Periodontal

Controlling the infection is the primary aim when treating periodontal disease. The type of treatment employed will vary in different individuals and is dependant upon the cause as well as the severity of the gum disease. With all treatments, what is vital is that the patient carries out a good daily dental care routine at home. Changing habits that are adverse to dental health, including quitting the use of all tobacco products is also one of the steps that will improve the outcome of the treatment.

Deep Cleaning (Scaling and Root Planing)

The deep cleaning procedure includes scaling and root planing and is a procedure that can only be carried out by a dentist, dental hygienist or a periodontist. During scaling, the tartar that is above and below the gum line is scraped off. Root planing is done to get rid of the disease-causing bacteria and to remove rough sots on the root of the tooth, where germs tend to gather.

Medications

Though they cannot always be used to replace surgery, medications are often used along side other periodontal treatments including scaling and root planing. Despite using medication, surgical treatment may still be recommended depending upon the severity of the gum disease.

Some of the medications currently used when treating periodontal disease include:

Prescription antimicrobial mouthrinse that contains chlorhexidine, which is an antimicrobial. It is used like a regular mouthwash and helps control bacteria during the treatment of gingivitis. It is also often prescribed following gum surgery.

Antiseptic “chip”, a tiny piece of gelatin filled with chlorhexidine helps control bacteria and decreases the size of periodontal pockets. After root planing, the chips are placed in the pockets where the medicine is released a little at a time.

Antibiotic gel that contains doxycline works to control the bacteria and reduce the size of the periodontal pockets. The gel is placed in the pockets after scaling and root planing, and the antibiotic is slowly released over a period of about seven days.

Antibiotic micro-spheres, tiny minocycline-containing particles also help control bacteria and decrease the size of the periodontal pockets. The micro-spheres are placed into the pockets after scaling and root planing and the antibiotic is slowly released over a period of time.

A low dose of enzyme suppressant, doxycycline, keeps destructive enzymes in check and prevents them from breaking down gum tissue. This medication comes in the form of a pill and is typically used in combination with root planing and scaling.

Surgery

Flap Surgery: A common surgical practice that involves removal of tartar after lifting back the gums. The gums are then sutured back in place in order to make the tissue fit snugly around the tooth again. Flap surgery is undertaken if the inflammation and deep pockets persist despite deep cleaning and treatment with medications.

Bone and Tissue Grafts: Often done in addition to flap surgery, bone or tissue grafts replace and encourage new growth of bone or gum tissue that has been destroyed by periodontitis. Guided tissue regeneration is often done along side bone grafting. This procedure involves inserting a tiny piece of mesh-like fabric between the gum tissue and the bone. This prevents the gum tissue from growing into the area where the bone is supposed to be, thus allowing the connective tissue and the bone to grow unhindered.

Frequently Asked Questions

QUESTION:
periodontal?
- ANSWER:
  Perio in the dental world means around. Periodontal in the dental world means gum disease. It basically means that the bone that holds the teeth in place is deteriorating and going away. It can cause a bad odor, loose teeth and bleeding gums. As cliche’ as it may sound, brushing twice a day a flossing once a day will help. If your gums bleed when you do this does not mean that you hurt something, it just means your are cleaning out stuff that you left behind and you are finally removing it.
QUESTION:
What will happen when periodontal disease has removed all of your teeth?
What will happen when periodontal disease has removed all of your teeth, or after a tooth extraction? Will you still have gum disease? Will it restore? Please help me out.
- ANSWER:
QUESTION:
What is the difference between periodontal and dentist cleaning?
Is there any difference?

Does the periodontal tools reach deeper than the dentist tools?
- ANSWER:
  Dental cleaning is a routine measure to prevent gum disease. Periodontal treatment is a non surgical method to treat gum disease.
QUESTION:
What has been your experience with periodontal disease and deep cleaning therapy?
I just recently found out I have periodontal disease. Soon I will be having the scaling and planing done. I have to admit I am a bit nervous about the procedure. But also nervous about how to take care of my teeth properly once it is done.

Please share your experiences with me. Or if you are a dental professional I would love to hear your advice.

Thanks!
- ANSWER:
  Scaling and root planing can be an uncomfortable procedure. You will be anesthetised for the procedure since the hygienist will be scaling your teeth below the gum line. I’ve had it done and I’m also in the dental field. What you can expect is to be a little tender and possibly sore in the area afterwards for maybe a day at most. I’m sure you’re hygienist or doctor explained to you why you were diagnosed with periodontal disease. It is not as uncommon as you think it is.
  After you’ve completed the treatment, you will have to be diligent with your home care. That means brushing and flossing twice daily. I’ve found that using an electric toothbrush has helped me with effectively brushing my teeth. You should ask your hygienist which brand would benefit you. Your hygienist will also recommend that you been seen for periodontal maintenance cleanings every 3-4 months. Please keep up with those as they are just as important as your home care.
  You can find more information about periodontal disease at
  www.ada.org/public/topics/periodontal_…
  Hope this helps…
QUESTION:
How long a recovery from periodontal surgery?
I’m 27 years old and will be starting braces this October. I am seeing a periodontist at the end of July to fix some minor periodontal problems (deep cleaning/gum grafting) and the surgery I am told is minimally invasive. If I have the periodontal procedure done in August, will I heal in time to start braces in October?
- ANSWER:
QUESTION:
How much does periodontal surgery cost in dogs?
I rescued a four year old shih tzu who has advanced periodontal disease. We’re probably talking extractions.
- ANSWER:
  I just had my 10 year old Chihuahua’s teeth cleaned. He gets the cleaned at the vets office every year, however he did have to have one extraction. For a small dog like yours keep in mind that they are more fragile than a big dog, and I would recommend you allow them to give the dog intravenous fluids. You have to stop food & water at midnight the night before the procedure, so your dog might go 24+ without drinking or eating.
  
  The cleaning was 0 (including extraction)
  Sedation
  Intravenous fluids
  New toothbrush & toothpaste
  
  I would be very careful in selecting a vet that routinely cleans teeth.
  
  There is a shot available that the vet can give to keep the periodontal disease at bay. There is also a sealant they can apply to the dogs teeth, too.
  You might want to ask about those and be sure to get a toothbrush & toothpaste, too.
  
