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Dr. David Scharf has information for you on gum disease, periodontal disease, gingivitis, health aspects periodontal disease, smoking pregnancy, low birth weight, respiratory disease, heart disease, stroke, diabetes, genetics, FAQ for patients in Long Island, Suffolk County and Babylon, New York (NY) Periodontal Disease and Gum Disease Topics Your Dentist has referred you to a periodontist, now what? What Can Be Done? What Happens on the First Visit? Can I Delay Treatment to a More Convenient Time? Is it worth it to keep up with maintenance visits after Periodontal therapy? Bad Breath and Periodontal Disease Tobacco Products & Gum Disease Periodontal Disease and Women Gum Disease and Respiratory Disease Heart Disease and Gum Disease Gum Disease and the Diabetic Patient The Genetic Component of Periodontal Disease Your Dentist has referred you to a periodontist, now what? Your family dentist is recommending that you visit my office so that the extent of your periodontitis or gum disease may be evaluated. I am a specialist in this area of dentistry and I am known as a periodontist. Commonly known as Pyorrhea, periodontal disease is a progressive ailment suffered, to some extent, by nearly 90% of adults over age 35. It is the primary reason for loss of teeth by people over 30. Periodontal disease begins when bacteria invade the gum tissue surrounding the teeth. Once this bacterial invasion takes hold, the gums become puffy, bleed easily, and gradually lose their "grip" on the teeth they are supposed to protect. Pockets for where the gum loses its grip. These pockets allow more bacteria to lodge under the gum line below the reach of a toothbrush. Some of the bacteria produce toxins that attack the bone which supports the teeth. Without treatment, teeth become loose and may need to be removed. Because this destruction usually occurs beneath the gum line, the gum tissue may appear normal. This explains why many people discover too late that they have the disease. Only a thorough periodontal examination can reveal if hidden disease is present. Periodontal Disease Progression What Can Be Done? Appropriate treatment along with follow-up care by you and your family dentist can help to prevent recurrence of the disease. Treatment usually begins with a thorough cleaning of the tooth roots and any gum pockets. The plaque and calculus are removed and tooth roots smoothed to eliminate any crevices that can harbor plaque. This is followed by a daily home care program including careful brushing and flossing to remove plaque from under the gum margins. Sometimes, the biting surfaces of the teeth may be adjusted to evenly distribute the chewing pressures throughout the mouth. Other forms of treatment are necessary to help the gums reattach to the teeth for those patients who postpone periodontal care until the disease has progressed to an advanced state. What happens on my First Visit? Since your resistance to disease is affected by many factors, we begin with a medical history and dental history. This is followed by a thorough periodontal examination of your mouth. At your second appointment, the findings and a recommended treatment plan will be reviewed with you. You may find it helpful to bring your spouse or a friend with you to this appointment. Many patients find such a person's opinion very valuable. In most cases no treatment is performed at this appointment. Can I Delay Treatment to a More Convenient Time? Delaying diagnosis and treatment means delaying the benefits that treatment provides. Immediate diagnosis and treatment prevents further destruction to the gum and bone tissue. Your ability to enjoy a wide variety of foods and to taste your food properly will be protected. Also, you can avoid suffering unnecessary pain caused by the disease. With treatment, a patient can eliminate the unpleasant taste in the mouth often associated with the disease as well as the embarrassment of offensive breath. Your appearance will be protected through early treatment as successive loss of teeth often encourages lines, wrinkles and a "sunken" look due to the loss of tone in the facial muscles. A patient's self-confidence and self-image is often renewed through an improved appearance. Early treatment is also less expensive. Periodontal disease can be stopped. Your mouth can be restored to health. And, with help from your family dentist, the disease need not return. Is it worth it to keep up with maintenance visits after Periodontal therapy? You bet it is. Periodontal treatment is divided into two phases. The first phase or the active phase is designed to get your mouth healthy. The second phase or the maintenance phase is designed to keep your mouth healthy. Gum disease is s chronic disease. You can never be immune to it. But you can minimize the chances of it coming back. Studies have shown that periodontal treatment with maintenance is very effective at preserving ones teeth and dramatically reducing the incidence of tooth decay and gum disease recurrence. Studies have also shown that periodontal treatment without maintenance is of little value in the long run in preserving periodontal health. The Implications of Periodontal Disease on your Medical Health Bad Breath and Periodontal Disease Over 25 million Americans suffer with chronic bad breath. They resort to mints ans sprays to mask the odor, but these products do not address the cause of the problem. Dr. Scharf will perform a thorough examination to discover the cause of the problem and devise a treatment plan to address it. While certain medical conditions such as lung infections, diabetes and digestive imbalances can cause bad breath, most cases of halitosis originate in the mouth. Bacteria that cause gum disease also release gasses called volatile sulfur compounds. These gasses are responsible to the odor of halitosis. Treatment consists of a detailed review of your medical history and a thorough dental examination. Once the cause of the halitosis has been determined, Dr. Scharf can recommend a course of treatment to address the problem. Many times the results are quick and dramatic. Tobacco Products and Gum Disease Of all the risk factors for developing gum disease, smoking is the most powerful. Smokers are more than three times more likely to lose their teeth due to periodontal disease than non-smokers. Nicotine in the blood stream decreases the bodies ability to defend itself against gum disease then impairs the bodies ability to repair itself. We also know that periodontal therapy is less effective in smokers than in nonsmokers. Pockets tend to reform more quickly and regenerative therapy is not as successful. We know that quitting smoking is not easy, but it can add decades to your teeth.   