SHARON MIYAMOTO, DDS

FAQ’s

Here are some of the frequent questions we receive:

 

WHAT IS PERIODONTIST?

A periodontist is a dentist who specializes in the prevention, diagnosis, and treatment of periodontal disease, and in the placement of dental implants.

Periodontists are also experts in the treatment of oral inflammation. They have the training and experience required by the American Dental Association to diagnose, treat, and prevent the various forms of gum disease. They are familiar with the latest techniques for diagnosing and treating periodontal disease, and are also trained in performing cosmetic periodontal procedures.

WHAT IS PERIODONTAL DISEASE?

Periodontal disease begins when plaque, a sticky, colorless, film of bacteria, food debris, and saliva, is left on the teeth and gums.  The bacteria produce toxins (acids) that inflame the gums and slowly destroy the bone.  Brushing and flossing regularly and properly will ensure that plaque is not left behind to do its damage.

Other than poor oral hygiene, there are several other factors that may increase the risk of developing periodontal disease:

  • Smoking or chewing tobacco – Tobacco users are more likely than nonusers to form plaque and tartar on their teeth.
  • Certain tooth or appliance conditions – Bridges that no longer fit properly, crowded teeth, or defective fillings that may trap plaque and bacteria.
  • Many medications – Steroids, cancer therapy drugs, blood pressure meds, oral contraceptives. Some medications have side affects that reduce saliva, making the mouth dry and plaque easier to adhere to the teeth and gums.
  • Pregnancy, oral contraceptives, and puberty – Can cause changes in hormone levels, causing gum tissue to become more sensitive to bacteria toxins.
  • Systemic diseases – Diabetes, blood cell disorders, HIV / AIDS, etc.
  • Genetics may play role – Some patients may be predisposed to a more aggressive type of periodontitis. Patients with a family history of tooth loss should pay particular attention to their gums.

How can I tell if I have gingivitis or periodontitis?

Four out of five people have periodontal disease and don’t know it!  Most people are not aware of it because the disease is usually painless in the early stages.  Unlike tooth decay, which often causes discomfort, it is possible to have periodontal disease without noticeable symptoms. A periodontal consultation will give you the diagnosis you need.

Signs and Symptoms of Periodontal Disease

  • Red and puffy gums – Gums should never be red or swollen.
  • Bleeding gums – Gums should never bleed, even when you brush vigorously or use dental floss.
  • Ongoing bad breath – Caused by bacteria in the mouth.
  • New spacing between teeth – Caused by bone loss.
  • Loose teeth – Also caused by bone loss or weakened periodontal fibers (fibers that support the tooth to the bone).
  • Pus around the teeth and gums – Sign that there is an infection present.
  • Receding gums – Loss of gum around a tooth.
  • Tenderness or Discomfort – Plaque, calculus, and bacteria irritate the gums and teeth.

If left untreated, periodontal disease can contribute to other health problems, including heart disease and diabetes. If you’re pregnant, having periodontal disease is also linked to premature birth or low birth weight. These can develop if gum disease is not treated by a professional.

Your smile’s health affects the overall health of your body.

WHO SHOULD SEE A PERIODONTIST?

Some patients’ periodontal needs can be managed by the general dentist. However, as more and more patients are exhibiting signs of periodontal disease, coupled with research that suggests a relationship between periodontal disease and other chronic diseases, sometimes related to aging, periodontal treatment may necessitate a greater understanding and increased level of expertise by a trained specialist. Patients who present with moderate or severe levels of periodontal disease, or patients with more complex cases, will be best managed by a partnership between the dentist and periodontist.

AM I AT RISK OF HAVING PERIODONTAL DISEASE?

You may be at risk of having periodontal disease if you smoke or use tobacco products, do not brush your teeth and floss regularly, have health conditions such as diabetes, heart disease, or osteoporosis, or several of your family members have had gum disease since it can, in some cases, be genetic. If you are experiencing any of the symptoms of gum disease, schedule an appointment with your dentist, who can determine whether treatment is necessary.

IS PERIODONTAL DISEASE TREATABLE?

Gum disease is both preventable and treatable. Today’s periodontal regenerative treatments offer a variety of options that are gentle, safe, and effective. If you have been diagnosed with gingivitis or gum disease, our office can help you determine which treatment best meets your needs.

  How often should I brush and floss?

Brushing and flossing help to control the plaque and bacteria that cause gum disease.

Bacterial plaque formation and growth is continuous and can only be controlled by regular brushing, flossing, and the use of other dental aids. If plaque and calculus are not removed, they begin to destroy the gums and bone, causing periodontal (gum) disease.

