HOWARD KAUFMAN, D.D.S
Specialist - Gum Disease & Dental Implants

EVELINE HAMDANI, D.M.D.
General & Cosmetic Dentistry

Periodontal DiseaseGum disease in Long Beach

FAQ

What is a periodontist?
A periodontist is a dentist specializing in the treatment of gum (or periodontal) disease.

What is periodontal disease?
 
It is a chronic inflammatory disease that affects the gum tissue, ligaments and bone around the teeth.  It causes weakening and ultimate destruction of these tissues which protect and support the teeth and hold them in place.

Is periodontal disease common?  
 
Yes!  1 in 3 adults in the United States between ages 30 and 54 and 1 in 2 adults between 55 and 90 have some form of periodontal disease.

How does periodontal disease start?
 
It starts with gum inflammation. Gum inflammation is caused by toxins that are released by the bacteria in plaque.  Plaque is an organized colony of bacteria which causes inflammation.   If the problem is not corrected the inflammation gradually extends below the gum line.  Now the fibers connecting each tooth to its bony socket are affected.  As time goes on, the bone will also become involved as the inflammation extends deeper into the fiber area.

What causes periodontal disease?
 
Bacterial plaque!  Bacterial plaque is a sticky, colorless film that constantly forms on your teeth.  If the plaque is not removed, it can turn into a hard substance called tartar (calculus).  The tartar is so hard it can only be removed during a professional cleaning.  There are also other causative factors which contribute to periodontal breakdown.   These include missing teeth, food impactions, and poor occlusion.

What, exactly, is plaque?
 
Plaque is a sticky, transparent substance which clings to the teeth.  Once removed, it reforms again in 24 hours.  An enormous number of microorganisms live in plaque.  Most of the bacteria that comprise plaque live in protected areas which are inaccessible to conventional toothbushing so they pose a constant threat to the teeth and gum tissue.  As the bacterial elements organize to form plaque they produce toxic acids which are destroy the fibers that hold the teeth and the supporting bone.

I am very anxious about my mouth and teeth, what can you suggest?
Dr. Kaufman is licensed by the State of California to perform IV conscious sedation.  Conscious sedation allows us to complete treatment while the patient is comfortably sedated.  You have no concept of time while under sedation, so long appointments seem to fly by.  You also have little or no recollection of the appointment once the sedation wears off.  This is a great option for anxious patients.

What are the symptoms of periodontal disease?
 
•    Bleeding gums
•    Swollen or puffy gums
•    Sensitive teeth
•    Loosening of teeth
•    Enlarged spaces between teeth
•    Bad breath
•    Excessive formation of tartar
•    Shifting of the teeth 
•    Bite changes
•    Gums pulling away from the teeth
•    Pain 

Why do teeth become loose?
 
Think of your tooth as a fence post.  If most of the fence post is in the ground, it is solid.  However, if erosion occurs and much of the supporting soil is lost, less of the fence post will be in the ground and the post will no longer be firmly anchored.  As a result, it becomes loose.  When a tooth loses its support, which is the fibers and bone, it, too, becomes loose.

How do bacteria attack the teeth?
 
Visualize the neck of a tooth encircled with a tight turtleneck sweater, which represents gum tissue.  The threads in the sweater could be compared to the tough elastic fibers.  Healthy tissue is so tight that bacterial action cannot affect it.  However, if bacterial plaque is allowed to accumulate where the gum meets the tooth, the bacterial toxins slowly destroy the elasticity of the fibers.  In this situation, the turtleneck loosens, allowing the bacteria and toxins to slip into the deeper fiber areas.  Here they find a more favorable environment and multiply and produce more toxins.

Can a periodontist actually measure the amount of destruction caused by periodontal disease?
 
Yes!  We use an instrument called a periodontal probe to measure the depth of the space between the tooth and the gum tissue.  With this instrument we can determine the amount of bone destruction.  

Is periodontal disease inherited?
 
Yes and no.  The scientific community believes that individuals may inherit a weakness, such as the tendency toward heavier plaque formation and bone destruction.  However, an individual who maintains good oral hygiene and routine dental and periodontal cleanings may control periodontal disease.

