FAQs

“Periodontal” means “around the tooth”. Periodontal disease, or periodontitis (also called pyorrhea), is caused by an acid generated by bacteria in the mouth. These bacteria live in a thin, sticky film, known as plaque, that coats the surfaces of teeth and the tongue, and they respond to carbohydrates in foods.

Plaque eventually hardens into tartar around the gum line, a hard mineral shell that erodes healthy gum tissue. Gingivitis is the first stage of the disease. In advanced gum disease, gums receed and pockets form below the gum line, where millions of bacteria move in. Supporting bone may then erode, which may lead to tooth loss. However, this is not inevitable.

Everyone is susceptible to gum disease, but some people have factors that make them more likely to have gum disease than others.  These are:

Plaque and tartar- some people actually develop plaque and tartar more easily than others.  As a consequence they tend to have more gum disease.

Heredity- we all inherit a degree of resistance, some people are very resistant to gum disease, plaque, and tartar, and others are not.

Medications- some medications reduce saliva, leaving a dry mouth.  Without the cleansing and antibiotic effect of saliva, plaque and calculus can build up more easily.  Alcohol may also decrease saliva.

Smoking- smoking slows the gum’s ability to heal.  Smoking causes a decrease in blood supply to the gum and therefore its healing potential is diminished, so bacteria can do more damage.

Pregnancy-hormonal changes that occur during pregnancy make the gum more susceptible to the damaging effects of plaque.  Also, because of the hormonal changes, plaque grows easier during pregnancy.

Illness –during illness there is usually a decrease or weakening of the immune system, one is more prone to infection, which can lead to gum disease.

Stress- stress has been known to change both the blood flow and the hormonal balance in the gum tissue.  These changes make the gum more susceptible to periodontal breakdown.  The bone loss, and loss of ligament and tissue that occurs subsequently can lead to destruction even when the person is trying diligently to take very good care of themselves.

Your bite- your bite can cause micro-movement of the teeth, causing an increased susceptibility to bacteria and tartar getting in the gap between the gum and the tooth.  Grinding or clenching your teeth can actually increase the gap around your teeth allowing bacteria to enter the space.  This can accelerate the pocket formation.

The first sign is gums that bleed when you brush your teeth, and red, swollen gums. This usually indicates gingivitis. If the condition worsens, you may develop chronic bad breath and more bleeding. With severe periodontal disease, teeth may loosen, and you may notice gums pulling away from teeth. Your bite may change, and your teeth may start to move or change position. But you should not wait for such symptoms to develop. Regular dental visits – ideally at least every six months – should catch periodontal symptoms early.

Some people never do, even though they do not take care of their teeth and never see a dentist. But it’s not worth gambling on being one of those lucky people. About one-third of the population is thought to have a genetic susceptibility to gum disease.

One of the major risk factors is smoking. The chemicals in tobacco smoke and chewing tobacco have harmful effects on the gums and teeth. A poor diet is also a factor; especially a diet high in sugars and other sticky or gummy carbohydrates (as in dried fruit or potato chips). Hormonal changes, particularly in women, can also affect your gums adversely. Oral contraceptives may increase a susceptibility to gum disease. During puberty, pregnancy, menstruation, and menopause, women may find themselves more prone to gingivitis.

Constant emotional and psychological stress may wear down your ability to fight infection, or may simply promote poor eating habits or cause you to neglect dental hygiene. Because saliva helps wash away foods as well as bacterial toxins, anything that decreases saliva production (certain medications, breathing through your mouth at night) can make gum disease worse. Diabetes, AIDS, an other chronic diseases lower resistance to infection and can play a role; the chronically ill need to be particularly careful about dental care.

Periodontal disease may be passed from parent to children and between couples, according to an article in the September 1997 issue of the Journal of the American Dental association. Research suggests that the bacteria that causes periodontal disease passes through saliva.

In addition to regular dental care, thorough, daily flossing and brushing are crucial.

Choose a soft-bristled brush, because hard bristles can damage your gums. Your technique matters more than the tool. Our office will show you this in detail.

Any floss you prefer, waxed or unwaxed, flavored or plain. If the spaces between your teeth are tight, you might prefer waxed floss, which is less likely to catch and fray in tight spots.

For the moment, any fluoride paste that carries the seal of the Canadian Dental Association (CDA) is fine. A tartar-control paste may be a good choice, but no paste controls tartar below the gum line. Brushing, with any toothpaste (or even without paste), will help control tartar by removing plaque, but you will eventually need a professional cleaning. A baking soda toothpaste is as good as any other as long as it contains fluoride. Toothpastes with “natural” ingredients are okay, too, as long as they have fluoride and the CDA seal. In spite of their claims, they offer no special benefits for dental hygiene.

No mouthwash can take the place of regular brushing and flossing. If you want one to freshen your breath temporarily or because you like the taste, any mouthwash will do. If you have one of the periodontal diseases, your dentist may prescribe a particular mouthwashes, which contain the antibacterial ingredient chlorohexidine. We do recommend using a mouthwash without alcohol.

Depending upon the stage of the disease, you may need a prescription mouth rinse, oral irrigation with and antibiotic solution, general antibiotic treatments, more thorough removal of tartar below the gum line, or surgery. Your regular dentist will probably refer you to us, a periodontist. A wide range of non-surgical and surgical treatments are now available.