What Is It?

Periodontitis is a term used to describe a group of conditions that involves inflammation of the gums and other structures that support the teeth. Periodontitis is caused by bacteria found in dental plaque and often, but not always, starts as gingivitis.

In trying to eliminate the bacterial infection, your body produces substances that destroy the structures that hold the teeth in the jaw, including the periodontal ligament and underlying bone. As this process continues, the teeth become loose. Pockets form between the teeth and gums, allowing more bacteria to accumulate. Left untreated, periodontitis can result in tooth loss.

Periodontitis usually is relatively painless. The onset of significant pain may signal the development of an abscess.

Older adults are more likely to have periodontitis.

People who smoke are four to seven times more likely than nonsmokers to get periodontitis. Smoking may impair the body's defense against bacteria.

Symptoms

Symptoms include:

• Reddened, swollen or bleeding gums
• Receding gums
• Loose Teeth
• Bad breath
• An unpleasant taste in the mouth

However, many people are unaware of these symptoms or do not believe they are signs of a serious problem.

Diagnosis

Your dentist in Seattle, Dr. Alex Park will examine your mouth, paying special attention to your gums and teeth. If you have periodontitis, a dental probeinserted between your tooth and your gums will penetrate deeper than it normally would.

Your dentist may also test for loose teeth. Teeth have a normal range of mobility, but in people with periodontitis, the teeth are looser due to the destruction of the fibers and bone supporting the teeth.

Your dentist may also order X-rays to help diagnose periodontitis. These can be compared with older X-rays to see if changes have occurred in your teeth and gums.

Expected Duration

Unlike gingivitis, periodontitis cannot be completely reversed. In some situations, the supporting fibers and bone that have been lost can be regenerated. In most cases, however, particularly in advanced stages of the disease, the effects are permanent. However, treatment and improved oral hygiene at any stage can improve the health of your gums and prevent further destruction.

Prevention

Daily brushing and flossing (morning and night) and regular visits for professional cleaning can help prevent periodontitis or allow you to have it treated during its earliest stages. If you smoke, quitting will reduce your risk significantly.

Treatment

Treatment depends on how severe your periodontitis is. Dentists classify the disease as mild, moderate or severe.

Mild periodontitis is usually treated first with a thorough cleaning called scaling and root planing. Scaling removes plaque or calculus that has accumulated on the crowns of your teeth (the parts that show) and slightly below the gum line. Root planing has two purposes: 1) to remove plaque or calculus from the roots of your teeth and 2) to smooth the roots of the teeth, making it more difficult for bacteria to cling to them. This, combined with good oral hygiene at home, often is enough for successful treatment.

Moderate periodontitis may require more than scaling and root planing. Typically, your dentist will scale and root-plane your teeth. If this does not take care of the problem, he or she may decide that you need surgical treatment. Surgery can involve reshaping the gums to fit the teeth (resective surgeries) or encouraging lost bone to regrow (regenerative surgeries). Your dentist will decide whether you will need surgery and what type you need.

Severe periodontitis likely will require surgical intervention and, in some instances, antibiotics. At this stage of disease, tooth loss is a distinct possibility.

No matter which treatment you undergo, you should start a strict regimen of brushing and flossing to help restore your teeth to health.

When To Call Your Seattle Dentist

The best course of action is to get regular dental checkups. If you have persistent bleeding or swelling of your gums or notice loose teeth, call your dentist.

Prognosis

The outlook is good if the disease is recognized early and treated aggressively. Once bone loss occurs, the prognosis depends on the severity of the loss. Quitting smoking is very important for periodontal therapy to be successful. Lifelong maintenance will be required once the disease is controlled.

In order to achieve a sparkling smile, you’ll need to treat your teeth to more than just regular brushing. Healthy teeth start with healthy habits — from your brushing routine to the foods you should and shouldn’t eat.