Toothbrushing – Brush your teeth at least twice a day (especially before going to bed at night) with an ADA approved soft bristle brush or an electric toothbrush such as a Sonicare, and toothpaste.

Electric toothbrushes are recommended for most of our patients.  They are easy to use and can remove plaque efficiently.  Simply place the bristles of the electric brush on your gumline and teeth and allow the brush to do its job.

FlossingDaily flossing is the best way to clean between the teeth and under the gumline.  Flossing not only helps clean these spaces, it disrupts plaque colonies from building up, preventing damage to the gums, teeth, and bone.

  • Take 12-16 inches of dental floss and wrap it around your middle fingers, leaving about 2 inches of floss between your right and left hand.
  • Using your thumbs and forefingers to guide the floss, gently insert the floss between teeth using a sawing motion.
  • Curve the floss into a “C” shape around each tooth and under the gumline. At this point, gently move the floss up and down, cleaning the side of each tooth.

What should I do if I have bad breath?

Bad breath (halitosis) can be an unpleasant and embarrassing condition.  Many of us may not realize that we have bad breath, but everyone has it from time to time, especially in the morning.

There are various reasons one may have bad breath, but in healthy people, the major reason is due to microbial deposits on the tongue, especially the back of the tongue.  Some studies have shown that simply brushing the tongue reduced bad breath by as much as 70 percent.

What may cause bad breath?

  • Morning time – Saliva flow almost stops during sleep and its reduced cleansing action allows bacteria to grow, causing bad breath.
  • Certain foods – Garlic, onions, etc. Foods containing odor-causing compounds enter the bloodstream; they are transferred to the lungs, where they are exhaled.
  • Poor oral hygiene habits – Food particles remaining in the mouth promote bacterial growth.
  • Periodontal (gum) disease – Colonies of bacteria and food debris residing under inflamed gums.
  • Dental cavities and improperly fitted dental appliances – May also contribute to bad breath.
  • Dry mouth (Xerostomia) – May be caused by certain medications, salivary gland problems, or continuous mouth breathing.
  • Tobacco products – Dry the mouth, causing bad breath.
  • Dieting – Certain chemicals called ketones are released in the breath as the body burns fat.
  • Dehydration, hunger, and missed meals – Drinking water and chewing food increases saliva flow and washes bacteria away.
  • Certain medical conditions and illnesses – Diabetes, liver and kidney problems, chronic sinus infections, bronchitis, and pneumonia are several conditions that may contribute to bad breath.

Keeping a record of what you eat may help identify the cause of bad breath.  Also, review your current medications, recent surgeries, or illnesses at your periodontal visit.

What can I do to prevent bad breath?

  • Practice good oral hygiene – Brush at least twice a day with an ADA approved fluoride toothpaste and toothbrush. Floss daily to remove food debris and plaque from in between the teeth and under the gumline.  Brush or use a tongue scraper to clean the tongue and reach the back areas.  Replace your toothbrush every 2 to 3 months. If you have an electric toothbrush, also change the toothbrush head every 2-3 months. If you wear dentures or removable bridges, clean them thoroughly and place them back in your mouth in the morning.
  • Get your exam and cleaning regularly – Get a check-up and cleaning at least twice a year. If you have or have had periodontal disease, we recommend more frequent visits.
  • Stop smoking/chewing tobacco – Ask at your visit what they recommend to help break the habit.
  • Drink water frequently – Water will help keep your mouth moist and wash away bacteria.
  • Use mouthwash/rinses – Some over-the-counter products only provide a temporary solution to mask unpleasant mouth odor. We may discuss an antiseptic rinses that not only alleviate bad breath, but also kill the germs that cause the problem.

In most cases, your dental visits and home care can treat the cause of bad breath.  If it is determined that your mouth is healthy, but bad breath is persistent, you may be referred to your physician to determine the cause of the odor and an appropriate treatment plan.

Will I have to have surgery?

Not necessarily. Our practice provides many treatment options depending on your specific situation and the severity of your problem. We prefer to use the least invasive, conservative, and most cost-effective manner. Non-surgical periodontal treatment is preferred, but does have its limitations. When it does not achieve periodontal health, localized surgery may be necessary. When it is necessary, please rest assured you are in expert hands and we use modern surgical regenerative techniques and have options to help make you as comfortable as possible.

When do I go back to my general dentist?

We work very closely as a team with your general dentist and any other specialists involved in your case.

Often during treatment, you will alternate between your general dentist and our office for cleanings and check-ups.

Our goal is to get you back to your general dentist as soon as you are stable and in good health.