Salt Lake City Periodontal Disease

Dr. Willard Maughan is a dentist and has answered some common questions Bizymoms visitors have about Periodontal Disease.


Q. What is periodontal disease?

A. Take my word when I say that seeing the devastating effects of periodontal disease will make everyone more careful about taking care of their teeth!  Photos of periodontal damage are often hard to look at, but they do motivate patients to maintain better oral health.

First it is important to point out that periodontal disease is often more commonly called "gum disease."  It is an infection of the tissues, as well as the bones that surround and support the teeth in your mouth. 

There are two types, or stages, of gum disease.  The first is gingivitis.  If left untreated, this becomes the more serious periodontitis.  Gingivitis forms when long-term plaque deposits gather and develop on the exposed parts of the teeth.  These plaque deposits are a mixture of food debris, bacteria and mucus which is found in everyone’s mouth.  If left untreated, these plaque deposits become hard and are then called "tartar." As deposits grow, plaque becomes trapped at the base of the tooth, where your sensitive gum line is located and is not easily visible to the person who is affected.

Since the bacteria and the toxins produced by plaque and tartar will inflame and tend to irritate the gums, the gums become infected and show signs of redness and swelling. They also become tender to the touch.  Basically gum disease has begun.

Gingivitis is easier to treat than periodontitis because the infection is only affecting the gums and the tissues surrounding the teeth. 

Periodontitis however is what happens when gingivitis is left untreated or ignored.  This occurs when the infection/gum disease worsens and spreads below the gums and damages the tissues and bones that hold teeth in the mouth. 

In periodontitis cases, the gums pull away from the teeth leaving large pockets that can become places for the bacteria in our mouths to fester, and really begin attacking the tooth bases and bones in our jaws.  Teeth may eventually become loose and begin to fall out, or have to be removed by a dentist since the bone holding them in place was compromised by the gum disease.

Q. Who gets periodontal disease?

A. Basically, anyone!  Although more common among adults, everyone can develop periodontal disease as it is caused by the plaque in our mouths.  Now there are certain factors that can increase the odds of becoming susceptible to both gingivitis and periodontitis. 

The best news is that the most important factor to avoid who is prone to getting periodontal disease is in one’s very own hands!  If you do not clean/brush your teeth well, or fail visit your dentist every six months for checkups and a regular cleaning, this greatly increases your risk of developing periodontal disease.

Other factors that make people more susceptible to periodontal disease are those who smoke or especially for those who chew tobacco.  There are also some genetic predispositions for developing periodontal disease and researchers have found that if you have someone in your family who has gum disease, you may be at a slightly higher risk for developing it during your lifetime—another reason to see a dentist regularly!

Even hormonal changes that occur during pregnancy, menopause, puberty and monthly menstruation makes gums more sensitive and therefore easier for gingivitis to develop, and have been known to contribute to increased risk of gum disease. 

Interestingly enough, there are certain medications containing side effects that can lessen the flow of saliva.  Saliva does have a protective effect upon teeth and gums and without it, this can create conditions increasing the risk of gum disease.  Also using the anticonvulsant medication Dilantin or other prescription drugs like Procardia and Adalat can contribute to gum disease because side effects cause abnormal growth of gum tissue.

Since periodontal disease is caused by plaque that create toxins, there are also those people who may have conditions that increase the odds of developing gum disease because their bodies already find it difficult to fight infections.  These conditions range from uncontrolled diabetes, AIDS or leukemia to people with high levels of stress or those with poor diets which are low in recommended vitamins and nutrients.

Q. How does one know if I have a gum disease?

A. Do your gums hurt after brushing?  Do you notice swelling and red, angry looking gums?  Usually it is pretty obvious to know if you are suffering from gum disease.  The tell-tale external signs of inflamed or swollen gums are the first indicators that you have gingivitis. Now if you think you are developing these symptoms, it is best to consult an expert such as your dentist.

Remember that healthy gums are generally pink and firm. They fit snugly around the teeth and even when brushing hard, they do not bleed easily. But in cases of mild gum disease which is called gingivitis and is the precursor to periodontitis, those affected will have gums that are red, swollen and are tender to the touch. Patients will also see that their gums bleed easily during brushing or flossing, and notice that they experience bad breath that will not go away, are all signs that you should consult a trained dentist or periodontist immediately.

