When is it time to see a periodontist?

When is it time to see a periodontist?
Many of my patients that come in to see me, have periodontal disease that is diagnosed and seen by their general dentist; however there are a certain population that are at a higher risk of getting gum disease than others. Sometimes, dentists overlook the health of the gums and bone so many patients now are very proactive about their health and see me as a self referral. Here are a couple of reasons to come see a periodontist.
1. SMOKING- If you are a smoker either currently or in the past, there is a high chance that you have bacteria that is harboring in the pockets of your gums. This can eventually cause bone loss and the loosening of your teeth. Smoking actually causes a change in the immune reaction to bacteria, thus your immune system can not fight the bacteria as well as a non smoker. It also causes vasoconstriction of your blood vessels and your bone really survives via the blood. Thus if there is less blood flow, there is more chance of bone loss around the teeth.
Typically, I see more severe bone loss in the front teeth because when you smoke, the smoke blows more concentrated in the front teeth. This causes bone loss as well as gum recession. The literature shows that smokers also have a higher risk of oral cancer and gingival recession.

2. DIABETES- Patients with diabetes (especially uncontrolled diabetics) have a higher risk of getting gum disease than those with controlled or non diabetics. This is due to the immune response to the bacteria in the mouth, causing more inflammation and bone loss around teeth. Diabetics are also much more prone to infections in general.

3. PREGNANCY- For those women that are pregnant, it is really important to make sure your gum health is in check. Due to the rising hormones during pregnancy, any increase in bacteria or plaque that forms on your teeth can cause bleeding and swollen gums. This can exaserbate into a more severe gum disease that research has shown can affect the well being of the baby (including pre-clampsia and pre term babies). It is really important to get your gums checked and keep up with good oral hygiene at home.

4. BAD BREATH- Bad breath typically stems from only 2 things: Bacteria in the mouth and gums and the Gastrointestinal tract. Many times, gum pockets can form around your teeth which are warm, dark places for bacteria to live and hide. These gum pockets are really hard to keep clean at home so occasionally, you will need a deep cleaning to get this bacteria out. Typically, a regular cleaning that you get every 3 to 6 months cleans above the gum tissue, but a deep cleaning goes under the gums and cleans the baceria out from under the gums.

5. GUM RECESSION- Gum recession is found in my rigourous tooth brushers. This can cause root exposure and thus sensitivity of the teeth.