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.
There are more and more adult orthodontic patients these days, and it's not hard to figure out why. Appliances that are barely noticeable have been developed to give adults more discreet choices when it comes to orthodontic treatment. And many adults realize that investing in a smile makeover can have significant benefits, socially and professionally. Straightening teeth can be an important part of that confidence-boosting makeover process.
Healthy teeth can be moved at any age, so there's no such thing as being too old for braces. However, orthodontic treatment for adults is different in two important respects: For one thing, the growth and development of the jaws is complete in adults, so changes in actual jaw structure can't be accomplished with orthodontic appliances in the way they can with a growing child.
Secondly, periodontal (gum) disease is more prevalent in adults than in children. While you are wearing the orthodontic appliances, gentle forces will be applied to your teeth so they can move through their surrounding bone. Periodontal health plays a key role in all of this; if the gum tissues are not healthy during orthodontics, bone loss can result and weaken the long-term prognosis of your teeth. So any gum disease must be brought under control before orthodontic treatment begins. And to maintain your periodontal health, you will need to make sure to have regular professional cleanings during the orthodontics while maintaining good oral hygiene at home.
Types of Orthodontic Appliances
All orthodontic appliances work essentially the same way: by employing light, constant force to move teeth into proper alignment. But how we apply these forces can vary, as numerous innovations have become available in recent years. Some of the newer, less visible orthodontic appliances have been designed to blend more easily into an adult's personal and professional lifestyle. Types of orthodontic appliances include:
Traditional Metal Braces — This is probably what you think of when you picture someone wearing braces: small metal brackets bonded to the front of the teeth. A thin wire runs through the brackets and is attached on either end to metal bands that go around a back molar.
Clear Braces — Instead of highly noticeable metal brackets, you can have clear ones made of ceramic, plastic or a combination of both. They are hardly visible, except for the thin wire running through, but they are more susceptible to breakage than metal braces.
Clear Aligners — As an alternative to the fixed type of orthodontic appliances mentioned above, clear aligners are removable. They are actually a series of clear plastic “trays” that fit over your teeth exactly. Each tray is part of a series of trays that move your teeth a little bit at a time until they are in the proper position. Your trays are designed with the help of specialized computer software that generates a virtual model of your bite.
Lingual Braces — These metal braces are bonded to the back of your teeth (tongue side) so that no one can see them. That is the plus side. On the minus side, they can be more difficult to get used to wearing, and are more expensive than traditional braces.
After Treatment
Wearing a retainer after orthodontic treatment is crucial, no matter which type of appliance you choose and what age you happen to be. Teeth that are not held in place by a retainer long enough for new supporting bone to develop around them can drift back to their original positions, and that's certainly not something you want to see happen. You will be instructed on how to retain your new, more beautiful smile so that it continues to make you look and feel great for years to come.
Related Articles

The Magic of Orthodontics Proper alignment of the teeth is basic to “Smile Design.” Their position dictates how they work together and affects the way you look and smile. Only orthodontic treatment can move teeth into the right position. Simply put, when things look right, they probably are right. Learn the basics of smile analysis and design and whether the magic of orthodontics will work for you... Read Article

Orthodontics for the Older Adult Healthy teeth can be moved at any age, so there's no such thing as “too old” for braces. In fact, nowadays about one out of every five orthodontic patients is an adult. Yet this figure represents only a small portion of adults who could actually benefit from orthodontic treatment... Read Article

Clear Orthodontic Aligners Orthodontic treatment using clear aligners consists of a series of aligners that you change about every two weeks over a course of treatment lasting six to eighteen months depending on how much movement is needed... Read Article