What is a Periodontist?
A periodontist is a dentist who specializes in the prevention, diagnosis and treatment of periodontal disease and in the placement of dental implants. A periodontist typically has had two to three years of additional training in diagnosing and treating gum disease and its associated problems.
Periodontists are familiar with the latest techniques for diagnosing and treating periodontal disease. Also, periodontists can perform cosmetic periodontal procedures to improve your smile. Often, referral is necessary to a periodontist when gum disease is advanced or implants are a consideration in addition to other procedures.

What is Inflammation?
Inflammation is your body’s normal way of healing itself after injury or infection. It is a natural process that lets your defense cells enter the site of injury or infection and allow for healing to occur. However, if the inflammation process goes on for a period of time it causes tissue damage. This is the case in long-term, chronic diseases such as arthritis. Oral inflammation can also lead to gingivitis, periodontitis and eventually, tooth loss.

Why is oral inflammation important to my general health?
The mouth may contribute to your body’s overall amount of inflammation. Your mouth is home to many different types of bacteria. Many of these types of bacteria are harmless but some cause cavities while other cause inflammation of the gums or gingivitis. When the bacteria get out of control it results in red, swollen, puffy and tender gums. A common sign of gingivitis is gums that bleed easily when you brush or floss.

Your mouth is directly related to the body by the bloodstream. This means that when you have inflammation in the mouth it affects your overall health or parts of the body. Studies have shown that oral inflammation may be linked to problems in other parts of the body. Some of these problems are heart disease, diabetes, arthritis and periodontal disease.

Insert diagram of Inflammation

Dental Professionals associate gum disease to fall under 3 stages:

Gingivitis

This is the first stage of gum disease. Some indications that you may have gingivitis may involve tender and some bleeding of your gums when you brush or floss. Gingivitis is reversible when corrective measures are undertaken. Some of these measures involve routine professional cleanings and proper brushing and flossing on a daily basis. Usually when the above measures are undertaken no bleeding or tenderness of the tissues results therefore the gingivitis has been reversed back to a degree of health. Untreated gingivitis can advance to periodontitis.

Periodontitis
This is considered the second stage of periodontal disease. At this stage plaque and tarter forms under the gums which are not accessible with brushing and flossing alone, professional therapeutic methods need to be incorporated. Plaque and tarter causes and infection, which may damage the bone and the attachment of the gums to the teeth. You may notice that your gums start to pull away from the gums and more tenderness and bleeding may result. Proper dental care may involve tissue and root therapy or deep cleanings with the incorporation of other therapies depending on the involvement of the disease. Professional intervention is very important to prevent further damage of this disease.

The first step involves a special deep cleaning or tissue and root therapy. This procedure helps gum tissue heal and periodontal pockets to shrink. A local anesthetic is often used to make you more comfortable. Usually, treatment occurs in one appointment. Sometimes antibiotics may be inserted under the gums to aid in healing of the gingival tissues. Also, a medication via pill may be recommended to control infection or to aid in healing. After a month after therapy and examination will determine if further treatment is required.

Advanced Periodontitis
In this final stage of gum disease, the bone and the attachment of the gums to the teeth have been destroyed. This may cause your teeth to shift or loosen and can affect how your teeth come together. You may notice a bad taste or smell in your mouth. Proper dental care must be initiated to save the teeth or they may need to be removed. Professional intervention may involve pocket reduction therapy and bone grafting along with the incorporation of other therapies.
Pocket reduction therapy is required when the gingival tissues have not resolved after initial treatment or tissue and root therapy. This is usually necessary when gingival tissues have not shrunk enough or when the supporting bone around the teeth has been lost. Since the gingival tissue have not shrunk they provide a greater place for bacteria to live and attack the bone and tissue causing further damage to occur.
Pocket reduction therapy turns or pulls back the gingival tissue and removes tartar and smoothes the roots so that the gingival tissue can reattach. Diseased tissue is also removed to allow the gingival tissue to heal. The gingival tissue is sutured back into place into a new position to make the gingival tissue snug around the tooth and aid in healing. Sometimes bone grafts may be necessary to correct for bony defects that occur around teeth and where roots divide to prevent loss of teeth.

Prevention and Maintenance
Once your periodontal treatment is completed it is very important you maintain regular professional cleanings. The research states that a 3 month recall is adequate and recommended. This is necessary because it takes 3 months for the bacteria to repopulate and start to cause destruction of gingival tissue attachment and bone loss. Good oral hygiene at home is essential to help keep periodontal disease from becoming more serious or from reoccurring. A few minutes a day is enough to care for your teeth and gums. You do not have to lose teeth to periodontal disease brush and clean between your teeth, eat a balanced diet, stay active and schedule regular dental visits for a lifetime of healthy smiles.

How do I know if I have gum disease?

Your dental professional will determine if you have gum disease at every professional cleanings, which should occur every 6 months. Since early gum disease or gingivitis is reversible it is important you see your dental professional if you see any of the following:

• gums that bleed or are red, puffy, swollen or sore
• gums that have pulled away from the teeth
• changes in the way your teeth fit together
• pus or a creamy discharge that appears around the teeth or gums
• constant bad breath or bad taste in your mouth

What should I do if I have gum disease?

• Get regular professional cleanings and checkups. Your dental professional will remove the plaque and tarter that forms under the gums that has been shown to cause gum disease.
• Do not smoke cigarettes or use other forms of tobacco.
• Brush and floss daily to keep the gum tissue healthy.

Studies have indicated:

• Links have been made between your mouth and overall health.
• People with diabetes are more likely to develop gum disease and result in tooth loss.
• The plaque in your mouth has been found to clog arteries around your heart leading to heart disease and stroke.
• Pre term low birth weight babies are more likely to occur in mothers with gum disease.
• The chemicals that lead to gingivitis are the same chemicals that play an important role in heart disease and rheumatoid arthritis.

Good oral hygiene- Daily Brushing and Flossing

Brushing
Step One:
For the outer tooth surfaces, place the toothbrush at a 45-degree angle toward the gum line
Use gentle, short strokes, moving the brush back and forth against the teeth and gums.

Step Two:
Use this same motion to clean the chewing and inner tooth surfaces.

Step Three:
To clean the inner front tooth surfaces, hold the brush upright and use gentle up-and-down strokes with the tip of the brush.

Step Four:
Don’t forget to brush along the gum line, and make sure you reach the teeth right at the back
Also give your tongue a brushing – it’ll help keep your breath fresh!

Flossing
Step 1:
Take about 18 inches (50cm) of floss and loosely wrap most of it around each middle finger (wrapping more around one finger than the other) leaving 2 inches (5cm) of floss in between.

Step 2:
With your thumbs and index fingers holding the floss taut, gently slide it down between your teeth, while being careful not to snap it down on your gums.

Step 3:
Curve the floss around each tooth in a “C” shape and gently move it up and down the sides of each tooth, including under the gum line Unroll a new section of floss as you move from tooth to tooth.

At first, flossing might feel awkward. But stick with it! With just a little patience and practice, it will begin to feel as natural as brushing your teeth.