.

Chronic periodontitis - Untreated gingivitis leads to inflammation within the supporting tissues of the teeth, progressive attachment and bone loss and is characterized by pocket formation and/or recession of the gingiva. It is recognized as the most frequently occurring form of periodontitis. It is prevalent in adults, but can occur at any age. Progression of attachment loss usually occurs slowly, but periods of rapid progression can occur.

Periodontitis as a manifestation of systemic diseases - Usually has an early onset associated with diabetes.

Necrotizing periodontal diseases - An infection of the gums characterized by necrosis of gingival tissues, periodontal ligament and alveolar bone. These lesions are most commonly observed in individuals with systemic conditions including, but not limited to, HIV infection, malnutrition and immunosuppression.
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Plaque is a colorless, sticky film of bacteria that constantly forms on teeth. If left undisturbed, it hardens to form tartar. The bacteria in the plaque produce byproducts that can not only irritate the gums and make them bleed, but it can also lead to periodontal disease. A daily regimen of proper brushing, flossing and rinsing (plus, regular dental visits), will help you keep your teeth healthy.
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The main cause of periodontal disease is bacterial plaque which is a sticky microbial film that constantly forms on teeth. Failure to remove this sticky film on a daily basis causes the disease process.

Other factors that contribute to the disease process and affect your gum health include:

• Smoking/Tobacco Use
• Genetics
• Poor Nutrition
• Systemic Diseases like Diabetes
• Stress
• Medications such as oral contraceptives, anti-depressants, and certain heart medicines
• Pregnancy and Puberty
• Grinding or Clenching your teeth
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Research has shown that smoking affects the development and progression of periodontal disease. Smokers are more likely to accumulate more plaque and tartar than non-smokers which leads to deeper pockets and eventually more bone and supporting tissue loss. Smoking is also one the main causes of oral cancer and lung disease. It is associated with low- birth weight infants.

Success of periodontal treatment and implants is lower in smokers.

Cessation of smoking is the first step towards better oral and systemic health.
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Healthy tissue doesn't bleed. This is most likely a sign of early gingivitis. If you experience bleeding gums, see your dentist or periodontist to review proper brushing and flossing techniques. Schedule a soft tissue evaluation with your periodontist that will include x-rays and prophylaxis cleaning. Gum bleeding must be taken seriously because if left untreated, it will lead to periodontal disease.
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At least once a day. There's an old adage among dentists: “Floss only the teeth you want to keep.” If you don't want to lose your teeth, floss every day. Otherwise, you'll be 75% more susceptible to periodontal disease that has been documented to have serious health consequences, e.g. a higher likelihood of heart disease, diabetes, pneumonia and infections. About 45% of American adults have some form of gingivitis, and most adults over 60 have already lost their teeth. Don't be one of them. Floss at least once a day.
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People accumulate plaque at different rates. Although most insurance plan coverage is for a twice a year schedule, it's sensible to get your teeth professionally cleaned as often as your dental health professional advises you, even if it's every 3 months.
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Bad breath occurs when sulfur compounds are produced in the body and released into the air. The most common source of this sulfur is anaerobic (without oxygen) bacteria that live in the grooves or fibers at the back of the tongue. These bacteria produce the sulfur that gives off an unpleasant smell. This frequently occurs when the mouth is dry, creating an ideal environment for anaerobic bacteria to thrive. Sulfur compounds are also produced when certain types of food are consumed. The compounds make their way into the bloodstream and then to the lungs, where they are excreted into the air we exhale.

Persistent problems with unpleasant breath can indicate diseases such as diabetes, liver dysfunction, pulmonary disease, and respiratory disease. Periodontal pockets, the spaces that form between the teeth and gums, are another source of bad breath. These pockets, which occur in the latter stage of periodontal disease, create spaces for bacteria to grow, and give off a chronic unpleasant odor. Dental work may be required in order to remove these pockets of bacteria. Periodontal disease is detected by the presence of bleeding gums, loose teeth, receding gums, or pain when chewing.

Proper oral hygiene eliminates many cases of bad breath. Daily brushing and flossing removes the plaque and bacteria that often cause bad breath. While brushing, take special care to thoroughly brush the back of the tongue where bacteria normally collect. Mints and mouthwashes can hide bad breath, but do not eliminate this condition. Avoid foods that have powerful odors and drink lots of water to insure that the mouth is cleansed and full of oxygen (an environment in which bacteria do not thrive). For information on current treatments, contact a dentist in your area regarding current products on the market that can eliminate bad breath
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About 30% of the population are genetically more susceptible to periodontal disease. These people are several times more prone to develop gum disease than the normal population despite aggressive oral care habits. Early intervention can help control the disease.
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Always choose oral care products that have the American Dental Association Seal of Acceptance. It is a seal of product's safety and effectiveness.

Choose a soft toothbrush .You can choose either a manual toothbrush or an automatic toothbrush. Change your toothbrush every 3 months. Bristles that have frayed will not clean teeth properly. Unwaxed floss is more effective in removing plaque from in between your teeth than waxed floss. However, if you have tight contacts you can use waxed floss.

If you have spaces between your teeth your periodontist will advise you to use interdental cleaning devices. (Small sticks or miniature bottle brushes) for effective plaque removal.

Oral irrigators (water spraying devices) can be used in conjunction with brushing and flossing for effective plaque removal.

Another aid is the rubber tip, often found on the handle end of a toothbrush used to massage the gums.
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When the lasers are used properly during periodontal therapy there can be less bleeding, swelling and discomfort to the patient during surgery. Lasers when used as an adjunct to scaling and root planing improve the effectiveness of the procedure.
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Many insurance plans pay a portion of periodontal services. Often the office staff will work with your insurance company to secure maximum benefits. Also talk to our office staff for payment options.
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