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Overview
Periodontics is a branch of dentistry that concerns itself with the supporting structures around your teeth. Dentists refer to these structures collectively as your teeth's "attachment apparatus". These structures involve different parts of each tooth, your gums and other soft tissues, and the bone of your jaws. These tissues can be damaged by a multitude of factors. When this damage occurs, dentists diagnose and treat a variety of periodontal diseases manifesting themselves in a variety of stages. Dentists who specialize in these treatments are called periodontists.

Like cavities in teeth, it is crucial that periodontal disease be diagnosed early in its less harmful stage. This is why our patients are encouraged to visit us routinely for hygiene visits. At Academy Dental, all our patients undergo comprehensive periodontal exams that include hard and soft tissue exams and periodontal screenings and recordings (known as PSRs). Low exposure digital radiographs also help us evaluate the periodontal health of bone and teeth.

Types of Periodontal Disease
Periodontal (gum) diseases, including gingivitis and periodontitis, are serious infections that, left untreated, can lead to tooth loss. The word periodontal literally means "around the tooth." Periodontal disease is a chronic bacterial infection that affects the gums and bone supporting the teeth. Periodontal disease can affect one tooth or many teeth. It begins when the bacteria in plaque (the sticky, colorless film that constantly forms on your teeth) causes the gums to become inflamed. Periodontal disease has also been increasingly associated with other severe health conditions.

Gingivitis. Gingivitis is the mildest form of periodontal disease. It causes the gums to become red, swollen, and bleed easily. There is usually little or no discomfort at this stage. Gingivitis is often caused by inadequate oral hygiene. Gingivitis is reversible with professional treatment and good oral home care.

Periodontitis. Untreated gingivitis can advance to periodontitis. With time, plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque irritate the gums. The toxins stimulate a chronic inflammatory response in which the body in essence turns on itself, and the tissues and bone that support the teeth are broken down and destroyed. Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Often, this destructive process has very mild symptoms. Eventually, teeth can become loose and may have to be removed.

There are many forms of periodontitis. The most common ones include the following:

Aggressive periodontitis occurs in patients who are otherwise clinically healthy. Common features include rapid attachment loss and bone destruction.

Chronic periodontitis results in inflammation within the supporting tissues of the teeth, progressive attachment and bone loss. This is the most frequently occurring form of periodontitis and is characterized by pocket formation and/or recession of the gingiva. 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 often begins at a young age. Systemic conditions such as heart disease, respiratory disease, and diabetes are associated with this form of periodontitis.

Necrotizing periodontal disease is an infection characterized by necrosis of gingival tissues, periodontal ligament and alveolar bone. These lesions are most commonly observed in individuals with systemic conditions such as HIV infection, malnutrition, and immunosuppression.

Treating Periodontal Disease
Academy Dental boasts one of the finest hygiene staffs in the state of Maine. Our professional, experienced, and friendly hygienists do an outstanding job of monitoring your periodontal health and treating the milder manifestations of gingivitis and periodontitis. Such treatments include educating you in the latest findings in prevention, screening and recording multiple characteristics of the periodontal tissues, removing plaque and calculus from your teeth, performing scaling and root planings (SRPs), and delivering chemotherapies to strengthen teeth and reduce the pathogens associated with periodontal disease.

In more severe cases of periodontitis, Academy Dental routinely refers our patients to dental specialists called periodontists. Periodontists treat periodontal disease, perform cosmetic periodontal procedures, and place dental implants.

Frequently Asked Questions

Who should treat my periodontal disease: my general dentist or a periodontist?
In Aroostook County, this is often an issue of logistics. The nearest periodontists are a long distance away. In early stage periodontal disease, Academy Dental does a great job in meeting the treatment needs of its patients. In cases of more involved and complex periodontal disease, Academy Dental recommends that our patients should consider a combined treatment with both a specialist and our office. This team approach will help us (we're familiar with your dental and medical history) and your periodontist (who has extensive experience treating periodontal disease) collaborate to tailor a treatment plan that works best for your individual case.

Is periodontal disease contagious?
Research has shown that periodontal disease is caused by the inflammatory reaction to bacteria under the gums, so periodontal disease technically may not be contagious. However, the bacteria that cause the inflammatory reaction can be spread through saliva. This means that if one of your family members has periodontal disease, it’s a good idea to avoid contact with their saliva by not sharing eating utensils or oral health equipment. If you notice that your spouse or a family member has the warning signs of a possible periodontal problem (bleeding, red and swollen gums, or bad breath) you may want to suggest that they come see us for an exam. It may help to protect the oral health of everyone in the family.

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 us since gum disease may increase this risk. Go here to find more information from perio.org.

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 preventive measures may save you the time and money of treating 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

source: American Academy of Periodontology

Additional Resources

The American Academy of Periodontology

The connection between gum disease and other systemic conditions

AAP Periodontal Disease Risk Assessment Test

ADA: Periodontal Disease