  Best of luck with your rescue baby. Take care.
QUESTION:
What is the quality of medical facilities and dental and periodontal facilities in Arizona?
Are good high quality dentists and gum specialists available in Phoenix,Arizona?
What is the general quality of medical facilities in Phoenix,Arizona?
How is it when compared to some other states in the USA?Which is the best place to undergo a periodontal (gum)surgery?
- ANSWER:
  I would imagine that they would have some of the best in your area. I can save you 80% on your dental costs! Here’s a list of providers in your area below and a fee schedule. It covers periodontal as well. Our plans are as low as .95 a month and same day coverage! 30 day money back guarantee! Just reply for more info
  808-990-3179
  
  Page 1 of 20
  MapDistanceNameAddressCityStateZipPhoneInfo
  
  Map1.61M&C Community Dental Care
  George Ayoub333 E Virginia Ave Ste 115PhoenixAZ85004(602) 307-5775General Dentistry
  Red Fee Schedule
  Extractions, Oral Surgery, Endodontics, Pedodontic Care, Periodontics, Full Dentures, Cosmetic Dentistry,
  Mon 9-6; Tue 9-6; Wed 9-6; Thu 9-6; Fri 9-6; Sat 8-3
  
  Map1.61M&C Community Dental Care
  Ibrahim Ismail333 E Virginia Ave Ste 115PhoenixAZ85004(602) 307-5775General Dentistry
  Red Fee Schedule
  Extractions, Endodontics, Periodontics, Full Dentures,
  Mon 9-6; Tue 9-6; Wed 9-6; Thu 9-6; Fri 9-6; Sat 8-3
  
  Map1.82Dental Services
  Giang Dang1902 North 16th Street PhoenixAZ85006(602) 253-3459General Dentistry
  Red Fee Schedule
  Extractions, Oral Surgery, Endodontics, Pedodontic Care, Periodontics, Full Dentures, Cosmetic Dentistry,
  
  Map1.82Dental Services
  Anh Tran1902 North 16th Street PhoenixAZ85006(602) 253-3459General Dentistry
  Red Fee Schedule
  Extractions, Oral Surgery, Endodontics, Periodontics, Full Dentures, Cosmetic Dentistry,
  
  Map2.29Tina Keyhani3330 N. 2nd St. Ste. 501PhoenixAZ85012(602) 277-3919Oral & Maxillofacial Surgery
  Red Fee Schedule
  Extractions, Oral Surgery, Implants, TMJ Treatment,
  
  Map2.84Southwest Dental Center, Inc.320 W Indian School PhoenixAZ85013(602) 248-9445General Dentistry
  Red Fee Schedule
  
  Map3.25Phoenix Dental Center PLLC
  Jamil Abdelghani1950 W. Indian School Rd. Ste. 6PhoenixAZ85015(602) 650-1700General Dentistry
  Red Fee Schedule
  Extractions, Oral Surgery, Endodontics, Periodontics, Full Dentures, Cosmetic Dentistry,
  Mon-Fri 9-6 Sat 10-3
  
  Map3.26Paik and Patel Family Dentistry
  Gerald Paik2546 E Thomas PhoenixAZ85016(602) 956-4111General Dentistry
  Red Fee Schedule
  Extractions, Oral Surgery, Endodontics, Pedodontic Care, Full Dentures, Cosmetic Dentistry,
  Mon 9-5; Tue 9-5; Wed 9-5; Thu 9-5; Fri 9-5
  
  Map3.26Paik and Patel Family Dentistry
  Snehal Patel2546 E Thomas PhoenixAZ85016(602) 956-4111General Dentistry
  Red Fee Schedule
  Extractions, Endodontics, Periodontics, Full Dentures, Implants, Cosmetic Dentistry,
  Mon 9-5; Tue 9-5; Wed 9-5; Thu 9-5; Fri 9-5
  
  Map3.79Kid’s Dental Place
  Joseph Nielsen4102 N 24th St Ste B2PhoenixAZ85016(602) 956-2024General Dentistry
  Red Fee Schedule
  Extractions, Oral Surgery, Endodontics, Pedodontic Care, Periodontics, Full Dentures, Cosmetic Dentistry,
  Mon 7-5; Tue 7-5; Wed 7-5; Thu 7-5; Fri 7-5
  
  Fee Schedule
  Red Fee Zip:85006
  
  GENERAL DENTIST FEE SCHEDULE
  
  ADA CodeSample General Dentist ProceduresDental Office Fees Up To*Our Fees Savings Up To
  00120Periodic Oral Evaluation80%
  00150Comprehensive Oral Exam (First Visit)371%
  00210Intraoral – Complete Series (including bitewings)366%
  00330Panoramic film758%
  01110Prophylaxis – Adult (to include light scaling and polishing364%
  02140Amalgam – 1 surface, primary or permanent, per tooth271%
  02150Amalgam – 2 surfaces, primary or permanent, per tooth968%
  02330Resin based composite – 1 surface, anterior666%
  02331Resin based composite – 2 surface, anterior862%
  02750Crown – Porcelain fused to high noble metal92556%
  03310Root Canal – Anterior (excluding final restoration8056%
  03320Root Canal – Bicuspid (excluding final restoration1559%
  04355Full Mouth Debridement659%
  08080Orthodontics (braces) under 19000056%
  08090Orthodontics (braces) 19 and over000056%
QUESTION:
What methods are effective against preventing periodontal disease in cats?
I’m doing a science fair on which method of cleaning prevents periodontal disease the best.
Note: I’ve already got toothpaste, thanks.
- ANSWER:
  Ever wonder why stray and feral cats don’t have periodontal disease while housecats do? That’s because those cats chew on raw bones. One of the best things for cleaning a cat’s teeth is to let them gnaw on raw bones such as chicken necks and wings (the soft bones will not hurt the cat and will be digested). Along this line, raw food helps, as tearing into muscle meat helps clean the fangs and middle teeth.
  