Periodontal Disease and Women From puberty to menopause, periodontal disease has implications for women. Puberty During puberty increased levels of sex hormones will occur. This will cause the gum to become more reactive to bacteria and other irritants in the mouth. This may appear as gums that bleed easily. During this time it is especially important to practice good oral hygiene and have frequent professional cleanings. If not treated, the bone and gum surrounding the teeth may be compromised. Menstruation Gum irritation can become very common during menstruation. This is due to increased hormone levels. Increased irritation, sensitivity and bleeding can occur just before a woman’s period. Good oral hygiene and periodontal health can minimize or eliminate these findings. Pregnancy Many women feel that tooth loss from pregnancy is inevitable because the baby takes the calcium from the mother. This is an old wives tale. The gums are affected by pregnancy though. Increased levels of hormones beginning in the second month and increasing through the eighth month can cause a disease called pregnancy gingivitis. This condition is marked by red, swollen, tender, bleeding gums. This occurs in response to very little plaque and calculus. It is very important to make sure your gums are healthy before becoming pregnant. Many times an existing periodontal problem is greatly exacerbated during pregnancy. This can result is tooth loss. Working in concert with your OB/GYN, Dr. Scharf can tailor a preventative maintenance program to keep both your gums and your baby healthy during the pregnancy. Low Birth Weight Babies It's possible that if you have periodontal disease and are pregnant, you may be at risk for having a premature, low birthweight baby. For a long time we've known that many risk factors contribute to mothers having babies that are born prematurely at a low birthweight -smoking, alcohol use, drug use and infections. Now evidence is mounting that suggest a new risk factor – periodontal disease. Pregnant women who have periodontal disease may be seven times more likely to have a baby that is born too early or too small. If you are planning to become pregnant or are at risk for periodontal disease be sure to include a periodontal as part of your prenatal care - because healthy gums may lead to a healthier body and a healthy baby. Oral Contraceptives Women taking oral contraceptives (birth control pills) may experience the same changes in the gums as pregnant women do. This is due to the fluctuations in hormone levels. If you are taking oral contraceptives and notice bleeding, reddened or sensitive gums, please contact our office. Menopause Many women take hormone replacement therapy during menopause. This may cause your gums to become more sensitive to local irritants like plaque and calculus. Some studies show that estrogen supplements may improve a women’s oral health. Gum Disease and Respiratory Disease It's possible that if you have periodontal disease, you may be at risk for respiratory disease. For a long time we've known that people who smoke, are elderly, or have other health problems that suppress the immune system, are at increased risk for the development of respiratory diseases like pneumonia, bronchitis, emphysema and Chronic Obstructive Pulmonary Disease. More research is needed to confirm how periodontal disease may put people at increased risk for respiratory disease. What we do know is that infections in the mouth, like periodontal disease, are associated with increased risk of respiratory infection.   Heart Disease and Gum Disease For a long time we've known that bacteria may affect the heart. Now evidence is mounting that suggests people with periodontal disease - a bacterial disease, may be more at risk for heart disease than patients without periodontal disease. One study showed that heart disease was 25% more common in people with gum disease. Men under the age of 50 had a 75% greater risk of heart disease than men with healthy gums. Another study demonstrated that men with gum disease had twice the death rate from heart disease than men without gum disease. These studies suggest that gum disease could be a strong a risk factor for heart disease as smoking which is blamed for 40,000 heart-related deaths per year.   Gum Disease and the Diabetic Patient Diabetic patients know how important it is to control their disease. But many diabetics do not know there is a relationship between diabetes and gum disease. Each one can make the other one worse. A diabetic is has a greater risk of periodontal disease if the diabetes is not well controlled. Uncontrolled periodontal disease can make it more difficult to control the diabetic state. Diabetics know that an infection will raise their blood sugar. Periodontal disease is an infection that has the same result. If you are a diabetic it is especially important to make sure that your gums are healthy. Your physician may be having difficulty controlling your blood sugar. This may become easier once the periodontal disease is controlled. In addition, your diabetic medications may need to be reduced once the gum disease is controlled. Dr. Scharf will work very closely with your physician to coordinate your care. Healthier gums can lead to a healthier body.   The Genetic Component of Periodontal Disease For years we have known that not all people get periodontal disease at the same rate or the same severity. Both environmental factors (bacteria) and genetics influence periodontal disease. We now have a test that will determine an individual’s genetic susceptibility to periodontal disease. The test is simple and inexpensive. Individuals who test positive have between a 6 to 19 times increased risk of developing severe periodontal disease. Smokers who test positive have even worse odds. The good news is that this information can be used to design a preventive program to minimize the genetic effect of periodontal disease. It also assures that you are not under or over treated. The test is done by collecting a small sample of saliva. The saliva contains DNA, which is sent to a lab for analysis. The lab will tell us if you are positive or negative for the gene that causes your body to overreact to bacteria involved in periodontal disease. This information will be used to determine your overall risk profile and tailor your individual treatment plan. Many of our patients ask to have their children tested for this gene. They want their kids to start on the right preventive program before disease develops.