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.
Do you think of bone as a hard, rigid material that never changes? In fact bone remodels itself all the time: Your body is constantly depositing new bone cells and removing old ones. In the case of the bone that supports your teeth, this process can be helpful or harmful. For example, the jawbone's adaptability allows an orthodontist to move teeth into a better position with braces. But in the case of losing a tooth as an adult, the bone changes that result can have serious consequences.
When teeth are lost, the bone that used to surround them begins to melt away or “resorb.” Tooth-supporting bone can also be lost when you have periodontal (gum) disease. If you loose enough teeth and bone, your facial features will sag, giving you a more aged appearance; it can also complicate treatment to replace your missing teeth. Fortunately, with modern bone grafting-techniques, the bone that has been lost can be built up again. This can benefit both your health and appearance by strengthening your jawbone, allowing more effective tooth replacement, and increasing support to your facial features.
Bone grafting is a minor surgical procedure that is normally done in a dental office. An incision is made in your gum to gain access to the bone beneath it, and then grafting material is added. Most often, the grafting material is processed bone minerals around which your body will actually deposit new bone cells.
The grafting material itself can come from your own body, but very often it is bone from an animal or human donor that has been treated by a laboratory to make it sterile and safe. It can even be a synthetic substance. Grafting material comes in a variety of forms: powder, granules, putty or a gel that can be injected through a syringe. The graft, which is generally covered by a collagen membrane for optimum bone repair, will act as a scaffold onto which your body will build new bone.
Uses for Bone Grafts
Bone grafts are used in dentistry to accomplish the following treatment goals:
- Saving Teeth — When severe periodontal disease causes bone loss, teeth can become loose and at risk of being lost. In order to save them, the bone around them can be regenerated through grafting; this increases bone support and helps keep them in place.
- Tooth Extractions — These days, it is very common to deposit bone grafting material into a tooth socket after a tooth has been removed. That way, should you want to replace your tooth with a dental implant later on, that option will be available.
- Dental Implants — In this optimal tooth-replacement system, a small titanium post embedded in the jawbone is attached to a highly realistic dental crown, permanently replacing the missing tooth. Implants require good bone volume and density to achieve their excellent functionality and high success rates. If you have already experienced bone loss, a graft can help regenerate enough bone to place the implant successfully.
What to Expect
The procedure for placing a bone graft usually requires only local anesthesia, though oral or IV (intravenous) sedatives can also be used to achieve a higher state of relaxation. Since a small incision is made in your gum tissue to gain access to the bone that will receive the graft, you may experience some soreness in the area after the surgery. This can usually be managed by over-the-counter anti-inflammatory medication and/or pain relievers, as well as ice therapy after the procedure. Any discomfort should only last a day or two. Then, over the next several months, your body will replace the graft with its own bone, reversing the decline in bone quantity you have experienced.
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Can Dentists Rebuild Bone? Yes they can! It is very important to maintain bone volume following removal of a tooth so that dental implants remain a viable option for tooth replacement. This is easily accomplished with today's routine bone-grafting techniques... Read Article