  Dry food or crunchy treats offer little to no help with periodontal disease in cats, although the theory of the “crunch” of the food is that it replaces a domesticated cat’s prey’s bones, and some dry-food manufacturers are adding ingredients that is supposed to help break down tartar. The theory with dry is good, but fails in practice. Cats don’t actually chew, but shear if they do anything, and only the molars benefit, not the all important fangs. Additionally, dry food can quickly collect bacteria which can be damaging to dental health.
  
  Periodontal health is also a function of genetics, nutrition while in vitro, as well as nutrition during the first few weeks of life, so good dental health starts with the health of the mama.
QUESTION:
How many millimeters is considered more than 50% periodontal bone loss?
I have periodontal disease. My insurance only covers treatments for pockets where there is greater than 50% bone loss. How many millimeters in depth are pockets where is there is greater than 50% bone loss?
- ANSWER:
  Over 4 millimeters is considered periodontal disease.
QUESTION:
How often does periodontal scaling have to be done?
My mom is having a lot of dental problems right and has had periodontal disease for sometime but was seeing a dentist who wasn’t really treating the problem. Now she is seeing a new dentist who just did scaling under the gums in June. He is saying she needs it again? Is it normal to have this procedure done this often?
- ANSWER:
  if the condition does not improve yes scaling can be done as often as every 3-4 months.
  
  Your mother has to try to maintain her hygiene. Sometimes a periodontal disease can be a manifestation of a systemic condition, such as diabetes. The best treatment for a periodontal disease is maintenance. If there’s no improvement, or is getting worse another round of scaling is needed. In worse cases, surgeries is indicated.
  good luck
QUESTION:
Any downsides to rinsing with hydrogen peroxide to treat periodontal disease?
While i’m waiting for my root planing appointment, are there any downsides to rinsing with hydrogen peroxide to treat periondontal disease? I have a generic brand bottle of 3% hydrogen peroxide. How often should I rinse with it? Does the hydrogen peroxide kill the good bacteria too? Should you rinse with water right after the hydrogen peroxide? Can the hydrogen peroxide make periodontal disease worse by irritating the gums more?
- ANSWER:
  Check with a dentist.
  Salt water is the safest rinse. do it before bed, and the salt can work overnight.
QUESTION:
How can I stop periodontal disease from getting worse?
I’m thinking I have periodontal disease. I haven’t really been taking care of my teeth. But now since my braces got off I’m finding really easy to brush them , and have been doing so since the braces got taken off. I can’t see my dentist until next month so is there any ways I can keep it from getting worse ?
- ANSWER:
QUESTION:
How to differentiate real periodontal pockets from false ones?
Hi can somebody tell me how to differentiate real periodontal pockets from real ones? Are both related to status of periodontal attachment? Thx
- ANSWER:
QUESTION:
Is it possible for periodontal disease to spread from a tooth to another? What causes plague to form on tooth?
My son brushes his teeth regularly, twice a day. Last December, his dentist told him that he has periodontal disease in his gum.
This may be due to his oral hygience as he was unprepared for his cleaning kit when he was asked to work till the next day. It was about 10 months ago and is it too late to undergo treatment?? Can periodontal disease spread from a tooth to another? It was so unfortunate for him to have caught the disease, and what causes plague to form on the tooth/gum?? How to prevent it??

Can anyone please kindly advise as soon as possible. Thank you very much.
- ANSWER:
  Once a diagnosis of perio disease has been made, professional treatment is of the greatest demand to save the teeth and bone structure from this diseases devastating demise. Every tooth is subjected to damage from this “active infection” and the bone loss associated with this disease as well as the whole body. The same plaque found in perio disease has been found to be associated with heart attacks.
  
  Brushing your teeth twice a day is good, but it isn’t the solution to the problem. A person can brush ten times a day, but if it’s not done “correctly” and thoroughly then it’s just not going to do any good. Your son needs to spend at least “2-3 minutes brushing” with a “soft toothbrush,” brushing each tooth about “20 strokes” not just the front ones. Also “flossing” is of the utmost importance because it removes the plaque caused from bacteria found in the mouth, under the gums that brushing can’t reach.
  
  A diagnosis of perio disease means that he has developed pockets in the gum of some areas that surround his teeth. These pockets can range in depth, but all are “too deep” for him to be able to clean. We consider anything deeper than 3-4mm as too deep for a tooth brush or floss to reach to clean. He will need to have root planing done which removes all the debris from the pockets and along the roots of the teeth in question. This allows for some shrinkage of the tissue which decreases the pocket depth and possible reattachment of tissue with hopes that proper techniques in brushing, flossing, along with continued professional care and his excellent home care will help to eliminate the disease from progressing.
  
