Frequently Asked Questions

How is gum disease linked to cardiovascular disease?
Research has shown that periodontal disease may increase the risk for developing cardiovascular disease. Both periodontal disease and cardiovascular disease are chronic inflammatory diseases, so researchers believe that inflammation may account for the association between the two. Untreated periodontal disease can increase inflammation in the body, which may increase the risk for development of more severe health complications, including cardiovascular disease. However, more research is needed to determine the exact relationship between the two conditions.

Is a topical antibiotic treatment necessary in conjunction to scaling and root planing?
According to the American Academy of Periodontology, topical antibiotic treatment may be used as an adjunct to scaling and root planing. Every person has different needs based on their particular situation, so be sure to talk to your dental professional about using these antibiotics as part of your course of treatment; he or she will determine if they are a good fit for you.

What is the difference between plaque and calculus?
Plaque is the sticky, colorless film that constantly forms on your teeth. Bacteria live in plaque and secrete acids that cause tooth decay and irritate gum tissue. This irritation causes an inflammatory reaction by your body that can eventually lead to gingivitis and periodontal disease. If plaque is not removed regularly by tooth brushing and flossing, it hardens to create calculus (also known as tartar). Calculus cannot be removed with a toothbrush; only a dental professional can remove it during an oral cleaning. To keep plaque and calculus under control, it is essential to brush your teeth twice every day, floss at least once every day, and see your dental professional for regular cleanings

Can children be at risk for developing periodontal disease?
Periodontal disease is rarely found in children, and only sometimes found in adolescents. However, children should still learn the importance of keeping their teeth and gums healthy to prevent periodontal disease in the future. Children should brush their teeth twice a day and learn how to floss properly- if children learn how to floss at an early age, they will be more likely to make it a lifetime habit. These two simple acts will help protect their teeth and gums from periodontal disease.

As a parent, you should also be aware of the warning signs of periodontal disease, which include red, swollen, bleeding gums or bad breath that won’t go away. If your child develops any of these symptoms, tell your dental professional right away. It’s also a good idea to ensure your dental professional knows your complete family history, as genetics can play an important role in the early development of periodontal disease.

What are common signs and symptoms of periodontal disease?
Periodontal disease is often silent, meaning symptoms – particularly pain – may not appear until an advanced stage of the disease. However, you should still be on the lookout for the signs and symptoms, which include:

• Red, swollen or tender gums or other pain in your mouth
• Bleeding while brushing, flossing, or when eating certain foods
• Gums that are receding or pulling away from the teeth, causing the teeth to look longer than before
• Loose or separating teeth
• Pus between your gums and teeth
• Sores in your mouth
• Persistent bad breath
• A change in the way your teeth fit together when you bite
• A change in the fit of partial dentures

If you notice any of these symptoms, be sure to contact your dentist or periodontist right away
Other than diagnose and treat gum disease, what else have periodontists been trained to do?
Most periodontists spend the majority of their time diagnosing and treating gum disease, but there are a variety other procedures that they are able to perform. Periodontists place dental implants when natural teeth cannot be saved. They also monitor the implants to make sure that they’re properly doing their job. Periodontists may also correct gum recession and cover up exposed root surfaces which can be unsightly as well as sensitive to hot and cold. These procedures are often used to lay the foundation for additional cosmetic procedures to help create a beautiful smile. Finally, periodontists can be integral in the comprehensive planning of your oral care, along with your general dentist or other dental professional

My dentist informed me that I need implants, but I can’t afford themat this time. Is there any financial assistance for periodontal treatments?
There are a few resources you can research for financial assistance. The first is your periodontist. Dr Perlus is willing to set up financing options, such as a payment plan. The office also may know of insurance plans that can help cover the cost of your implants.

What can I do at home to prevent periodontal disease?

The best way to prevent periodontal disease is to take good care of your teeth and gums at home. This includes brushing your teeth after every meal and before bedtime, flossing at least once each day, and seeing your dentist or periodontist for regular exams twice a year. Spending a few minutes a day on preventative measures may save you the time and money of treating periodontal disease.

Both of my parents have periodontal disease, and I’m worried that it may be genetic. Is there a way to determine my risk for developing gum disease?
First of all, congratulations on being proactive about your health! Recent research has shown that genetics may be involved in a person’s risk for gum disease, but there are a variety of other factors that also play a role.

Is there a link between periodontal disease and diabetes?
Research has suggested that there is a link between diabetes and gum disease. People with diabetes are more likely to have periodontal problems, possibly because people with diabetes are more susceptible to contracting infections. In fact, periodontal disease is often considered one of the major complications of diabetes. Interestingly, the relationship between the two conditions goes both ways; just as diabetes can increase a person’s chance of developing periodontal disease, research suggests that efficient and effective periodontal hygiene may positively affect blood sugar levels.

I have heard there is a connection between gum disease and heart disease. Is this true? Where can I find more information?
The connection between gum disease and heart disease is a very hot topic in the field of periodontics right now! Several research studies have indicated that heart disease and gum disease may be linked, and researchers suspect that inflammation may be the basis behind this relationship. If you are at risk for heart disease, it is a good idea to mention this to your periodontist, since gum disease may increase this risk. Get additional information on the connection between heart disease and gum disease, as well as the connection between gum disease and other systemic conditions.

