What is a periodontist? 

A periodontist specialises in the diagnosis, treatment and prevention of periodontal disease and other soft tissue diseases of the mouth. Periodontists also place dental implants and correct soft tissue deformities. All periodontists are general dentists who have received 3-years additional training in this specialty. Your general dentist may refer you to a periodontist, however, you can schedule an appointment on your own if you think you may have a problem with your teeth or gums. 

What is periodontal disease, and am I at risk of developing it?
Perio means around, dont means tooth.  Periodontal or gum disease is a disease that affects the supporting tissues of the teeth; the gums, ligaments, cementum and bone.  Periodontal disease is caused by bacteria (dental plaque), resulting in the destruction of the supporting tissues of the teeth.  If there is no dental plaque there is no disease. In addition to plaque there are risk factors that can modify the progression and or rate of destruction; these include smoking, poor nutrition, stress, diabetes and some medications.

Is periodontal disease contagious?
No, periodontal disease is not contagious, however the bacteria responsible for periodontal disease is transmissible.  This would likely involve a lot of kissing over years.

Are my children more at risk if I have periodontal disease?  Of those patients with periodontal disease 40-80% will have a genetic predisposition (polymorphism) that results in increased rates of destruction around teeth in the presence of plaque.  If you are genetically more susceptible then your children have a 50:50 chance of also having this gene.  If both you and your partner have a genetic susceptibility to periodontal disease then your children's susceptibility is likely to be much higher.  We recommend being screened for periodontal disease regularly if you are potentially at risk.

My gums bleed when I brush my teeth. Is this normal?
Bleeding can be an early sign of gum disease. If this persists you should schedule an appointment with your dentist, hygienist or periodontist for an assessment of your problem.

Are there any ways to prevent periodontal disease?
Regular and meticulous oral hygiene is imperative in preventing and controlling periodontal disease. Proper tooth brushing and cleaning in between your teeth, combined with regular dental visits for maintenance will help to keep your gums healthy for life.

Are dental implants the best restoration option?
There are a number of options available for the replacement of teeth.  These include a removable denture, fixed bridgework and implants.  These options will be discussed with you so that you can make an informed decision as to what option works best for you.  The advantagesof placing an implant-supported crown are that it stands alone, i.e. its survival is not dependent upon the survival or status of the adjacent teeth, the adjacent teeth do not have to be cut down so they can be crowned and that the tooth will function very much like your natural tooth.  Fixed partial dentures or bridges by contrast are reliant upon the teeth that support them, if one fails all associated teeth are affected; also if the supporting teeth are pristine there is usually a very significant amount of tooth reduction/destruction to accommodate the abutment crown. Removable partial dentures while cheaper do not give the same high degree of function are required to be removed from the mouth 8-hours out of every 24-hours and will collect greater amounts of plaque which may adversely affect the teeth the denture comes in contact with.  This can result in further damage to the teeth, bone and soft tissue of your mouth.

If I have periodontal disease, do I need surgery? 
For the most part a non-surgical option is preferred. This is very effective regardless of whether the disease is mild or severe especially around teeth that have single roots.  If, however, the 'pocket' is proving refractory or difficult to stabilise a surgical option may be preferred as this may provide better access and visibility to treat that site.  We often use a microscope which can  provide better visibility and allow minimal wound sizes and therefore greater likelihood of success and reduced postoperative discomfort.   

What is maintenance therapy?
The bacteria that cause periodontal disease will almost always be present in your mouth.  Maintenance therapy is used to help prevent a recurrence of your infection in the pockets that previously existed and also to stop new pockets forming. We will tailor a review schedule that fits your needs and treatment if required. The frequency of visits varies from patient to patient dependent upon your level of risk.  This not only includes how effective your home care is but also elements such as whether you appear to be more susceptible from a genetic point of view and whether you have systemic medical issues that may affect your periodontal health such as diabetes.