  It is unfortunate that he has “developed perio disease,” but he didn’t “catch it.” It progresses over time, usually from inadequate brushing and flossing techniques and lack of professional dental care. Although there is some research that links its cause to hereditary or genetics. The best treatment your son can follow is his dentist advice and see a periodontist for follow up cleanings every 3-4 months, they will alternate with his dental appointments. This may seem like a lot at first but will lessen with time, it’s to keep a close watch on the pockets depth and to eliminate the progression of this disease by maintaining and monitoring your son’s dental health. Perio disease can be devastating by destroying the surrounding tissue and bone structures that support the teeth, which left untreated will eventually lead to the loss of teeth. I hope you will encourage your son to continue with treatment to maintain his natural teeth and halt this disease. It can be stopped with proper treatment, your son isn’t alone with this disease. Good luck and I hope that I’ve given you enough insight to help you to understand this disease, how to correct it with his dentist and periodontist help and the causes of it so your son can change those habits to better his dental health.
QUESTION:
Can patients with periodontal disease get their teeth whiten?
Hello everyone, Can i use things like Crest whitening strips? harsh as it seems, i was shopping the other day – i was in the dental isle and was looking at another brand of whitening products. i read a section of it that people with gingivitis/periodontal disease can’t use the product.
- ANSWER:
  You need to get the periodontal disease under control before whitening. My Husband tried to have his teeth whitened and the dentist wouldn’t do it until he got the disease under control. he never said why though. That one you will need to research on or just call a dentist and ask. They will tell you.
QUESTION:
How much is an implant? And is it possible to get one if you have periodontal disease?
My orthodontist scared the crap out of me a while ago, said I’ll need 6 teeth pulled at least. I had periodontal disease and I am getting treated for it, but I was wondering if I can still get implants down the road with the disease?
- ANSWER:
  If possible, get the implants as soon as possible. They will prevent bone loss. You may see if your insurance will cover it. I had an implant about 4 years ago and can’t even tell it is there. The total cost was about 00. Expensive, but it stopped the bone loss I was suffering.
QUESTION:
Are there any options in cosmetic dentistry for patients with periodontal disease?
I have spaces between my teeth and a significant amount of bone loss due to periodontal disease. I am being told i will lose some teeth within the next few years and dental implants are not an option because of the bone loss and perio issues. One dentist recommended bonding, but another was against it because the teeth will shift. What other options do I have in cosmetic dentistry to get a better smile?
- ANSWER:
  yes
  better to visit dentist
QUESTION:
Can I pass the military overseas dental screening if i have periodontal disease?
We are PCSing to okinawa and I want to know if I’ll pass with periodontal disease. If you can please help.
- ANSWER:
  Yes. The Naval Hospital Okinawa does not list any dental conditions as cause for denial. The hospital and dental clinic are large and very capable. (Between the Navy, Army and USMC there are almost a dozen dental clinics on the island, including several that provide periodontal care).
QUESTION:
How to prevent cavities, gingivitis and periodontal disease besides brushing?
are there any other ways to prevent cavities, gingivitis and periodontal disease *besides* brushing at least twice a day, regularly flossing, regular dental cleanings/check ups, using mouth wash(my dentist recommends ACT which I use), scraping the tongue, avoiding sugary foods? Does sugar-free gum help? What about hydrogen peroxide?
- ANSWER:
  Try to limit snacking between meals, this includes drinking anything that contains calories. Every time you eat the bacteria in your mouth eat also, there by-product is acid. after you stop eating (assuming no pieces of food are stuck in your teeth) your mouth is acidic for 15 min taking minerals out of your teeth. Your saliva takes a little over 1.5 hours to replace these minerals. I would try to stick to an every 2 hour eating/snacking schedule and just plain water between meals.
QUESTION:
What Can I Do To Make My Periodontal Disease Better?
I was wondering if anyone could give me some advise to make my periodontal disease better whiles i’m at home, i’ve been having this disease for almost a year or two. My Oral hygienist said things have become worse, so i feel like i’ve lost my self -esteem and confidence to talk and smile at people, note that i’m only 16, i’m losing teeth at this sort of age.
- ANSWER:
  The ADA has alot of information here:
  
  http://www.ada.org/public/topics/periodontal_diseases.asp
QUESTION:
Best toothbrush to help slow down periodontal disease?
I have periodontal disease. I may buy a new toothbrush and I am wondering what kind would be best to help slow down the progression of periodontal disease.

Thanks!
- ANSWER:
  i would say any electric toothbrush, but those get pretty expensive if you talk about Sonicare. but there are other sonic technology toothbrushes out there like Oral B has one. and so does Sunstar. but if you dont want to use that you can try the toothbrush called Technique Plus. it is from GUM and it is made that however you hold it it is at a 45 degree angle which is the angle you are supposed to brush at.
  here is some info on that brush https://cart.jbutler.com/store.php?crn=221&rn=483&action=show_detail
  or check out some of these power brushes here http://www.dentalcare.com/en-US/products/power.jspx
  the vitality are pretty cheap for battery power toothbrushes.
QUESTION:
How much should it cost for planing & scaling if I were diagnosed with periodontal disease?
Most of the pockets were 5 to 6 milliliters, and I will need planing and scaling on all teeth according to the dentist.. The dentist quoted me 00.00 for the service, which includes the follow up visit, sonicare tooth brush, and other incidentals that I would use to maintain my teeth after the process is complete. That seems really, really high to me. Are there any less expensinve alternative treatments I can try first that may also prove effective? I’ve heard that regular flossing, rinsing with hydrogen peroxide , and regular brushing can also stop the progression of periodontal disease. I am also interested to here of any other over the counter products that can be used to slow or stop the progression of periodontal disease. I am a male, 42 years of age, and in otherwise excellent physical condition. Any informaiton you can provide would be greatly appreciated.
- ANSWER:
  00.00
  Where do you live?
  Youi must live in a high income area. .
  Cast ten lines like that and you only need one bite.
  I like your dentist.
  
  Koudos to him
  too bad for you if you are to proud to switch dentists
QUESTION:
If my periodontal pockets have shrunk, are my gum bones still dissolving?
I’ve been told that periodontal disease is not curable, but treatable. My pockets have shrunk to 3 mm or less, so does that mean that damage to my gum bones have halted, since the pockets are smaller and the bacteria don’t have as much access to the lower regions? Or does it mean that damage to them is still going on, but just more slowly?
- ANSWER:
  It means that you have stopped the progression of periodontal disease and no further damage such as bone loss is occurring. You should realize that once bone loss has occurred, you will not grow back new bone. Periodontal treatment can only stop thing from getting worse. So hopefully you did not have much if any bone loss. And if you maintain these pocket depths you will have no problems in the future. Good luck
QUESTION:
Dental question deep cleansing and root planning – for periodontal disease?
The dentist is saying that my boyfriend has periodontal disease. The first step is to come in for a deep cleansing which will be 120.00 per quadrant. She is then saying that the second step is to schedule the surgery. I have read some things on this board that just mention the cleansing not the surgery also. If he has the deep cleansing (which I am assuming right now if the deep scaling and root planning) why would he need to schedule the surgery as well. Wouldnt we have to see if the deep cleansing worked first?
- ANSWER:
  A truly natural treatment for periodontal disease and bad breath is in great demand but next to impossible to find. Everyone is looking for the symptom, cure, and treatment for periodontal disease, gingivitis, bleeding gums and bad breath because no one wants to loose their teeth and many health problem have now been directly linked to gum disease including heart attacks and strokes. It’s a much bigger contributor that originally thought!
  
  An all-natural oral health product OraMD tackles the problems associated with periodontal disease, pockets and receding gums and is also extremely effective against chronic bad breath product. Because the ingredients are natural enemies of bacteria, it cleans your mouth and stops halitosis ( bad breath ) in it’s tracks.
  