"Your mouth is your body’s initial point of contact with the nutrients you consume," says Kimberly A. Harms, DDS, a spokesperson for the American Dental Association (ADA). "So naturally, what you put in your mouth impacts not only the health of your teeth and gums, but also your overall health." That includes beverages, the type and frequency of snacks, and even the gum you chew.

It’s important to go beyond brushing and change your daily habits to get the bright, healthy smile you want. Here's how:

• Avoid enamel damage. The layer of protective enamel on your teeth is your first defense against cavities, but certain foods and drinks strip it away, putting your smile at risk. Opting for sugar-filled sodas, sticky sweets (such as taffy), sweetened fruit drinks, and sugary snacks promotes tooth decay, Dr. Harms says. "When you eat sugary foods or sip sugary drinks for long periods of time, plaque bacteria use that sugar to produce acids that attack your enamel." Be sure to read food labels and choose foods that are lower in sugar.
• Eat nutrient-rich foods. Your teeth need nutrients to stay strong, white, and cavity-free. "For good dental health, it’s important to eat a variety of foods from each of the five major food groups," Harms says. This ensures that your teeth get the essential nutrients they need. Calcium, found in dairy products and leafy greens, is especially important for your teeth. Phosphorous, which can be found in proteins such as eggs, fish, poultry, meat, and dairy, is also essential. Both of these nutrients help protect and restore the enamel on your teeth, according to the ADA.
• Limit snacks. Too much snacking isn't only bad for your waistline; it's bad for your smile, too. "Foods eaten as part of a meal cause less harm to teeth than eating lots of snacks throughout the day do because more saliva is released during a meal," Harms says. "Saliva helps wash foods from the mouth and lessens the effects of acids, which can harm teeth and cause cavities." Some snacking is inevitable, so make sure to opt for something healthy such as cheese, veggies, nuts, or fruit, the ADA recommends.
• Don’t smoke or use tobacco. Smoking and using any kind of tobacco stains your teeth, but it also affects your whole mouth, the ADA says. It causes gum disease, which can lead to tooth loss as well as oral cancer. If you have oral surgery or a tooth extraction, smoking can slow your healing time. If you smoke or use other tobacco products, find a plan that works for you to quit. Ask your doctor or dentist for help or look for local or online quit programs.
• Limit teeth-staining culprits. Your favorite beverages might be dulling your smile. Coffee, tea, and red wine are some of the biggest culprits, Harms says. "They have intense color pigments called chromogens that attach to the enamel, which is the white, outer part of your tooth." For whiter teeth, cut back on these teeth-staining beverages. To help counteract existing stains, consider using fluoride toothpaste that also whitens teeth, or ask your dentist about whitening treatments to help reverse any damage.
• Drink plenty of water. It's healthy, it's free, it's widely available, and it's great for your oral health — so try to carry a water bottle with you everywhere and sip all day long. "Drinking water is also one of the best things you can do for your teeth, especially if it’s fluoridated," Harms says. Fluoride is considered "nature's cavity fighter," according to the ADA. It helps strengthen your teeth and ward off tooth decay. Water also helps keep your mouth moist and clean and washes away food particles that bacteria feed on.
• Chew sugar-free gum. It's always beneficial to brush between meals, but if you can't get to a sink, chew sugar-free gum. "Chewing sugarless gum increases the flow of saliva, which washes away food and other debris, neutralizes acids produced by bacteria in the mouth, and provides disease-fighting substances throughout the mouth," Harms says. "Increased saliva flow also carries with it more calcium and phosphate to help strengthen tooth enamel." Opt for gum with a seal from the ADA on the package to be sure it's sugar-free.
• See your dentist regularly. Be sure to get regular cleanings and checkups in order to spot dental problems before they get out of hand. Early diagnosis and treatment of dental issues is often simpler and more affordable, Harms says, and regular dental visits can help prevent many problems from developing. "Visiting your dentist is also important because some diseases or medical conditions have symptoms that can appear in the mouth," she says. Schedule regular checkups with your dentist so your smile is bright, white, and healthy, and to know you're doing all you can for your teeth.

