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.
If your teeth seem especially sensitive after you brush them or when you consume certain foods or beverages, you're hardly alone: By one estimate, around 35 percent of the U.S. population experiences some degree of tooth sensitivity. While the difference between sensitivity and pain may be somewhat blurry, we can say that sensitive teeth usually produce discomfort in response to a stimulus like temperature, pressure, or even the sweetness of particular foods. What causes tooth sensitivity — and what should you do about it?
In general, tooth sensitivity results when dentin, the living tissue that makes up most of the “body” of the tooth, begins transmitting sensations to nerves deep in the tooth's inner core. The nerves relay these sensations to the brain, and they're felt as pain. To understand how this works, let's take an even closer look at your teeth.
Tooth Anatomy 101
Dentin is a sturdy, calcified tissue, that can't usually be seen. It's normally covered by super-hard enamel on the visible part of the tooth (the crown), and by softer tissue called cementum on the tooth's roots (which typically lie below the gum line). The dentin itself is composed of many tiny tubules. When these tubules become exposed to the environment of the mouth, tooth sensitivity and pain may result.
There are several reasons why the dentin can become exposed. For one, the gums may recede (shrink down), revealing some of the tooth's root surfaces. This can be caused by genetic factors, periodontal disease, excessively vigorous brushing — or a combination of all three. This problem may be worsened if the tooth's roots weren't completely covered by cementum during their development, as sometimes occurs.
Another factor that may contribute to sensitivity is the erosion of tooth surfaces due to excessive acid in the diet. While acids occur naturally in the mouth, habitually drinking sodas and sports drinks can severely erode teeth — and brushing soon after you drink actually worsens the effect. That's because these acids soften the outer surfaces of the teeth, and brushing then makes it easy to wear them away. It's best to wait for an hour afterwards, to give your saliva a chance to neutralize the acid.
Tooth decay can also cause sensitivity. Decay may not only expose dentin, but can work its way down to the nerves themselves — at which point, your pain level may escalate. And sometimes, even dental work itself can cause sensitivity. Because the same tooth structures are involved, it may sometimes take a few days after a cavity is filled, for example, for a tooth to “calm down.”
Dealing With Tooth Sensitivity
What can you do about sensitive teeth? If it's a relatively minor irritation, try not to brush the affected teeth too long or hard. Make sure you're using a soft-bristled brush and the proper, gentle brushing technique. Always use a toothpaste containing fluoride, as this ingredient is proven to increase the strength of tooth enamel, which helps resist erosion. You can also try a toothpaste with ingredients designed especially for sensitive teeth, such as potassium. Studies show that these can be effective… but it may take approximately 4 – 6 weeks for you to notice the difference.
If sensitivity persists, however — or if your tooth pain becomes more intense — don't wait to get an examination to determine what's causing the problem. Once diagnosed, the most appropriate way to reduce the sensitivity will be recommended. Some treatments may include concentrated fluoride varnishes, prescription mouthrinses, or materials that are bonded to the outer surfaces of teeth. But tooth sensitivity may also be an early warning sign of other dental problems — and the sooner they're taken care of, the better off you'll be!
Related Articles
Treatment of Tooth Sensitivity As many as 35% of the U.S. population suffers from tooth sensitivity. Causes include overly aggressive brushing, which causes the gum tissue to recede exposing the root surfaces of the teeth; and acidic beverages, which erode the teeth. Fortunately, there are products available for use at home or in the dental office that can help... Read Article
Sensitive Teeth Tooth sensitivity — to hot or cold, for example — is often a problem where the gums have receded, exposing the root surfaces of the teeth. These areas of the teeth have sensitive nerve fibers. Find out what steps you can take to minimize this problem... Read Article
A Severe Toothache You may think a painful toothache that goes away on its own is no longer cause for concern. However, it's still worth a visit to the dentist. The disappearance of pain could mean that the nerve tissue deep inside the tooth has died, yet an infection is still present... Read Article