  Source: http://www.oramd.co.uk/
QUESTION:
Can a periodontal probe damage your gums?
When the dental assistant uses the periodontal probe to check your periodontal pocket depths, can the use of the probe itself further damage your gums? It seems like it wouldn’t be a good thing to wedge a probe down into your gums when you are trying to get your gums to attach more snugly to your teeth.
who is licensed to use the periodontal probe? dental hygienists and dentists?
- ANSWER:
  The answer to all of your questions is yes: A periodontal probe *could* damage your gums, if it is used by an inadequately trained person. And yes, in most states, only dental hygienists and dentists receive that training.
  
  A dental assistant is a differnt profession, and dental assistants do not (usually) receive training on how to a perio probe, although some states are allowing them to do more patient care.
  
  I suspect, however, that you are just using the word “assistant” in its everday sense–someone who works in the dentist’s office and relieves the dentist of some of the patient care duties that the dentist would otherwise perform. That person is probably a trained hygienist rather than a dental assistant.
  
  If you have any concerns about who is working in your mouth, just ask in some non-threatening way. (Something like, “How long did you have to go to school to become a hygienist?”) She will probably be proud to discuss her profession with you.
QUESTION:
Why is periodontal disease a chronic disease?
I have read a lot about periodontal disease. I understand it is an advanced stage of gum disease: accumulated plaque on your teeth and gums attacks the gum and the bone.

But plaque can be removed by professional cleaning, and good oral hygiene helps to prevent accumulation of plaque.

So, why is periodontal disease chronic then? Why can it be treated but not cured?

Thanks.
- ANSWER:
  Periodontitis is usually chronic because it is slowly progressing. Recall that first we see gingivitis (inflammation of the gums with no active bone loss) before the bone loss (periodontitis) starts. Gingivitis can be seen fairly soon after bad hygiene starts, and usually goes away when local causative factors are removed. Periodontitis, however, takes years to start and the bone loss is slow. It happens after years of gingivitis.
  
  When the teeth are cleaned and the plaque removed, the bone loss will stop (providing the patient improves their oral hygiene habits). This is how it is treated. Rather than saying that periodontitis is “incurable,” it is better to say that it is “irreversible” since the bone does not regrow and the bone loss is permanent. But as long as the bone loss is stopped, the patient does not have periodontitis.
  
  Hope this helps!
QUESTION:
What are some foods that I can easily consume after Periodontal Surgery?
It feels as if almost anything I eat is painfully sensitive to my gums. I’m currently taking two medications: Advil and Amoxicillin, and when the pain becomes unbearable: Hydrocodone.

I’ve been told not to eat anything spicy or hard, and I haven’t been, but almost everything seems painfully sensitive.

I have stitches on my gums, and this is in preparation for my root canal crown. I had endodontal surgery two weeks ago (root canal surgery) and periodontal surgery last week.
I was told specifically not to use any straws.
- ANSWER:
  Anything soft and cool for a couple more days. Then softer foods like mac and cheese and soups. Good luck with all your dental work.
QUESTION:
Is there an over the counter mouth wash for periodontal disease?
i was diagnosed with periodontal disease a while back and i was prescribed a mouth wash that helped fix the problem, but now its back. I cant afford a trip to the dentist to get a new prescription so im looking for an otc. Anyone able to help?
- ANSWER:
  Let me ask you: are you using a Water Pik and an electric toothbrush? Are you flossing after every meal? Have you stopped drinking carbonated beverages?
  
  Those are the most important steps you can take right now to maintain good oral health.
  
  Regular Listerine mouthwash will help kill decay-causing bacteria in your mouth, but you must eat properly and keep your teeth free of debris and tooth-destroying acids to keep your gums and teeth healthy.
  
  White bread has been shown to cause even more decay than candy. I am not recommending that you eat a lot of candy, either.
  
  In addition, you need to visit your dentist and get your teeth cleaned if you have not been there in a year. You can get a new prescription from the dentist when you get your teeth cleaned and checked for decay. Save up your money, because this is very important!
QUESTION:
I have Periodontal Disease what is the the most effective treatment?
The Periodontal disease has been really getting me down and the dentist has not been very helpful. Does anyone know of over the counter treatments or will i need surgery? My gums have receeded quite a lot and i need something more effective than mouthwash.
- ANSWER:
  I have found Q10 supplement has really helped me, I wish I had heard this before I lost so many teeth, so much nonsense with ‘we get enough in food’ just is not true for the vast majority. WHY don’t they tell us this stuff, profit for dentist’s ? :-
  
  http://www.google.co.uk/search?q=q10+Periodontal+Disease
  
  And a ‘sonic’ toothbrush / floss:-
  
  http://www.google.co.uk/search?q=Periodontal+Disease+sonic
  
  AGAIN WHY ?
QUESTION:
What is normally done in a periodontal cleaning?
My dentist recommended I have this cleaning done, and since I am very anxious about dental work, I researched the procedure on the internet, and everywhere said that it is normally done in steps, sometimes 4 or 5, and takes about an hour, with craping under the gums.

Well, I went today and all they did was scrape my teeth, like in a normal cleaning. No polish, no fluoride, no flossing…..and it took like a half hour.

