A periodontist is a dentist who specializes in the prevention, diagnosis and treatment of periodontal disease and in the placement of dental implants. Periodontists receive extensive training in these areas, including three additional years of education beyond dental school. Periodontists are familiar with the latest techniques for diagnosing and treating periodontal disease. In addition, they can perform cosmetic periodontal procedures to help you achieve the smile you desire. Often, dentists refer their patients to a periodontist when their periodontal disease is advanced. However, you don't need a referral to see a periodontist. In fact, there are occasions when you may choose to go directly to a periodontist or to refer a family member or friend to your own periodontist.

During your first visit, your periodontist will review your complete medical and dental history with you. It's extremely important for your periodontist to know if you are taking any medications or being treated for any condition that can affect your periodontal care. You will be given a complete oral and periodontal exam. Your periodontist will examine your gums, check to see if there is any gum line recession, assess how your teeth fit together when you bite and check your teeth to see if any are loose. Your periodontist will also take a small measuring instrument and place it between your teeth and gums to determine the depth of those spaces, known as periodontal pockets. This helps your periodontist assess the health of your gums. Radiographs (x-rays) may be used to show the bone levels between your teeth to check for possible bone loss.

If you value your oral as well as overall health, anytime is a good time to see a periodontist for a periodontal evaluation.
Sometimes the only way to detect periodontal disease is through a periodontal evaluation. A periodontal evaluation may be especially important in the following situations:

• If you notice any symptoms of periodontal disease, including:
  gums that bleed easily, such as during brushing or flossing red, swollen or tender gums gums that have pulled away from the teeth persistent bad breath pus between the teeth and gums loose or separating teeth a change in the way your teeth fit together when you bite
• If you are thinking of becoming pregnant. Pregnant women who have periodontal disease may be seven times more likely to have a baby born too early and too small. In addition, about half of women experience "pregnancy gingivitis." However, women who have good oral hygiene and have no gingivitis before pregnancy are very unlikely to experience this condition.
• If you have a family member with periodontal disease. Research suggests that the bacteria that cause periodontal disease can pass through saliva. This means the common contact of saliva in families puts children and couples at risk for contracting the periodontal disease of another family member.

To keep your teeth for a lifetime, you must remove the plaque from your teeth and gums every day with proper brushing and flossing. Regular dental visits are also important. Daily cleaning will help keep calculus formation to a minimum, but it won't completely prevent it. A professional cleaning at least twice a year is necessary to remove calculus from places your toothbrush and floss may have missed.

Periodontal disease may be passed from parents to children and between couples, according to an article in the September 1997 issue of the Journal of the American Dental Association. Researchers suggest that bacteria causing periodontal disease are passed though saliva. This means that when a family or couple come into contact with each other's saliva, they're at risk for contracting the periodontal disease of another family member. Based on this research, the American Academy of Periodontology recognizes that treatment of gum disease may involve entire families. If one family member has periodontal disease, the AAP recommends that all family members see a dental professional for a periodontal disease screening.

Research proves that up to 30% of the population may be genetically susceptible to gum disease. Despite aggressive oral care habits, these people may be six times more likely to develop periodontal disease. Identifying these people with a genetic test before they even show signs of the disease and getting them into early interventive treatment may help them keep their teeth for a lifetime.

Bleeding gums are one of the signs of gum disease. Think of gum tissue as the skin on your hand. If your hands bled every time you washed them, you would know something was wrong. There are a number of other warning signs of gum disease.

Your bone and gum tissue should fit snugly around your teeth like a turtleneck around your neck. When you have periodontal disease, this supporting tissue and bone is destroyed, forming "pockets" around the teeth. Over time, these pockets become deeper, providing a larger space in which bacteria can live. As bacteria develop around the teeth, they can accumulate and advance under the gum tissue. These deep pockets collect even more bacteria, resulting in further bone and tissue loss. Eventually, if too much bone is lost, the teeth will need to be extracted.

Studies have shown that tobacco use may be one of the most significant risk factors in the development and progression of periodontal disease. Smokers are much more likely than non-smokers to have calculus form on their teeth, have deeper pockets between the teeth and gums and lose more of the bone and tissue that support the teeth.

Research has shown that periodontal disease may increase the risk for developing cardiovascular disease. Both periodontal disease and cardiovascular disease are chronic inflammatory diseases, so researchers believe that inflammation may account for the association between the two. Untreated periodontal disease can increase inflammation in the body, which may increase the risk for development of more severe health complications including cardiovascular disease. However, more research is needed to determine the exact relationship between the two conditions.

Periodontal disease is rarely found in children, and only sometimes found in adolescents. However, children should still learn the importance of keeping their teeth and gums healthy to prevent periodontal disease in the future. Children should brush their teeth twice a day and learn how to floss properly- if children learn how to floss at an early age, they will be more likely to make it a lifetime habit. These two simple acts will help protect their teeth and gums from periodontal disease.
As a parent, you should also be aware of the warning signs of periodontal disease, which include red, swollen, bleeding gums or bad breath that won't go away. If your child develops any of these symptoms, tell your dental professional right away. It's also a good idea to ensure your dental professional knows your complete family history, as genetics can play an important role in the early development of periodontal disease.

Periodontal disease is often silent, meaning symptoms - particularly pain - may not appear until an advanced stage of the disease. However, you should still be on the lookout for the signs and symptoms, which include:

• Red, swollen or tender gums or other pain in your mouth
• Bleeding while brushing, flossing, or when eating certain foods
• Gums that are receding or pulling away from the teeth, causing the teeth to look longer than before
• Loose or separating teeth
• Pus between your gums and teeth
• Sores in your mouth
• Persistent bad breath
• A change in the way your teeth fit together when you bite
• A change in the fit of partial dentures
• If you notice any of these symptoms, be sure to contact your dentist or periodontist right away!

The best way to prevent periodontal disease is to take good care of your teeth and gums at home. This includes brushing your teeth after every meal and before bedtime, flossing at least once each day, and seeing your dentist or periodontist for regular exams twice a year. Spending a few minutes a day on preventative measures may save you the time and money of treating periodontal disease!

Research has suggested that there is a link between diabetes and gum disease. People with diabetes are more likely to have periodontal problems, possibly because people with diabetes are more susceptible to contracting infections. In fact, periodontal disease is often considered one of the major complications of diabetes. Interestingly, the relationship between the two conditions goes both ways; just as diabetes can increase a person's chance of developing periodontal disease, research stuggests that efficient and effective periodontal hygiene may positively affect blood sugar levels.

Regular examinations are very important to keep track of the present status of your disease and any disease progression over time. Your periodontist will work with you to create a maintenance schedule depending on how advanced your periodontal disease is at that time. Based on many variable factors such as your overall health, the severity of bone loss, and risk factors such as smoking and genetics, your periodontist will constantly tailor your care so your periodontal disease does not progress further. He or she may recommend exams every six months for mild periodontal disease, or every few months for more advanced stages.