What causes periodontal disease? 
Periodontal (gum) disease is caused by bacteria in the dental plaque in the mouth, which cause inflammation and bleeding gums. As the disease progresses, the gums separate from the teeth allowing damage to the underlying bone and loosening of the teeth. Good oral hygiene and regular visits to your dentist can prevent periodontal disease.

Is it true that there is a relationship between periodontal disease and systemic disease?
Yes, there is solid clinical evidence that some systemic conditions (e.g., diabetes, respiratory and heart disease) cause patients to become more prone to periodontal disease, and periodontal disease leads to the exacerbation of systemic diseases. Ask your periodontist about which systemic diseases are connected to periodontal disease.

Can treatment for periodontal disease stop tooth loss?
If caught early enough, surgical and non-surgical treatments can prevent the loss of teeth for those with periodontal disease. Discuss a treatment plan with your periodontist.

I have had periodontal treatment in the past. Why do I need it again?
Periodontal disease can be cured when the disease is in the early stages. After that, treatment helps to slow or stop progression of the disease. If treatment and oral health care is not kept up, the progression of the disease can start again, so discuss treatment with your dental care specialist. Prevention

I brush my teeth all the time so why do I have plaque and tartar?
Brushing and flossing help prevent tartar and plaque, but there are other ways tartar and plaque build on teeth. Some people are more prone to it in their saliva. Certain foods, beverages and toothpastes also promote tartar formation.

What can I do to reduce plaque formation?
Besides ramping up your oral health care, you may want to make changes to your diet or your dental products. Discuss ways you can reduce plaque formation with your dentist.

Which toothbrushes are most effective against gum disease?
Electric toothbrushes rotate at a fast speed and can clean your teeth more effectively in the same length of time with added brush strokes, so they are often recommended for those who are struggling with gum disease. Talk to your hygienist for more information.

Why have a dental implant instead of dentures or bridges?
For patients with healthy gums and bones, dental implants offer the look and feel of real teeth. Dentures can slip even with adhesive, and can cause gum irritation. Bridges can take their toll on gums, bones and surrounding teeth over time. Find out if you are a candidate for implants from your implant specialist.

How long does it take to get a dental implant?
These procedures are getting shorter all the time. Be aware that it takes time for the implant to take hold, so between the time that the titanium implant is put in and the time that the permanent artificial tooth is screwed in, several months will have passed. A temporary tooth will be put in place until the implant is secure. Your dental specialist will give you a timeline based on your individual circumstances.

What about the “tooth in a day” I see advertised?
Implants can happen in one day, but again, these will not be your permanent final teeth. It takes several months before the implant is securely fixed. However, you can walk out with a temporary tooth/teeth the day of your implant appointment. Talk to your implant specialist about this option.

Why do my gums recede and why does it matter?
There are many causes, including aggressive brushing, genetics, the position of teeth, grinding teeth and poor oral health. As gums recede, teeth can loosen and eventually be lost. Receding gums can be repaired with the help of your periodontist.

How do I prevent gum recession?
First, identify the cause with the help of your dentist or periodontist. Then discuss specific prevention and treatment options for your receding gums.

How to I repair my receded gums?
Once your gums begin to recede, you cannot repair damage by changing your diet or oral health care habits. You need advice and treatment from your periodontist. There are surgical and non-surgical options, depending on the extent of your condition.

Do I have to use my own tissue for gum transplants?
Many patients use their own tissue, but you can also use donor tissue. Ask your periodontist about the best choice for you.

What is bone grafting? 
Bone grafting is a surgical procedure that replaces missing or insufficient bone. In addition, the procedure also helps your body regrow lost bone. The bone graft material sometimes comes from the patient or sometimes from a donor; some are synthetic.

What is soft tissue grafting?
Gum tissue is scraped from the palate or some other source and used to prevent further recession, cover the exposed root or roots to protect teeth from decay, reduce sensitivity and improve the look of your smile.

My dentist says I need crown lengthening. What is it?
It doesn’t mean you have short teeth. Crown lengthening is a surgical procedure to expose a greater amount of the teeth, done by removing some of the gum tissue and often some of the bone from around the teeth.

Why do I need it?
Often it is a cosmetic procedure, but sometimes more length to the teeth is required to support a crown or filling. Typically, it would be a few teeth that would have the crowns lengthened for cosmetic reasons.

How is it done?
Using local anaesthesia. The periodontist starts by moving gum tissue away from the teeth to expose the roots and surrounding bone. Sometimes bone tissue also has to be removed. Once enough tooth has been exposed to support the planned restoration, sutures are used to stitch the gums in their new position. For cosmetic purposes, tissues are gradually reshaped to give the appearance of longer teeth and a less gummy smile.

My teeth are very short and I have a gummy smile. Can they be made more natural?
Gummy smiles are generally not due to short teeth, but too much gum tissue. With a simple surgical procedure, excess gum tissue can be removed to expose more tooth for a more pleasing smile. Ask your periodontist for more details about this procedure.

My teeth are long and roots are showing. Can they be made more natural?
When too much tooth is showing and roots are exposed, it first must be determined why the gums have receded so a proper treatment plan can be developed. While there are non-surgical procedures, often a soft tissue (gum) graft and possibly a bone graft must take place. Your periodontist can discuss your options with you.