So it didn’t hurt so bad, but the issue is this: My dental insurance pays 100% for regular cleaning, and only 25% for periodontal. I fell like I get more done in a regular cleaning!!! Should I ask the office what is going on? I work in the insurance field, so I am kind of wary that I am getting ripped off.
- ANSWER:
  I’m a dental hygienist and I do this procedure daily. (and I know it was just a typo but I laughed out loud when you typed “craping under the gums” instead of “scraping”!!!! Don’t think I’ll ever do that!!)
  You should definitely speak with the dentist about the procedure you had done and ask him to explain to you how it was different from a regular cleaning. I always fully explain what I’m doing and why I’m doing it; an educated patient is the best thing for me.
  In a regular prophy appointment (just a normal routine cleaning) the teeth are scaled (“scraped”) both above and below the gumline (unlike what the other person who posted above said…the hygienist always cleans below the gumline).
  Then when all surfaces have been scaled, the hygienist will polish any residual stain off the teeth.
  A patient that requires a periodontal therapy needs this because over time, they haven’t taken good care of their teeth and gums and because of this, tarter has built up heavily below the gumline (where a brush can’t reach and if you haven’t been flossing regularily, the gunk under there that started out as soft plaque you could have flossed out is now hardened to a concrete-like chunk you can’t remove yourself) I tell my patients that the tarter is much like a splinter under your skin, it irritates the gum tissue both physically and chemically because it’s decaying bacteria that gives off toxins. The gums do not like it being there and your body tries to defend itself by sending white blood cells to the area, thus increasing blood flow and swelling in that area. Gum disease usually does not cause any pain, but you may notice that the gums are red and/or swollen and almost always have bleeding when you do brush and floss. Healthy gums should never bleed. After the gums have been irritated awhile, they react by pulling away from the source of the irritation, they recede. And the gums don’t just pull away and leave raw bone, when they recede, they trigger the bone underneath to start to dissolve too. The bone and the supporting soft tissue structure of the gums and ligaments are what hold you teeth in place so the loss of these structures is very significant….lose them and you will eventually lose your teeth! Your dentist and hygienist should show you the tarter build up and bone loss on your xrays. A patients xrays are the best teaching tools I have! Ask them to show you and explain. When you can see the cause and effect for yourself, it begins to make sense. So now, the treatment is to remove the source of infection/irritation and that requires a scaling or deep cleaning as some offices call it. If you go to a periodontist (a dentist who specializes in gum disease), the extreme method of doing this procedure is to do “flap surgery” where they do cut the gums into a flap, lay it down to expose the root surface which they clean thoroughly, then stitch the flap back in place. This is pretty extreme and it does work quite well but it’s painful and expensive and many patients simply won’t go through that. If you do this through your general dentist, they won’t do the flap surgery, just deep clean and they will do the procedure in steps, as you noted. Usually they will do a quadrant of the mouth at a time (such as lower right, then lower left, upper right, then upper left) and then after about a 2 week period when that’s all done, I have my patient come back in for one more appt. where I check how well the tissue is healing and go over any areas where it doesn’t appear to be healing as well, evaluate how well the patient is doing at home with brushing and flossing (if I see new fresh plaque and tarter build up, they aren’t doing a very good job and I go over it with them again) and then I polish the teeth. In my office, we break it down to 3 appts. because I do an entire arch at a time, the lowers on the first appt. and then the uppers on the next, then the follow up appt in 2 weeks. When I do a periodontal scaling and root planing, it differs from the regular cleaning on a patient without gum loss because I have to reach much further down onto the root surface below the gumline due to the bone loss. There is a gap, which we call a “pocket” between tooth and gum where all the bacteria and “crud” gets stuck. That pocket is deep in a perio-involved patient and we take our instruments (often using an ultrasonic cleaner that isn’t sharp, no scraping, just uses sound waves to “jiggle” the tarter off) all the way to the bottom of that pocket and also smooth off the rough surfaces of the root of the teeth as we go (it’s harder for new build up to attach to a smooth surface than it is to a rough one, that’s why we smooth it out.) This is a very thorough, deep cleaning. It should not hurt, no more than mild discomfort. You may notice alot of bleeding as she is working, that’s normal as the gums are swollen with extra blood and this is just releasing that inflamation.
  Yes, it’s more involved than a regular cleaning and again, if you look at the xrays compared to the xrays of a healthy mouth, you can see why. It’s important to remember that periodontal disease is not something we can CURE, it’s something we can MANAGE. When bone is gone, it’s gone, it will not grow back neither will the gums. BUT if the area is cleaned out well and kept clean by the patient at home and with regular 6 month cleaning appts. the perio problem can be slowed or halted at that point. You have valid questions and you should have been educated about this procedure, why you needed it and what to expect. Sounds like your dentist/hygienist dropped the ball on that. Go back and ask about it, ask to see the xrays, etc. Good luck!
QUESTION:
I have periodontal disease, what happens if I kiss a girl or lick her? Can she get a disease from my mouth?
I have periodontal disease, and I want to know if that would get in the way of sex with a woman. What can happen?
- ANSWER:
  Periodontal disease means that you have bacteria living at the spaces where the tooth and the gum meet.
  
  You probably have bad breath a lot, so kissing may be kinda yucky (guessing here)
  no she can’t really “catch” this
  
  all that really happens is that you are at higher risk of getting an abscess or something.
QUESTION:
What are the risk factors for Periodontal Disease?
What causes periodontal disease, and what is it?
- ANSWER:
  disease of the periodontia. Infection of the gum. Mainly due to plaque & calculus formed around the teeth. The plaque contains bacteria which disolved the gum to form pockets so that more plaque can collect. Its a visious cycle. You will get periodontal abcess & bone loss & removal of teeth.
  Heart disease too can be cause due to periodontitis.
QUESTION:
I have a few questions about periodontal disease? I will award 10 points to the best answerer?
1: If I was to go to my local doctor would he be able to diagnose me with this disease? Or does it have to be a dentist?

2: Is periodontal disease curable if caught early? Is there a way to make it go away completely?
- ANSWER:
  1. Your doctor can diagnose periodontal disease but cannot help with the treatment and will refer you to see your dentist, so it is advisable to visit your dentist and save yourself some time.
  2. Periodontal disease is just as it says, it is a disease and can be cured but takes some time and commitment from the patient…..most tooth loss is due to gum disease so it is very important to maintain good oral hygiene, this involves at least 2 routine visits to your dentist annually and at least 4 visits to a hygienist or therapist. At home you should brush at least 3 times a day after meals and floss at least once a day, if your gums bleed during brushing, do not stop brushing them just brush them softly, I always have a medium and soft toothbrush at home, so if my gums do bleed then around that area i will use the soft brush until it stops and them continue with the medium brush when it has completely stopped bleeding. Check your gums regularly, if they are nice and pink, they are healthy if they are red and inflamed they are unhealthy. I hope this helps and good luck
QUESTION:
If I have modorate periodontal disease, will my teeth fall out?
I haven’t seen my dentist about this yet, though I’m fairly sure that I’m suffering from this if the articles and images I’ve seen online are of any indication.