If you are overdue for a dental cleaning, please contact our Seattle Dentist today.

Dental implants have been used successfully for many years. Your implant should last for a very long time if you take the following points to heart.

Smoking

This is one of the greatest risks for implant-related complications. You should therefore try to quit smoking.

Oral Hygiene

Thoroughly cleaning and caring for the implant during all steps of the treatment is extremely important. Careful attention to your oral hygiene every day is important for the survival of your implant.

Maintenance

Visiting your dental practice for regular checkups (recalls) is just as important. You and your dental team have to decide how often these visits should take place, but they are usually at intervals of 3 to 6 months. At these visits, your implants, teeth, and gums are checked and professionally cleaned, including the areas you cannot reach at home. Professional cleaning of implants is more complex than cleaning teeth, which means that it takes longer and may require special instruments.

Mucositis and peri-implantitis can develop without any obvious symptoms. This is another reason why regular checkups with your dentist are so important. Mucositis and peri-implantitis do not usually cause pain, so patients often fail to notice the development of these diseases.

Jennifer Flach was a college junior when her wisdom teeth started making themselves known.

"My other teeth started moving around," she remembers. "The wisdom teeth were pushing out and undoing some of the orthodontic work I had done in high school."

At the same time, her brother — who's two years younger and was also in college — had no symptoms. But the family dentist suggested his wisdom teeth should come out too.

Jen and her brother had back-to-back wisdom tooth extractions and recovered together at home during spring break. "It was quite a week at my parents' house," she says.

Patrick Grother was 26 when his dentist mentioned that his wisdom teeth might need to be removed. His bottom left wisdom tooth had partially erupted into his mouth and a flap of gum still covered it. "The dentist said food would get trapped there and it could get infected," he says. Patrick then visited a periodontist, who said that the gum flap could be cut away but it would grow back.

"I put it off for awhile," Patrick said, but he eventually had the wisdom teeth on the left side of his mouth extracted.



A few people are born without wisdom teeth or have room in their mouths for them, but like Jen and her brother, many of us get our wisdom teeth taken out during our college years. And like Patrick, many of us are first alerted to the problem when our wisdom teeth don't emerge (erupt) into the mouth properly because there is not enough toom for them to fit.

"A part of the tooth may remain covered by a flap of gum, where food particles and bacteria can get trapped, causing a mild irritation, a low-grade infection called pericoronitis and swelling," says Dr. Donald Sadowsky, professor emeritus of clinical dentistry College of Dental Medicine and the Mailman School of Public Health. This usually happens with the lower wisdom teeth. Pericoronitis and the pain it causes is the most common reason people need their wisdom teeth taken out.

Pericoronitis is just one of the reasons that you may need to have a wisdom tooth or more than one removed.

In many people, the wisdom teeth never even partially enter the mouth. Often the teeth are tilted under the gum and blocked from coming in by bone or other teeth. Dentists call these impacted teeth; they may cause pain, but you may feel nothing at all for years. You may not even be aware that you have wisdom teeth until your dentist sees them on an X-ray.

Regular dental visits are important during your teens and early twenties because this is the time when teeth are most likely to decay. Regular visits allow your dentist to follow the progress of your wisdom teeth with X-rays.

Even if your wisdom teeth aren't causing any pain or other problems, they may cause problems at some point. The most common problems are decay, infection, and crowding or damage to other teeth. But more serious complications can occur, including the development of a cyst that can cause permanent damage to bone, teeth and nerves.

However, not all wisdom teeth need to be removed.

If removing wisdom teeth is necessary, it's easier in younger people because the tooth roots are not fully developed and the bone in which the teeth sit is less dense. Extracting your wisdom teeth before any complications develop also allows for shorter recovery time and less discomfort after the surgery.

Teeth for a Lifetime

Thanks to better at-home care and in-office dental treatments, more people than ever before are keeping their teeth throughout their lives. Although some diseases and conditions can make dental disease and tooth loss more likely, most of us have a good deal of control over whether we keep our teeth into old age.

