Angie's LIST Guide to

People with sore or infected gums often see a periodontist, a dentist who specializes in gum diseases. The most serious gum condition, periodontitis, can cause the teeth to fall out if left untreated.


  A woman smiles outside in the sunshine while wearing sunglasses.
Peridontist diagnose and treat diseases and conditions that surround the teeth. (Photo courtesy of Rupert Taylor-Price)

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What is periodontal disease?

The word periodontal refers to the area around the tooth.

Periodontists are specially concerned with the prevention, diagnosis and treatment of diseases surrounding the teeth.

Brushing one's teeth after meals and flossing once a day will typically keep the teeth and gums healthy. However, when people do not brush and floss, bacteria and other particles build up and develop plaque.

Plaque becomes a hard substance, which is called tartar, and the gums become red and puffy, and begin to bleed.

In most cases, it is tartar that eventually leads to the first stage of gum disease or gingivitis. It is possible to reverse this gum problem with regular brushing, flossing and teeth-cleaning appointments with a dental hygienist.

When gingivitis is left untreated, it often leads to periodontitis, or inflammation around the tooth. The gums start separating from the teeth, forming pockets or spaces that become infected.

In severe cases, the bacteria and the body's reaction to infection erode the bone and tissue surrounding the teeth. The bones, gums and tissue are greatly harmed, and the teeth may start falling out.

Other causes of gum disease

Several other factors also can influence the health of a person's gums and the need to see a periodontist. Cigarette smoking is clearly linked to a greater chance of periodontal problems. The tobacco from cigarettes hardens plaque, which increases the spaces between the teeth and gums and the loss of bone and tissue.

A higher risk of gum disease is genetic and common in certain families. Even when taking proper precautions, some people are up to six times more prone to develop periodontal problems. Women have higher risk of periodontal concerns when they are going through puberty or menopause, or when they become pregnant, because of hormonal changes. Pregnant women with gum problems may also have a greater chance of delivering low birth-weight babies.

A study by Columbia University College of Dental Medicine found that gum disease is an early complication of diabetes. Dental visits can make patients aware of their diabetes or prediabetes condition.

Surgical treatment for gum disease

When gum disease goes untreated and affects the tissue and bone in the mouth, it may be necessary to do more than dental cleaning. Nonsurgical treatment includes scaling and root planning. This consists of a very extensive cleaning of the roots of the teeth for plaque, tartar and bacteria removal. If necessary, the doctor will put medicine on the area.

After this treatment, very few patients usually need extra care, as long as they brush and floss every day and get regular dental checkups. When the root cleaning does not completely help, surgery may be needed to restore the harm caused by gum disease. Periodontal surgery is necessary when the tissue around the teeth is too unhealthy to repair through other treatments. Most recently, some periodontists have begun to use lasers for scaling and root planning. Using lasers causes less bleeding and swelling of the gums.

In one form of surgery, the doctor goes into the pockets around the teeth and removes all the bacteria and makes sure the tissue is in its proper place. If the bones and tissue are completely damaged, the doctor may have to do restorative surgery and reverse some of the damage.

Sometimes people do not have any gum problems, but their gums tissues are longer than usual and cover the natural teeth. In dental crown lengthening surgery, the periodontist will reshape the gums and tissues, exposing the hidden parts of the teeth. The surgery is done with one or more teeth or even to the entire gum line in the mouth.

Consistently brushing and flossing teeth is the best way to keep the gums healthy. A relationship exists between the teeth's condition and the gums' health. It is important to keep one's teeth from decay, so the gums remain problem free.

The Centers for Disease Control and Prevention (CDC) reported in 2006 that smokers faced seven times the risk of contracting periodontal disease that nonsmokers faced.

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