What does moderate periodontal disease mean for the future of my teeth? Will they stay in my mouth as long as I continue to brush and floss, or is it inevitable that my teeth will fall out at some point?
- ANSWER:
  See a dentist have your mouth deep cleaned and sort out the problem that way you keep your smile
QUESTION:
I need help paying for my periodontal care?
I am a college student and I dont have enough money to pay for periodontal cleaning. It costs so much! Does anyone know any programs that will help me. Also I am from Michigan.
- ANSWER:
  There’s a company that most dentists offer called CareCredit. It allows you to make payments, its very convenient for people who don’t have insurance, low income, or someone like you who is a college student. Check into it.
QUESTION:
How much does a periodontal cleaning normally cost with insurance?
I have dental insurance and I have to go in to have my gums cleaned out and my dad says it normally costs 0 or so but my dental place says it costs 4…WITH my insurance. Should I call my insurance company and check up on that?
- ANSWER:
  I just had mine cleaned the total was 5.00.That was for what the dentist called a deep cleaning, but i didn’t pay anything with my insurance and i have a co-pay type of insurance.
QUESTION:
What’s involved in a periodontal follow-up visit?
I just had scaling and root planing done by my hygienist to combat periodontal pockets and a gum infection. I have to return in 4-6 weeks for a ‘periodontal follow-up’. What does this typically involve, is it just an examination?
- ANSWER:
  Just an examination where they re-probe your gums and record your depths and bleeding sites. Then they’ll compare your old numbers and your new numbers with you, and schedule your next appointment.
QUESTION:
Does periodontal surgery change the way your gums/teeth look? Is it painful?
I just discovered that I have advanced periodontal disease – might loose up to 3 of my front teeth. I am so upset! I’m thinking of implants, but first my periodontist recommended scaling, and then surgery. Should I get a second opinion? Are implants the best choice?
- ANSWER:
  I had the same thing a few years ago and went through both procedures. The scaling was like in intensive teeth cleaning and really didn’t hurt, but they will numb you up first if you are really sensitive. When I had the surgery, I had full anesthesia so I was pretty much out for the whole thing. The worst part is having to eat soft foods for the next couple of weeks until the stitches came out. It doesn’t change the way your teeth and gums look after you are healed up and as for implants, I would see what the periodontist recommends. My doctor was able to save all my teeth, so I didn’t have to go that route.
  Good luck!!
QUESTION:
What home remedies are suggested for gingivitis and periodontal disease?
I sometimes have bleeding when brushing my teeth and chronic bad breath. I have exhausted my dental insurance (0.00 annually) I do not have more money for a dentist right now.
- ANSWER:
  If you are diagnosed with periodontal disease, there are no home remedies that can do what a Periodontist does. Continue brushing, flossing and you could use a rubber-tipped instrument between the teeth to massage the gums to prevent further problems, but the Periodontist really needs to get in there and do the proper root planning and scaling procedures to get all that tartar that is down under the gums off so that the gums can heal up properly and tighten back up, (hopefully).
QUESTION:
If teeth are loose cause of periodontal disease, how do you tighten the teeth back up?
Just early periodontal disease thought, how does a dentist or will they tighten themselfs if your brush 2x a day & floss??
Loose front bottem teeth that is..
- ANSWER:
  You need a professional cleaning because anything that you can do at home will not be enough. After the cleaning, if there is not too much bone loss it is possible for the tooth/teeth to tighten up, but it is not a certainty.
QUESTION:
How does smoking lead to tooth decay, gingivitis and periodontal disease?
I always hear that tobacco smokers have a greater risk of developing many different dental and mouth problems. I realize that smoking stains the teeth brownish yellow and causes bad breath(besides causing many serious diseases), but how exactly does it lead to tooth problems like causing cavities and gum disease? Please note, I am a non-smoker, but some people in my family smoke. Does the same go for marijuana smokers, or only tobacco smokers?
- ANSWER:
  Smoking and other tobacco products can lead to gum disease by affecting the attachment of bone and soft tissue to your teeth. More specifically, it appears that smoking interferes with the normal function of gum tissue cells. This interference makes smokers more susceptible to infections, such as periodontal disease, and also seems to impair blood flow to the gums — which may affect wound healing.
QUESTION:
I have a gum disease called periodontal disease, it has weakened my teeth, can my teeth be strong again?
I have got a gum disease called periodontal disease and my teeth feel weak because of this, i have to get a deep clean (Scaling). This will leave a gap where the calculus have been removed and will leave my teeth quite loose. Will the gap close up and will my teeth strengthen? If not, how can I strengthen them?

