Below are some of the most frequently asked questions patients have about periodontics and oral health issues. If you have any other questions, or would like to schedule an appointment, we would love to hear from you.
Click on a question below to see the answer.
How often should I brush and floss?
Brushing and flossing help control the plaque and bacteria that cause dental disease.
Plaque is a film of food debris, bacteria, and saliva that sticks to the teeth and gums. The bacteria in plaque convert certain food particles into acids that cause tooth decay. Also, if plaque is not removed, it turns into calculus (tartar). If plaque and calculus are not removed, they begin to destroy the gums and bone, causing periodontal (gum) disease.
Plaque formation and growth is continuous and can only be controlled by regular brushing, flossing, and the use of other dental aids.
Toothbrushing – Brush your teeth at least twice a day (especially before going to bed at night) with an ADA approved soft bristle brush and toothpaste.
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Brush at a 45 degree angle to the gums, gently using a small, circular motion, ensuring that you always feel the bristles on the gums.
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Brush the outer, inner, and biting surfaces of each tooth.
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Use the tip of the brush head to clean the inside front teeth.
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Brush your tongue to remove bacteria and freshen your breath.
Electric toothbrushes are also recommended. They are easy to use and can remove plaque efficiently. Simply place the bristles of the electric brush on your gums and teeth and allow the brush to do its job, several teeth at a time.
Flossing – Daily flossing is the best way to clean between the teeth and under the gumline. Flossing not only helps clean these spaces, it disrupts plaque colonies from building up, preventing damage to the gums, teeth, and bone.
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Take 12-16 inches (30-40cm) of dental floss and wrap it around your middle fingers, leaving about 2 inches (5cm) of floss between the hands.
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Using your thumbs and forefingers to guide the floss, gently insert the floss between teeth using a sawing motion.
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Curve the floss into a “C” shape around each tooth and under the gumline. Gently move the floss up and down, cleaning the side of each tooth.
Floss holders are recommended if you have difficulty using conventional floss.
Rinsing – It is important to rinse your mouth with water after brushing, and also after meals if you are unable to brush. If you are using an over-the-counter product for rinsing, it’s a good idea to consult with your dentist or dental hygienist on its appropriateness for you.
How can I tell if I have gingivitis or periodontitis (gum disease)?
Four out of five people have periodontal disease and don’t know it! Most people are not aware of it because the disease is usually painless in the early stages. Unlike tooth decay, which often causes discomfort, it is possible to have periodontal disease without noticeable symptoms. Having regular dental check-ups and periodontal examinations are very important and will help detect if periodontal problems exist.
Periodontal disease begins when plaque, a sticky, colorless, film of bacteria, food debris, and saliva, is left on the teeth and gums. The bacteria produce toxins (acids) that inflame the gums and slowly destroy the bone. Brushing and flossing regularly and properly will ensure that plaque is not left behind to do its damage.
Other than poor oral hygiene, there are several other factors that may increase the risk of developing periodontal disease:
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Many medications – Steroids, cancer therapy drugs, blood pressure meds, oral contraceptives. Some medications have side affects that reduce saliva, making the mouth dry and plaque easier to adhere to the teeth and gums.
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Pregnancy, oral contraceptives, and puberty – Can cause changes in hormone levels, causing gum tissue to become more sensitive to bacteria toxins.
Signs and Symptoms of Periodontal Disease
Good oral hygiene, a balanced diet, and regular dental visits can help reduce your risk of developing periodontal disease.
Why is it important to use dental floss?
Brushing our teeth removes food particles, plaque, and bacteria from all tooth surfaces, except in between the teeth. Unfortunately, our toothbrush can’t reach these areas that are highly susceptible to decay and periodontal (gum) disease.
Daily flossing is the best way to clean between the teeth and under the gumline. Flossing not only helps clean these spaces, it disrupts plaque colonies from building up, preventing damage to the gums, teeth, and bone.
Plaque is a sticky, almost invisible film that forms on the teeth. It is a growing colony of living bacteria, food debris, and saliva. The bacteria produce toxins (acids) that cause cavities and irritate and inflame the gums. Also, when plaque is not removed above and below the gumline, it hardens and turns into calculus (tartar). This will further irritate and inflame the gums and also slowly destroy the bone. This is the beginning of periodontal disease.
How to floss properly:
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Take 12-16 inches (30-40cm) of dental floss and wrap it around your middle fingers, leaving about 2 inches (5cm) of floss between the hands.
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Using your thumbs and forefingers to guide the floss, gently insert the floss between teeth using a sawing motion.
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Curve the floss into a “C” shape around each tooth and under the gumline. Gently move the floss up and down, cleaning the side of each tooth.
Floss holders are recommended if you have difficulty using conventional floss.
Daily flossing will help you keep a healthy, beautiful smile for life!
What are my options if I have missing teeth?
With many state-of-the-art dental treatments and prevention options available in dentistry today, there are fewer reasons for having to extract (remove) teeth. When something does go wrong with a tooth, we try to do everything possible to restore the tooth to its original function. Removing a tooth is the last option because we know that removal may lead to severe and costly dental and cosmetic problems if the tooth is not replaced.