The most important thing you can do to maintain good oral health is to brush and floss your teeth regularly.

Most mouth woes are caused by plaque, that sticky layer of microorganisms, food particles and other organic matter that forms on your teeth. Bacteria in plaque produce acids that cause cavities. Plaque also leads to periodontal (gum) disease, a potentially serious infection that can erode bone and destroy the tissues surrounding teeth.

The best defense is to remove plaque daily before it has a chance to build up and cause problems. Brushing removes plaque from the large surfaces of the teeth and, if done correctly, from just under the gums. Flossing removes plaque between teeth.

Brushing

Most of us learned to brush our teeth when we were children and have kept the same technique throughout our lives. Unfortunately, many of us learned the wrong way. Even if we learned the correct method, it's easy to become sloppy over the years. Brushing correctly isn't instinctive. Getting the bristles to remove plaque without damaging your gums is a little trickier than you might think.

There are different ways to brush teeth, and your dentist or dental hygienist can show you the method that he or she feels would be best for you. The modified Bass technique is among the most popular for adults and is very effective in removing plaque above and just below the gum line. Children, however, may find it difficult to move the toothbrush this way. A dentist or dental hygienist can explain to your child the best way to brush. Parents should supervise their children's oral hygiene until age 9 or 10.

Here are a few general pointers about brushing:

• Brush at least twice a day: Many oral health professionals recommend brushing just before going to bed. When you sleep, saliva decreases, leaving the teeth more vulnerable to bacterial acids. Teeth should also be brushed in the morning, either before or after breakfast, depending on your schedule. After breakfast is ideal so food particles are removed. But if you eat in your car, at work or skip breakfast entirely, make sure you brush in the morning to get rid of the plaque that built up overnight.
• Brush no more than three times a day: Brushing after lunch will give you a good mid-day cleaning. Remember, though, that brushing too often can cause gums to recede over time. Brush lightly —Brushing too hard can cause gums to recede. Plaque attaches to teeth like jam sticks to a wooden spoon. It can't be totally removed by rinsing, but just a light brushing will do the trick. Once plaque has hardened into calculus (tartar), brushing can't remove it, so brushing harder won't help. Try holding your toothbrush the same way you hold a pen. This encourages a lighter stroke.
• Brush for at least two minutes: Set a timer if you have to, but don't skimp on brushing time. Longer is fine, but two minutes is the minimum time needed to adequately clean all your teeth. Many people brush for the length of a song on the radio. That acts as a good reminder to brush each tooth thoroughly.
• Have a standard routine for brushing: Try to brush your teeth in the same order every day. Some oral health professionals feel that this helps patients remember to brush all areas of their mouths. If you do this routinely, it eventually will become second nature. For example, brush the outer sides of your teeth from left to right across the top then move to the inside and brush rights to left. Repeat the pattern for your lower teeth.
• Always use a toothbrush with "soft" or "extra soft" bristles: The harder the brush, the greater the risk of harming gum tissue.
• Change your toothbrush regularly: As soon as the bristles begin to splay, the toothbrush loses its ability to clean properly. Throw away your old toothbrush after three months or when the bristles flare, whichever comes first. If you find your bristles flaring much sooner than three months, you may be brushing too hard. Try easing up.
• Electric is fine, but not always necessary: Electric or power-assisted toothbrushes are a fine alternative to manual brushes. They are especially useful for people who are less than diligent about proper brushing technique or for people with physical limitations that make brushing difficult. As with manual brushes, choose soft bristles, brush for at least two minutes and don't press too hard or you'll damage your gums.
• Choose the right toothpaste for you: It can be overwhelming to face the huge number of toothpaste choices in the average supermarket. Remember, the best toothpaste for you may not be the best toothpaste for someone else.

Toothpastes don't merely clean teeth anymore. Different types have special ingredients for preventing decay, plaque control, tartar control, whitening, gum care or desensitizing teeth.