It scares me as I can’t even bite through anything with my front teeth unless the food is really soft, like bread for instance.
- ANSWER:
  It is not your teeth, it is the foundation that is deteriorating. You have lost bone due to perio disease. Bone cannot grow back. That stuff HAS to be scaled off so it will not destroy what ever bone is left. Once you go through this process and your oral hygiene improves, you will no doubt be advised to show up for cleanings every three or four months, this is called perio maintenance. And this is forever now. All you can do, is stop it where it is and be very religious about your home care and keeping dental appointments. The gums will shrink down and firm up a bit without all that calculus sitting there. But the “gaps”, as you call them, will not fill in, bone is gone, never to return. Teeth that are really loose can be splinted together with bonding if needed. There are other things you can do if you end up losing a couple due to mobility. No worries, just follow their instructions to the tee, you cannot afford not to at this point. Yes, taking the calculus off will make your teeth loose, but leaving it there will make them “gone” in no time. So remember, it is not your teeth that are the problem, it is their foundation, ie…bone. They will tighten up a bit once you have a more healthy situation, possibly. It is hard to say without knowing the severity of the disease and the class of mobility. But hang in there, you will have a lot of dental homework to do for a long long time if you want to keep them.
  Peace
QUESTION:
Can you get braces if you have periodontal disease?
Ok I’m an idiot because I had braces for 4 yrs when I was in middle-high school and I quit wearing my retainers when I got out of the house and moved in with my boyfriend because I was embarrassed (I now know he wouldn’t have cared) but now I’m in between stages 2&3 of periodontal disease. Is it possible that no orthodontist will ever touch me again?
- ANSWER:
  It is not just a question of getting your perio disease under control as someone else put it. It depends on this yes, but also how much bone you have lost. If you have lost a large amount of bone support, then braces are def. not a good idea. Your teeth are already susceptible to movement from lack of bone support, put braces on these vulnerable teeth and you might be doing more harm then good. Yes you may have straight teeth for a while, but at what cost? If you are moderate periodontal disease then I am sure you have lost some bone support. How much is only what your dentist can see on the x-ray. You had braces in high school in which the orthodontist moved your teeth, now you have periodontal disease In which you have lost more bone and ligament support, then say you get braces again after your perio therapy, that is a lot of movement through-out your life. If I were you I would research carefully all of the pros and cons of getting braces when you have periodontal disease. Think about how your teeth have shifted since high school. This is not just from not wearing your retainers, this happens with perio too. So if you go and have braces put on again, go through the expense, and guess what, your teeth have shifted again. What then? I would be very careful, like I said research, research, so you can make an informed decision, not a blind one. Good luck.
QUESTION:
What is a homeopathic way to stop the progression of periodontal disease?
I have an aggressive form of periodontitis. In some places, I have 50% bone loss. I have had scaling done, twice. My gums are not responding to these procedures as well as the dentists predicted. I use fluoride-free toothpaste (recommended by an herbalist). I am otherwise healthy. HELP!!
christoph – My oral hygiene is not the problem. I brush, proxybrush, floss, and use listerine 2x / day. And at night, use the prescription Fluoridex Rinse. I’m neglecting trips to my dentist? I go every 3 months, along with visiting my periodontis every 3 months. Marketing Scam? I went to an herbalist FREE of charge because I am willing to try anything at this point. I wish I could count the number of dentists who ‘gave up’ on me, saying they didn’t know what could control the progression of my disease. I have researched this condition extensively. So, I DO have education, information, responsibility and great dental care, and it is NOT the answer. If you can’t give me any homeopathic suggestions why did you answer my question?
And I take periostat 20 mg. 2x/day !
- ANSWER:
  Continue seeing your Dentist for treatment…but, do not stop being pro-active in your own healing. (brush and floss)
  Think about what periodontitis is…it is an infectious disease…and your body has the ability to resist diseases through the immune system. Research how you can ‘boost’ your weakened immune system and apply what you learn. (dietary changes, supplementation, exercise etc.)
  Taking drugs, drinking alcohol, excess sugar consumption and smoking, weaken the immune response greatly, so if you do any of these things…you’ll need to stop.
  A good ‘natural’ mouth wash you might have some success with is a combination of..lemon juice, apple cider vinegar, garlic oil (a few drops), tea tree oil (few drops) salt, in a little bit of alcohol (can be gin or vodka)…make it yourself at home and swoosh it around in your mouth a few times a day, and ‘spit out’…Your breath might stink but, it does help draw out and kill impurities from the gums…
  I wish you well…have a happy day…
QUESTION:
Can a cat die of periodontal disease or any other gum disease?
I think one of my aunts cats has it. She has brownish saliva drooling out of her mouth. She has brownish tints on her teeth. Plus what would the treatment probably cost?
- ANSWER:
  Yes, it can and will kill the cat without treatment. The infection in the cat’s mouth could enter the bloodstream, causing sepsis, or the cat will simply stop eating due to the pain in her mouth and starve to death.
  
  Treatment costs vary, depending on the severity of the disease and the veterinarian. In Colorado, a basic dental cleaning will cost around 0, including anesthesia and pain meds. However, if tooth extractions, x-rays, or other procedures are necessary, that will increase the cost. Call one of your local veterinarians and ask about an estimate for a dental cleaning. To get the most accurate estimate, you will need to take the cat to the veterinarian to have the mouth examined.
QUESTION:
Can you have periodontal disease even if your gums look pink and healthy?
I floss daily. Maybe I have a bit of recession but usually no bleeding when I floss and my gums look pink and healthy. Can I still have periodontal disease? My new dentist is recommending deep cleaning (scaling and root planing). I’m skeptical…
- ANSWER:
  if gums are firm and pink and NOT BLEEDING then they are healthy,i my opinion you wont require any root planing.
QUESTION:
What can i do to increase my chance of losing my periodontal disease fast?
I’ve tried the warm water with salt trick, but what can i do every time when my mouth feels like its being attacked?
- ANSWER:
  All that plaque is below your gumlike and salt water won’t do a darned thing. You need to go to a periodontist and have your teeth cleaned by deep scaling.
  
  You will never regain LOST GUM which is what periodontal disease is. Once the roots of your teeth are exposed, only surgery to raise up the gumline surgically might help.
  
  So brush and floss and avoid getting it altogether. If only you knew then what you know now right?
QUESTION:
Is there any way to get periodontal treatment covered by medicaid?
I’m in quite dire need of dental work but I don’t have adequate funding to get proper treatment. I’m assuming, though, that my state medicaid won’t cover the costs, which is very disheartening. Has anyone had experience with this sort of circumstance?
- ANSWER:
  Medicaid is different from state to state, check with your state d to see what their Medicaid program covers.
QUESTION:
Is it possible to use a periodontal scaler cleaning your own teeth to provide your own dental care?
Or is it something only someone else can do.
- ANSWER:
  You may damage your gums since you are not trained to do this. Only let the dentist or periodontist scale/clean your teeth.
QUESTION:
Can a general dentist check to see if i suffer from PERIODONTICS AND GIVE ME Periodontal treatment?
When i go to a general dentist can they check to see if i suffer from PERIODONTICS AND GIVE ME Periodontal treatment for that or do i have to go to a specialist?
- ANSWER:
  A general dentist should be able to determine if you have periodontal disease by doing a thorough dental exam. The exam would likely include a full set of xrays (approximately 16 xrays) that would allow them to assess for bone loss around the teeth and by doing a full periodontal probing which is where readings are taken with a small ruler (probe) to measure the space between the gums and the teeth. Depending on how comfortable the dentist (or hygienist) is and the technology that they have they may treat you or refer you to a periodontist who specializes in that type of care. Whether your hygienist is working for a general office or periodontal office they are all basically trained the same. The periodontist is more likely than a general dentist to be able to due gum and bone surgeries to help correct and improve a periodontal situation. Good luck!
  JAMRDH – a dental hygienist