Why Am I Being Referred?
Periodontists are specially qualified to treat a number of conditions which include periodontal and peri-implant disease, missing teeth, and soft tissue problems, among others. Dr. Dow performs a complete range of periodontal services to treat these conditions. We partner with dentists and specialists to provide excellent patient care.

Periodontal Disease

Gingivitis is redness or swelling of the gums caused by a bacterial plaque on the teeth. The toxins produced by the plaque begin to irritate and cause inflammation of the gum tissues. Once this bacterial infection colonizes the gum pockets between the teeth, it becomes much more difficult to remove and treat. Gingivitis is is a progressive condition that eventually leads to the destruction of the connective tissue and jawbone at which point it is referred to as periodontitis. If left untreated, it can lead to shifting teeth, loose teeth and eventually tooth loss. Periodontal disease is the leading cause of tooth loss among adults in the developed world and should always be promptly treated.

Common Types of Periodontal Disease

Healthy Gums: The gums are firm and pink. The bone is healthy and supports the teeth.

Gingivitis: Bacterial Plaque collects on the teeth at the gums. Eventually mild inflammation develops and the gums become red and inflamed progressing to become red, puffy and bleed easily.

Periodontitis: Periodontitis is a very common form of gum disease. Without proper home care, including brushing and flossing, bacterial plaque accumulates on the teeth. Over time, this will eventually result in inflammation and damage to the gum tissues and bone. In its advanced stages, the gums pull away from the teeth. Bone is lost and the patient will experience pain and the teeth become loose.

Early Periodontitis: Inflammation continues for a long period of time. Eventually the gums will pull away from the teeth forming a deep pocket or gum crevice. These pockets become filled with bacterial plaque and hard tartar and bone is lost. Infections at this stage are usually painless although pus may be present. The bone is damaged and begins to deteriorate.

Moderate Periodontitis: The infection over time spreads and becomes worse. This results in bone loss. The teeth shift and start to become loose.

Advanced Periodontitis: Advanced gum disease is one of the leading causes of tooth loss in adults. Bone loss is severe and there are gum abscesses. The infection becomes severe and painful.

Causes of Gum Disease

Periodontal disease is a progressive disease, which if left untreated may result in tooth loss. It begins with the inflammation and irritation of the gingival tissues which surround and support the teeth. The cause of this inflammation is due to the bodies response to toxins found in bacterial plaque.

The bacterial infection colonizes in the gingival tissue and deep pockets form between the teeth and the gums. If treated promptly by a periodontist, the effects of mild inflammation (known as gingivitis) are completely reversible. However, if the bacterial infection is allowed to progress, periodontal disease begins to destroy the gums and the underlying jawbone; promoting tooth loss. In some cases, the bacteria from this infection can travel to other areas of the body via the bloodstream.

There are genetic and environmental factors involved in the onset of gum disease, and in many cases the risk of developing periodontitis can be significantly lowered by taking preventative measures. Here are some of the most common causes of gum disease:

  • Poor dental hygiene: Preventing dental disease starts at home with good oral hygiene and a balanced diet. Prevention also includes regular dental visits, which include exams, cleanings, and x-rays. A combination of excellent home care and professional dental care will ensure and preserve the natural dentition and supporting bony structures. When bacteria and calculus (tartar) are not removed, the gums and bone around the teeth become affected by bacteria toxins and can cause gingivitis or periodontitis, which can lead to tooth loss.
  • Tobacco use: Research has indicated that smoking and tobacco use is one of the most significant factors in the development and progression of gum disease. In addition to smokers experiencing a slower recovery and healing rate, smokers are far more likely to suffer from calculus (tartar) buildup on teeth, deep pockets in the gingival tissue and significant bone loss.
  • Genetic predisposition: Despite practicing rigorous oral hygiene routines, as much as 30% of the population may have a strong genetic predisposition to gum disease. These individuals are six times more likely to develop periodontal disease than individuals with no genetic predisposition. Genetic tests can be used to determine susceptibility and early intervention can be performed to keep the oral cavity healthy.
  • Pregnancy and menopause: During pregnancy, regular brushing and flossing is critical. Hormonal changes experienced by the body can cause the gum tissue to become more sensitive, rendering them more susceptible to gum disease.
  • Chronic stress and poor diet: Stress lowers the ability of the immune system to fight off disease, which means bacterial infections may possibly beat the body’s defense system. Poor diet or malnutrition can also lower the body’s ability to fight periodontal infections, as well as negatively affecting the health of the gums.
  • Diabetes and underlying medical issues: Many medical conditions can intensify or accelerate the onset and progression of gum disease including respiratory disease, heart disease, arthritis and osteoporosis. Diabetes hinders the body’s ability to utilize insulin which makes the bacterial infection in the gums more difficult to control and cure.
  • Grinding teeth: The clenching or grinding of the teeth can significantly damage the supporting tissue surrounding the teeth. Grinding one’s teeth is usually associated with a “bad bite” or the misalignment of the teeth. When an individual is suffering from gum disease, the additional destruction of gingival tissue due to grinding can accelerate the progression of the disease.
  • Medication: Many drugs including oral contraceptive pills, heart medicines, anti-depressants and steroids affect the overall condition of teeth and gums; making them more susceptible to gum disease. Steroid use promotes gingival overgrowth, which makes swelling more commonplace and allows bacteria to colonize more readily in the gum tissue.