Most toothpastes on the market today contain fluoride, which has been proven to prevent, stop or even reverse the decay process. Tartar-control toothpastes are useful for people who tend to build up tartar quickly, while someone who gets tooth stains may want a whitening toothpaste. Whitening toothpastes will remove only surface stains, such as those caused by smoking, tea or coffee. To whiten teeth that are stained at a deeper level, talk with your dentist.

Your needs will likely change as you get older, so don't be surprised if your hygienist recommends a type of toothpaste you haven't used before. Look for the ADA seal of approval, which assures that the toothpaste has met the standards set by the American Dental Association. Once these conditions are met, choose the toothpaste that tastes and feels best. Gel or paste, wintergreen or spearmint — these work alike, so let personal preference guide your decision.

Some people find that some toothpaste ingredients irritate their teeth, cheeks or lips. If your teeth have become more sensitive or your mouth is irritated after brushing, try changing toothpastes. If the problem continues, see your dentist.

Flossing

Many people never learned to floss as children. But flossing is critical to healthy gums and it's never too late to start. A common rule of thumb says that any difficult new habit becomes second nature after only three weeks. If you have difficulty figuring out what to do, ask your dentist or dental hygienist to give you a personal lesson.

Here are a few general pointers about flossing:

• Floss once a day: Although there is no research to recommend an optimum number of times to floss, most dentists recommend a thorough flossing at least once a day. If you tend to get food trapped between teeth, flossing more often can help remove it.
• Take your time: Flossing requires a certain amount of dexterity and thought. Don't rush.
• Choose your own time: Although most people find that just before bed is an ideal time, many oral health professionals recommend flossing any time that is most convenient to ensure that you will continue to floss regularly. Choose a time during the day when you can floss without haste.
• Don't skimp on the floss: Use as much as you need to clean both sides of every tooth with a fresh section of floss. In fact, you may need to floss one tooth several times (using fresh sections of floss) to remove all the food debris. Although there has been no research, some professionals think reusing sections of floss may redistribute bacteria pulled off one tooth onto another tooth.
• Choose the type that works best for you: There are many different types of floss: waxed and unwaxed, flavored and unflavored, ribbon and thread. Try different varieties before settling on one. People with teeth that are closely spaced will find that waxed floss slides more easily into the tight space. There are tougher shred-resistant varieties that work well for people with rough edges that tend to catch and rip floss.

If you have any further questions regarding keeping your teeth healthy, please contact our Seattle dentist today!

Any injury to the gums or teeth can be very painful. In some cases, however, the cause of severe dental pain is not obvious. For example, pain that comes on suddenly may be caused by particles of food that got lodged in a cavity and have started to irritate the nerve inside the tooth. If you lose a filling or a crown, the nerve inside the tooth may be exposed, and you may feel severe pain when air or hot or cold substances touch the uncovered part of the tooth.

Pain that becomes more severe over a period of time is commonly caused by debris lodged under the gum. Popcorn is a common offender. Because the hard cellulose fibers of the popcorn kernel don't break down, it can remain stuck between your gum and your tooth. The longer a food particle stays trapped between the gum and tooth, the greater the chance the gum will become irritated and infected and the pain will get worse. If you develop an infection, called an abscess, it can become a serious health problem if left untreated.

Pain when you bite or chew, especially if it is accompanied by a foul odor and a bad taste, can be a sign of an abscess that needs immediate treatment.

What You Can Do

First, call your dentist and make an appointment.