Losing a tooth can be a very traumatic experience and it’s very unfortunate when it does happen. Injury, accident, fracture, severe dental decay, and gum disease are the major reasons for having to remove a tooth. If teeth are lost due to injury or have to be removed, it is imperative that they be replaced to avoid cosmetic and dental problems in the future.
When a tooth is lost, the jaw bone that helped to support that tooth begins to atrophy, causing the teeth on either side to shift or tip into the open space of the lost tooth. Also, the tooth above or below the open space will start to move towards the open space because there is no opposing tooth to bite on. These movements may create problems such as decay, gum disease, excessive wear on certain teeth, and TMJ (jaw joint) problems. These problems and movements do not result immediately, but will eventually appear, compromising your chewing abilities, the health of your bite, and the beauty of your smile.
Options for replacement of missing teeth:
Removable bridges - This type of bridge is a good solution for replacing one or more missing teeth, especially in complex dental situations where other replacement options are not possible. They are usually made of tooth-colored, artificial teeth combined with metal clasps that hook onto adjacent natural teeth. Removable bridges are the most economical option for replacing missing teeth, but may be the least aesthetically pleasing. This is because the metal clasps on the appliances are often impossible to completely conceal.
Fixed bridges - This type of bridge is generally made of porcelain or composite material and is anchored (cemented) permanently to a natural tooth adjacent to the missing tooth site. The benefit of this type of bridge is that it is fixed (not removable) and it is very sturdy. The disadvantage is that in order to create a fixed appliance, two healthy, natural teeth will have to be crowned (capped) to hold the bridge in place.
Dentures - This type of tooth replacement is used when most or all of the natural teeth are missing in one dental arch. Dentures are removable artificial teeth that are made to closely resemble the patients’ original teeth.
Implants - Are a great way to replace one or more missing teeth. They may also be great to support ill fitting dentures. A dental implant is an artificial root that is surgically placed into the jaw bone to replace a missing tooth. An artificial tooth is placed on the implant, giving the appearance and feel of a natural tooth. Implants are very stable, durable, and are the most aesthetically pleasing tooth replacement option.
If you are missing teeth, ask us if they need replacement and what options are available to you. Together we will select the best replacement option for your particular case. Prevention and early treatment is always less involved and less costly than delaying treatment and allowing a serious problem to develop.
What does heart disease and other medical conditions have to do with periodontal (gum) disease?
Many people are unaware that having periodontal disease (the destruction of gum tissue and bone that hold our teeth in place) can affect your overall health. Periodontal disease is one of the most common infections; often more prevalent than the common cold! Periodontal disease is not only the number one reason people lose teeth; it can also affect the health of your body!
Periodontal disease is a bacterial infection, and in its earliest stages, it’s called gingivitis. It starts when an accumulation of plaque (a colony of bacteria, food debris, and saliva) is NOT regularly removed from the gums and teeth. The bacteria in plaque produce toxins/acids that irritate and infect the gums and eventually destroy the jaw bone that supports the teeth. When periodontal disease is not treated it can eventually lead to tooth loss!
There are numerous studies that have looked into the correlation between gum disease and major medical conditions. These studies suggest people with periodontal disease are at a greater risk of systemic disease and indicate that periodontal disease may cause oral bacteria to enter the bloodstream and travel to major organs and begin new infections. Research suggests that periodontal bacteria in the blood stream may:
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Contribute to the development of heart disease
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Increase the risk of stroke
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Compromise the health of those that have diabetes or respiratory diseases
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Increase a woman’s risk of having a preterm, low-birth weight baby
Researchers conclude there is still much research to be done to understand the link between periodontal disease and systemic diseases, but enough research has been done to support that infections in the mouth can play havoc elsewhere in the body.
To ensure a healthy, disease-free mouth, we recommend the importance of regular dental check-ups and cleanings, which include a periodontal evaluation. Also, diligent home care and a proper diet can help reduce the plaque and bacteria in the mouth.
Remember….the mouth body connection! Taking care of your oral health may contribute to your overall medical health!
What can I do about a "gummy" smile or short stubby front teeth?
Coordinating treatment between the general dentist and the periodontist can many times correct a "gummy smile" by esthetic tissue recontouring combined with restorative therapy of crown or veneer placement. Conversely, short and unesthetic upper front teeth can be greatly improved by repositioning the gum tissue to a higher level followed by veneer or crown placement. These procedures are relatively straight forward but require very close coordination between the referring dentist and the specialist.
Everyone tells me periodontal therapy is painful. Is this true?
Newer therapy techniques and enhanced local anesthetics have eliminated any discomfort experienced during periodontal therapy. Conscious sedation is also an option in making treatment a more pleasant experience. Following any surgical procedure, discomfort is expected, but with judicious and effective use of newer drugs, post-surgical complications are minimized. Certainly the thought of losing teeth would be significantly more painful mentally than the discomfort involved with periodontal therapy aimed at maintaining a functional and esthetic dentition.
Is periodontal treatment expensive?
Our fees are regarded as usual, reasonable, and customary. Even though a patient may feel that fees are beyond their expectations, we believe that it is never less expensive to do something twice, and that treatment will never be more conservative, more cost effective or less invasive than it is today. Our office accepts most insurance plan benefits realizing that benefits rarely cover the entire fee. We also have various payment options and attempt to maximize any insurance coverage that patients may have. Our fees are based on need and not what the insurance covers as we give each patient the quality of professional care they deserve.