We hope that we can answer some of your questions in the F.A.Q. section below and in printable pre-surgical and post-surgical documents in "Patient Instructions". Please call us if any questions remain.


(Periodontal Disease FAQs, Oral Hygiene FAQs, and Breath Odor FAQs, Informational Links)



1. What is periodontal disease?

It is a bacterial gum infection that destroys the attaching fibers and supporting bone that hold your teeth in your mouth. (more info)


2. What causes gum disease?

The main cause of gum disease is bacterial plaque, a sticky film that forms on your teeth. If plaque is not removed, it can turn into a hard substance called calculus (or tarter) in less than two days. If calculus develops below the gums on the tooth root, it makes plaque removal more difficult, increasing your risk for developing periodontal disease. Toxins (poisons) produced by the bacteria in plaque irritate the gums, causing infection. These toxins also can destroy the tissues supporting the teeth, including the bone. When this happens, gums separate from the teeth, forming "pockets" that fill with even more plaque and more infection. As the diseases progress, these pockets deepen, more gum tissue and bone are destroyed, and the teeth eventually become loose. If periodontal diseases are not treated, the teeth may need to be removed. For more information about gum disease and treatment, visit Patient Resources at the American Academy of Periodontology's website: www.perio.org.


3. What other factors might contribute to gum disease?

There are many factors other than plaque that contribute to periodontal disease , including:

  • Smoking/Tobacco Use , which decreases both blood flow to the gums and the strength of the body's defenses against gum disease.


  • Stress, which also affects the body's defenses. Increased stress contributes to the progression of gum disease and may reduce the body's ability to fight gum infections.


  • Health Issues also contribute to periodontal disease. For example, blood vessel fragility in uncontrolled diabetic patients contributes to greater breakdown and delayed gum healing.


  • Medications. Certain drugs, such as oral contraceptives, anti-depressants, and certain heart medicines, can affect your oral health. You should notify your dental care provider of all medicines you are taking and of any changes in your overall health.


  • Pregnancy and Puberty. Hormonal changes can affect many body tissues, including gums. Gums can become sensitive, red and tender, and at times may react strongly to the hormonal fluctuations, making you more susceptible to gum disease.


  • Genetics. Research proves that up to 30% of the population may be genetically susceptible to gum disease. Despite aggressive oral care habits, these people may be six times more likely to develop periodontal disease. Identifying these people with a genetic test before they even show signs of the disease and getting them into early intervention treatment may help them keep their teeth for a lifetime.


  • Poor nutrition may make it harder for the body to fight off infection.


  • Clenching or Grinding Your Teeth can put excess force on the tissues that support teeth and could increase the rate at which these tissues are destroyed.


4. What are the signs of periodontal disease.

  • Bleeding gums during tooth brushing or flossing

  • Red, swollen and tender gums

  • Gums that have pulled away from the teeth (recession)

  • Persistent bad breath

  • Loose or separating teeth

  • A change in the way your teeth fit together when you bite.

  • A change in the fit of partial dentures

  • Gum abscesses or boils.


5. How do I find out if I have periodontal disease?

The best way to find out if you have periodontal disease is to have your dentist or a periodontist examine your mouth. Many times the common signs, such as bleeding gums and tooth looseness, are not present and the disease goes undiagnosed until the gum disease is very advanced.


6. Is periodontal disease contagious?

Research suggests that the germs that cause gum disease may be transferred in saliva.


7. How do I prevent gum disease?

To keep your teeth for a lifetime, you must remove plaque from your teeth by brushing and flossing every day. Regular dental care is equally important. A professional cleaning by a dentist or hygienist will remove bacterial colonies and hardened deposits (tarter) both above and below the gumline.


8. Will treatment cure my problem?

Periodontal disease is not cured; in most people, most of the time, it is controlled. Failure to practice good oral hygiene and get the prescribed regular dental cleanings can lead to relapse. Changes in your health may also lead to increased disease susceptibility.


9. Why is it necessary to treat periodontal disease if I don't mind losing my teeth?

Research has shown that periodontal bacteria are associated with cardiovascular disease. Treating your periodontal disease can decrease these bacteria and may decrease the risk of developing cardiovascular disease and other systemic health conditions (such as diabetes and premature low birth weight babies).


10. Is periodontal treatment painful?

Not usually. There may be minor discomfort, which is usually well controlled with local anesthesia and pain medications. Most patients go back to work and normal activities the day after surgical therapy.


11. Is periodontal surgery necessary?

Many times surgery is not necessary, and we try non-surgical therapy first when possible. We offer current, evidence-based periodontal therapies which include regenerative techniques that rebuild the structures that support teeth.


12. Is treatment covered by dental insurance?

Yes, it's usually partially covered, depending on the comprehensive dental plan that you have. Some plans include periodontal surgery and grafting, and others do not. Our staff can help you answer these kinds of questions.


13. Can I schedule an appointment without being referred by a general dentist?

Yes, we can evaluate and treat your periodontal condition without a referral. And if you do not have a general dentist we can refer you to one.




14. When is the best time to brush and floss?

There is no best time. Whenever you feel you can focus and do a thorough job is the best time. It is important to have a good mirror and light for self assessment. You should do at least two focused hygiene sessions every 24 hours.


15. Which should I do first?

Many people like to do a light brushing first to decrease the plaque load, then follow with a thorough brushing and flossing. If you use a proxabrush, use it just before flossing. If you take your time and concentrate on what you are doing, then it shouldn't matter what order you brush or floss. If you use a powered toothbrush (Oral B, Braun, Sonicare, etc.), use with minimal toothpaste or alone with water, which allows the best visibility.


16. Which is better -- waxed or unwaxed floss?

Don't worry about whether floss is waxed or unwaxed. Just find a floss which you find comfortable and easy to use - and use it! You should gently slide the floss below the gumline without cutting the gum tissues. For the first week of flossing your gums may bleed or be sore. As you daily remove the plaque, your gums will heal and the bleeding should stop.


17. What about waterpiks?

Water piks are OK as an extra measure, but are no substitute for dental floss. For patients with extensive bridgework, they can be helpful in removing food debris. However, they do not remove plaque from the root surfaces effectively. Do not use high pressure settings, as this can injure gum tissues.




18. What causes bad breath?

Bacteria living in the mouth on the tongue, teeth, gums and around crown margins can metabolize or break down foods we eat. They produce substances known as volatile sulfur compounds which are the most common cause of halitosis or breath odor. The bacteria that live in the deeper pockets of patients with periodontal disease also cause bad breath.


19. What can I do to get rid of bad breath?

Good oral hygiene is a great place to start. Untreated periodontal disease should be addressed. Brush your tongue! Your dentist or periodontist can show you how!


20. What else can be done to improve my breath problems?

Flossing removes many of the bacteria which cause breath odors. Some odor may be caused by reflux of stomach acid, post nasal drip, infections in the tonsils, or sinus infection. Persistent breath odors should be followed up by both your dentist and your physician.





For additional information regarding periodontal conditions and treatment, please visit the following websites:

American Academy of Periodontology. . . .  www.perio.org

(Patient Resources)

American Dental Association . . . . www.mouthhealthy.org

(Gum Disease)

CareCredit (patient financing) . . . . .  www.carecredit.com

Emdogain (enamel matrix proteins) . . www.straumann.us.com   




Free, confidential smoking cessation phone support . . . . . . . . www.QuitlineNC.com

Phone: 1-800-QUITNOW or 1-800-784-8669

Info on smoking cessation . . . . . . . . . . . . . . . www.chantix.com