Q. How is periodontal disease detected?

A. To know for sure, either your hygienist will notice these signs during a routine cleaning or your dentists will perform an exam and look for signs of bleeding gums, build-ups of plaque and tartar that are visible above the gum line, and deposits that are hard to see below the gum line.  A dentist, and especially a trained periodontist, will be able to easily spot areas where your gums are shrinking or beginning to pull away from your teeth.

In severe cases of periodontitis, patients will notice that their gums have severely pulled back from the teeth, even in some cases causing them to become loose.  This will also affect how the teeth will fit together when they bite down, and how the teeth move or do not line up correctly as they once did.  Also if the patient becomes aware of noticeable "pockets" that have developed between their teeth and gums it is a sign that they are in, or approaching, advanced cases of periodontitis.

Q. How is periodontal disease treated?

A. That all depends on how serious the case of gingivitis, or periodontitis, that has developed.  In the cases of mild gum disease, or gingivitis, patients can expect to be able to take care of it by brushing and flossing their teeth regularly twice a day and making sure they see their dentist or hygienist for regular cleanings at the dental office. 

There are also special tools that may be recommended and used for those who are more likely to develop gum disease.  These supplemental tools may be specially formed toothpicks, cleaning devices, toothbrushes and water irrigation devices, all of which can help plaque and tartar from gaining a foothold on the patient’s teeth and gums.

Anti-plaque and anti-tartar toothpastes and mouthwashes may also be recommended to help fight gum disease for those who are prone to it.  Furthermore for those who are more susceptible to gum disease because of genetics, lifestyle or decreased ability to fight infection, then the dentist may recommend these patients to brush and floss their teeth after each and every meal.

But if the gum disease has advanced from mild gingivitis into periodontitis, a specialist like a periodontist will likely perform a root planning and scaling procedure.  This is where they remove the excess plaque and tartar build-up that is hidden below the gum line, as well as that which has developed above the gum line.  At this stage, some dentists may prescribe antibiotics to help rid the infections that are in the patient’s mouth, now that the plaque and tartar have subsequently been removed.  Most periodontists would agree that after scaling and root planing, many patients do not require any further active treatment, including surgical therapy.

Now in advanced cases of periodontitis where pockets have developed, the gums have pulled back, teeth have become loose and so forth, then the only other option at this point is to consult a trained and certified periodontist for surgery to restore that integrity to your teeth.  Surgery is necessary when the periodontist determines that the tissue around the teeth is unhealthy and cannot be repaired with any non-surgical treatment. 

A Diplomate of the American Board of Periodontology like myself will usually use the following four types of surgical procedures when addressing this issue; Pocket reduction procedure and regenerative procedures.  Using one, or a combination, of these treatments usually results in stopping the periodontitis from further damaging the affected area.

Q. Why does one need to see the hygienist regularly?

A. The short answer is because a hygienist can get to and remove the plaque and tartar before it becomes a problem.  Even with good brushing and regular flossing, there are still build ups. 

Good dental habits are important and consist of brushing your teeth two times a day with a fluoride-based toothpaste.  Flossing at least once a day makes a huge difference when it comes to gum disease.  Besides seeing the hygienist regularly, try avoiding tobacco products altogether.  These habits assist in eliminating the risk of gum disease but perhaps the one most important thing to do is see your hygienist on a regular basis!  If you think you have a mild case of gum disease, I urge you to take the steps necessary to stop it before it gets worse. 

Not to be an alarmist but having gum disease may increase a pregnant woman’s risk of have a premature or low-birth weight baby.  Recent studies have also discovered that there is a direct link between heart disease victims and the very same bacteria that cause gum disease.

This may sound odd, but as a Diplomate of the American Board of Periodontology, I really do not want to see you in my office, because that means the problem of periodontitis has advanced to a critical stage.  I want your teeth and gums to be healthy and seeing a dentist or hygienist every six months cuts down on the odds you will have to see someone like myself.

Q. How can we contact Dr. Maughan if we have further questions?

A. If you do have further questions about gum disease, gingivitis, periodontitis and other oral health topics, I invite you to look at The Center of Dental Professionals Facebook and A Kid’s Place Dentistry pages, as we give plenty of information there.  Our website is: dentalprosutah.com

My staff can also be reached by calling: 801 747-8018.  I can also be reached via email at: info@dentalprosutah.com