At what age is periodontal disease most prevalent?
 
Usually the onset of periodontal disease takes place at about 35 years of age, although it can occur earlier or later in life.  Most dentists agree that 90% of the population over age 35 is afflicted to some degree.

But, Dr. Kaufman, I brush all the time!
 
We do not wish to imply that patients do not brush.  However, brushing cleans only the cheek, tongue, and biting surfaces of the teeth.  Periodontal disease starts and does its greatest damage between the teeth.  How the patient cleans is the most important aspect, particularly between the teeth where the toothbrush cannot reach.

What happens if periodontal disease is not treated?
 
If periodontal disease is not treated, the teeth may need to be removed.  In addition, accumulating research links periodontal diseases to general health conditions such as heart disease, diabetes, and respiratory disease.

Periodontal Disease and…You!
 
Periodontal Disease and Stress
 
If you are stressed, you are twice as likely to develop periodontal disease due to altered habits and weakening of the body’s ability to fight infection.

Periodontal Disease and Senior Citizens
 
Periodontal disease can be aggravated by diabetes and osteoporosis.  It has also been linked with major health conditions including heart and respiratory diseases.  It is more important than ever for you to seek regular dental care.

Periodontal Disease and Women
 
Women’s healthcare needs are unique.   Research shows that women notice an increase in gum inflammation and discomfort during their menstrual cycle.  Women undergoing infertility treatments experience higher gum inflammation and bleeding.  Researchers found that periodontal disease is more severe in patients who have preeclampsia.  Women who get their recommended daily calcium allowance have significantly lower rates of periodontal disease.

Additional Information
 
These links offer additional information that may interest you.

American Academy of Periodontology
Please see the links for additional information on the following topics:
Gum Disease
Dental Implants
Improving Your Smile

Fruit/vegetable supplement helps fight periodontitis - 
DrBicuspid             
A diet supplemented with a combination of fruit and vegetable juice powder concentrates may help combat chronic periodontal disease when combined with conventional dental therapy, according to a new study in the Journal of Clinical Periodontology. The results of a preliminary randomized controlled study conducted at the University of Birmingham showed that taking a daily dose of capsules containing concentrated phytonutrients improved clinical outcomes for patients with chronic periodontitis in the two months following nonsurgical periodontal therapy, with additional beneficial changes recorded at five and eight months after therapy. The study is the first of its kind to report the impact of giving periodontitis patients such a supplement during standard mechanical therapy, according to the study authors. 

Tooth sensitivity - Healthy living
Fran Gensicki has suffered with painful tooth sensitivity since high school when her braces came off. "Cold air in the winter. If I walk in the morning and breathing in hurts. Cold water," said Gensicki. Pain can sometimes be from sweets even warm fluids. When the gums recede, often the root of the tooth is exposed causing pain. Grinding your teeth can contribute to the problem as well as a cracked or decayed tooth, acidic foods don't help. Gensicki said, "Anything that has a lot of acids in it..."

Protect your heart before it breaks - 
MSNBC 
Gum disease doesn't just make for foul breath and a mangled smile — it's also murder on your heart. If you're breeding bacteria between your teeth, your immune system is on chronic high alert, a condition called inflammation that taxes your vital organs, including your heart. In fact, a woman's chance of having a heart attack may double if she has gum disease, according to the Academy of General Dentistry. Flossing is the best way to banish dangerous oral bacteria, so whip out that string every night before brushing your teeth.

6 ways oral hygiene affects the rest of the body - 
The Huffington Post      
Your dentist has been nagging you to brush twice a day and floss daily for as long as you can remember — and while those habits, along with regular cleanings, are key components to keeping your teeth and gums healthy, it turns out that how well you take care of your mouth could actually affect your entire body. "Your mouth is the gateway to your body — and it's not a very pristine gateway," HuffPost blogger Deepak Chopra wrote on the topic. "It's filled with bacteria — in fact, there are more bacteria living in your mouth than there are people on earth." In July alone, two new studies have come out about the surprising effects of poor oral care on the body as a whole.