Online Dental Education Library
Our team of dental specialists and staff strive to improve the overall health of our patients by focusing on preventing, diagnosing and treating conditions associated with your teeth and gums. Please use our dental library to learn more about dental problems and treatments available. If you have questions or need to schedule an appointment, contact us.
Periodontal Disease
When to See a Periodontist
Periodontal treatment may be sought in several ways. Your general dentist or a hygienist may recommend a consultation with a periodontist if they find signs of periodontal disease through the course of a checkup or other dental care appointment. You may also decide to see a periodontist on your own, as a referral is not necessary to be seen at our office.
In fact, if you experience any of these symptoms, we encourage you to schedule an appointment at our office without delay:
- Unexplained bleeding while performing regular cleaning or consuming food is the most common sign of a periodontal infection.
- Ongoing halitosis (bad breath), which continues despite rigorous oral cleaning, can point to periodontitis, gingivitis or the beginnings of a gum infection.
- Longer-looking and loose-feeling teeth can indicate recession of the gums and/or bone loss as a result of periodontal disease.
Patients with heart disease, diabetes, osteopenia or osteoporosis are often diagnosed with correlating periodontal infections. The bacterial infection can spread through the blood stream, affecting other areas of the body.
- Bleeding while brushing or eating normal foods
- Bad breath
- Loose teeth and gum recession
- Related health concerns
What is Periodontal Disease?
Periodontal disease is a chronic infection of the periodontal or gum tissue. This infection is caused by the presence of a bacterial film, which is called dental plaque, that forms on the teeth surfaces. Bacteria that found in dental plaque produce toxins which irritate the gums. They may cause them to turn red, swell and bleed easily. If this irritation is prolonged, the gums separate from the teeth, causing pockets (spaces) to form. Plaque can also harden into a rough, porous substance known as calculus (or tartar). This can occur both above and below the gum line.
As periodontal diseases progress, the supporting gum tissue and bone that holds teeth in place deteriorate. If left untreated, this leads to tooth loss. With periodontal disease, bleeding, redness and swelling do not have to be present. Further, pain is usually not associated with periodontal disease. This disease damages the teeth, gum and jawbone of more than 80% of Americans by age 45. Each case is looked at individually, because in addition to plaque there are co-factors such as genetics, smoking, and overall health, which contribute to disease severity. Once periodontal disease is detected, our goal as therapists is to provide information and treatment necessary to control/ or arrest the active infection, and help keep the disease in an inactive or controlled state.
However, don’t be fooled!
With periodontal disease, bleeding, redness and swelling do not have to be present. The periodontal disease symptoms of inflammation may only be evident with sub gingival probing. Further, pain is usually not associated with periodontal disease.
If you're like most people, you probably learned how to brush as a child… and chances are, you haven't thought about it much since then. That's understandable — but there may come a point when we find our oral hygiene techniques could use improvement. Here are a few tips on the proper way to brush your teeth… plus, a reminder of why we do it.
First, the reasons why: Brushing is an effective way to remove plaque — a sticky, bacteria-laden biofilm that clings stubbornly to your teeth. The bacteria in plaque produce acids, which erode the tooth's enamel and may lead to tooth decay. Plaque can also cause gum disease and bad breath. In fact, it's believed that over 90% of dental disease is caused by plaque accumulation alone.
Besides removing plaque, the fluoride in toothpaste strengthens tooth enamel and makes teeth more decay-resistant. Plus, brushing makes your mouth feel cleaner and your breath smell fresher. While there is no single “right” way to brush your teeth, there are a number of techniques that can help you get them squeaky-clean. So why wait — let's take a refresher course in brushing right now!
Proper Brushing Technique
- To begin, select a small-headed, soft-bristled toothbrush, grasp it gently with your fingers (not your fist), and squeeze on a pea-sized dab of fluoride toothpaste.
- Hold the bristles gently against the outside of your top teeth, near the gum line, at about a 45-degree angle upward.
- Sweep the brush gently back and forth over teeth and gums in soft strokes — or, if you prefer, use an elliptical (circular) motion to clean the teeth.
- Be sure to clean the spaces between teeth: You can use a sweeping motion to brush food particles away from the gums.
- When you have done one brush-width, move to the adjacent area of your teeth and repeat. Keep going until you have finished cleaning the outside of the whole top row of teeth.
- Move to the bottom teeth. Repeat the procedure, tilting the brush down toward the gum line at about 45 degrees. Finish cleaning the outside of the bottom teeth.
- Go on to the inside of the top teeth. Tilting the bristles up toward the gums, clean the inside of the top teeth with gentle but thorough strokes.
- Move to the inside of the bottom teeth. Tilt the brush down and repeat the procedure.
- Now it's time for the chewing surfaces: Holding the bristles flat against the molars, clean the ridges and valleys of the back teeth. Do this for all the top and bottom teeth.
- Finally, brush your tongue gently to remove bacteria and freshen breath.
Check Your Work
How good a brushing job did you do? One way to get an idea is by simply running your tongue over your teeth: If they feel slick and smooth, then chances are they're clean. If not, you should try again. To know for sure whether you're brushing effectively, you can use a “disclosing solution” — a special dye that highlights plaque and debris your brushing missed.
One common error is not brushing for long enough: two minutes is about the minimum time you need to do a thorough job. If you have music in the bathroom, you could try brushing along with a pop song; when the song's over, you're done! But no matter your musical taste, good brushing technique can go a long way toward maintaining tip-top oral hygiene.
Variations for Comfort
If you're having trouble with the two-finger method, here's another way to try flossing: Just tie the same amount of floss into a big loop, place all your fingers (but not thumbs) inside the loop, and work it around your teeth with index fingers and thumbs. All the other steps remain the same.
Once you've got the basics down, there are a few different types of flosses you can try, including flavored, waxed, and wider width. Some people find waxed floss slides more easily into tighter gaps between teeth or restorations — but it may not make that satisfying “squeak” as it's cleaning. Others prefer wide floss for cleaning around bridgework. But whichever way works best for you, the important thing is to keep it up!
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