In the meantime, here are a few steps you can take at home to try to relieve some of the pain:

• Take an over-the-counter pain reliever, such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol). However, be aware that you need to see your dentist. If you mask the pain with a painkiller and ignore it, the infection can spread and could become life threatening.
• Rinse your mouth with warm water every hour or as needed to ease the pain.
• If the pain is caused by debris lodged in a cavity, washing the area may relieve the problem.
• Floss your teeth, then run a toothpick around the gum line. This may remove debris that's lodged under the gum.
• If you've lost a filling or crown, dip a cotton swab in clove oil and apply it to the exposed part of the tooth. Clove oil, available in pharmacies and supermarkets, works well to relieve tooth pain. You also can use a topical anesthetic, such as Anbesol, also available in pharmacies and supermarkets.
• Putting an ice pack on your face over the area that hurts also may relieve the pain. Apply the ice for 10 to 20 minutes of every hour, as necessary.
• If you will be traveling in an airplane, the change in pressure when the plane takes off or lands may make you feel more uncomfortable. You should get dental treatment before traveling by air.

What Our Seattle Dentist Will Do

Even when dental problems cause a lot of pain, the problems — and the treatments — often are relatively simple if you seek help right away.

If you have a cavity, your dentist will clean out any debris, remove the decayed part of the tooth, and place a filling. Once the inner part of the tooth is protected, the pain will usually disappear immediately.

If your problem is related to debris under your gums, our dentist in Seattle will use special instruments to remove the debris. If you have an infection, you may be given a prescription for antibiotics and pain medicine. If an antibiotic is prescribed, it is important that you take it as directed until you have finished all the medication.

An abscess in the tooth or gum may require more extensive treatment, such as drainage of the abscess, root canal treatment or tooth extraction.

To learn more about severe tooth pain, please call our Seattle dentist office today!

It is estimated that 35.7 million Americans are living with a bacterial infection of the gums known as periodontal disease. This infection attacks the tissue that keeps your teeth attached to your gums.

On average, more than 500 species of bacteria live in your mouth.2 Some of these bacteria are beneficial, while others under the right conditions can cause disease. Living a healthy lifestyle helps you keep the harmful bacteria under control. Not taking care of your overall health and your teeth and gums can cause an overgrowth of harmful bacteria, which may lead to serious health problems beyond the mouth, in addition to the threat of losing your teeth.

35.7 million Americans are living with a bacterial infection of the gums known as periodontal disease

Factors that predispose people to gum disease include bad oral hygiene and genetics. In fact, research has proved that up to 30% of the population may be genetically predisposed to gum disease.3

Periodontitis, a severe form of periodontal disease, is caused by plaque that develops just below the gum line, in the area called the sulcus or periodontal pocket, where it causes the attachment of the tooth and its supporting tissues to break down. The mildest form of periodontal disease is known as gingivitis and is triggered by bacterial plaque that forms at the gum line.

What Is Periodontal Disease?

Periodontal disease is an infection of the tissue that supports your teeth. It attacks just below the gum line, where it causes the attachment of the tooth and its supporting tissues to break down.


WARNING SIGNS

• Pain in the mouth
• Gums bleed when brushing
• Spaces develop between teeth
• Swollen and tender gums
• Receding gums (exposing the bottom of your teeth)
• Persistent bad breath
• Pus between teeth and gums
• Sores develop

RISK FACTORS

• Tobacco use
• Systemic diseases
• Use of certain types of medicine
• Bridges that no longer fit
• Crooked teeth
• Fillings that have become defective
• Pregnancy
• Oral cancer

If you're showing warning signs, see your Seattle dentist. Mild gum disease may be controlled by routine professional teeth cleanings and more diligent home care. Gingivitis and early periodontitis can be kept under control by your dental team.

Scaling and root planing also may be a step your dentist or hygienist takes to control early to moderate periodontitis. Scaling removes hard and soft deposits of calculus from the crown of the tooth. Root planing smooths away calculus deposits that collect on the root surfaces beneath the gums.1

Local, needle-free methods are available to keep you comfortable during this process. Your dental professional may also choose to perform this treatment one area of your mouth at a time over a series of office visits.

For advanced gum diseases, surgical treatments using local anesthetics may be performed. To reduce the size of gingival pockets, a periodontist folds back the gum tissue and removes the disease causing bacteria. He or she may also reshape the bone and gum, add bone grafts if necessary, and then stitch the tissue back into place.