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.
Sometimes little defects in teeth can attract more than their fair share of attention. The eye often seems drawn to the tiny chip in a front tooth; the slight mismatch in tooth size among adjacent teeth; the extra-pointy canine. If you find yourself staring at these subtle yet distracting features in your own smile, help is available — often with a minimally invasive, relatively inexpensive procedure known as tooth contouring (reshaping).
Tooth contouring involves removing a tiny amount of tooth enamel with a drill to sculpt a more pleasing shape and make the tooth fit in better with its neighbors. The tooth is then polished for a smooth finish. The procedure is most often used on the upper front incisors and canines, which are your most visible teeth.
Cosmetic problems that can be corrected with tooth contouring include: small chips, uneven tooth length, slight overlaps, and tooth edges that are too flattened or pointy. It can even be used to correct minor bite problems from teeth touching unevenly during contact. Conversely, your teeth should not be reshaped if any bite imbalances could result from it. In that case, one of several other highly effective cosmetic dental procedures would be recommended. Tooth contouring can also be used to give teeth a more feminine or masculine shape, simply by rounding or squaring the edges.
What to Expect
The first step in the contouring procedure is to examine your teeth and diagnose how the reshaping will accomplish your goal of smile enhancement or correct a bite problem if you have one. This will ensure that the teeth being reshaped will not only look better but also will be healthy. Sometimes a reshaping of the root surfaces is required to protect you from gum disease. In that case, an x-ray may be necessary to isolate and protect the sensitive inner tissue (the pulp). However, most often tooth contouring only involves the removal of a bit of enamel — the hard outer covering of the tooth. Because enamel is not living and contains no nerves, you will likely not need even a local anesthetic.
You will probably feel some vibration as your tooth is gently sculpted, and then polished smooth. Reshaping one tooth usually takes less than half an hour — and the results will be obvious as soon as you look in the mirror! Sometimes reshaped teeth can be a little sensitive to hot or cold after the procedure, but this should last no more than a day or two.
Tooth contouring can be combined with whitening for a dramatically younger-looking smile. It's also often used in conjunction with cosmetic bonding or dental veneers — both of which can be used to reshape teeth with larger imperfections.
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