Signs and Symptoms

It is extremely important to note that periodontal disease can progress without any signs or symptoms such as pain. This is why regular dental checkups are exceptionally important.

Described below are some of the most common signs and symptoms of periodontitis.If you have any of these signs or symptoms, the advice of a general dentist or periodontist should be sought as soon as possible:

  • Unexplained bleeding: Bleeding when brushing, flossing or eating food is one of the most common symptoms of a periodontal infection. The toxins in plaque cause a bacterial infection, which makes the tissues prone to bleeding.
  • Pain, redness or swelling: A periodontal infection may be present if the gums are swollen, red or painful for no apparent reason. It is essential to halt the progression of the infection before the gum tissue and jawbone have been affected. It is also critical to treat the infection before it is carried into the bloodstream to other areas of the body.
  • Longer-looking teeth: Periodontal disease can lead to gum recession. The toxins produced by bacteria can destroy the supporting tissue and bones, thus making the teeth look longer and the smile appear more “toothy.”
  • Bad breath/halitosis: Although breath odor can originate from back of the tongue, the lungs and stomach, from the food we consume, or from tobacco use, bad breath may be caused by old food particles which sit between the teeth and underneath the gumline. The deeper gum pockets are able to house more debris and bacteria, causing a foul odor.
  • Loose teeth/change in bite pattern: A sign of rapidly progressing periodontitis is the loosening or shifting of the teeth in the affected area. As the bone tissue gets destroyed, teeth that were once firmly attached to the jawbone become loose or may shift in position.
  • Pus: Pus oozing from between the teeth is a definitive sign that a periodontal infection is in progress. The pus is a result of the body trying to fight the bacterial infection.

Prevention of Gum Disease

Our practice focuses on coordinating a customized preventive program for each of our patients. This program is a cooperative effort by the patient, dentist, and a periodontist to preserve the natural dentition and supporting structures by preventing the onset, progress, and recurrence of dental diseases and conditions.

Preventing dental disease starts at home with good oral hygiene and a balanced diet. It is continued in the dental office by the efforts of your dental team to promote, restore, and maintain your oral health. Prevention includes regular dental exams, cleanings, and x-rays.

Prevention helps avoid serious and costly dental problems and is the key to having a healthy, confident, beautiful smile.

Treatment

Eugene Periodontics specializes in a wide range of periodontal treatments and services. Please visit Periodontal Therapy.

Soft Tissue Problems

Different patients exhibit different soft tissue problems, but generally they either don’t have enough soft tissue, they have too much or there is a problem with the tissue that they have. In health there is a thick band of protective tissue that surrounds the teeth, covers the roots, and is resistant to everyday wear and tear called gingiva. The other tissue that is present in the mouth that lines the cheeks and under the tongue is called mucosa. This tissue is loose and elastic and allows for movement of the mouth, but it is not protective and will allow bacteria to penetrate the tissue if it is close to the teeth.

Recession

Soft tissue recession and thin gum tissue can be the result of multiple factors including genetics, aggressive tooth brushing or flossing, periodontal disease, frenum pull, tooth position, and tooth grinding among others.

Are the roots of your teeth discolored or dished out?

Risks of not doing anything?

Dr. Dow is trained to evaluate your tissue and to let you know how severe your problem is. Mild problems can usually wait while delaying treatment on more significant problems can can lead to worsening situations, additional disease or even tooth loss. Thin gum tissue can be extremely delicate  and can be at risk of recession.

Before

No Treatment | 2 Years Later

Treatment

Eugene Periodontics specializes in a wide range of soft tissue grafting treatments and services. Please visit Soft Tissue Grafting.

Missing Teeth

Teeth may need to be removed for a variety of reasons which include severe periodontal disease, decay, fracture, restorative issues, endodontic problems, orthodontic reasons.

Periodontal Disease

Decay

Cracked Tooth

Impacted Teeth

Dr. Dow specializes in the removal of unhealthy teeth and replacement of missing teeth with dental implants. Whether the teeth are removed or they have always been missing, replacing missing teeth is a topic that should be discussed with your periodontist and restorative dentist as there are several replacement options including dental implants, bridges or partial dentures. If dental implants are the ultimate goal then bone grafting may be required to preserve or build up the bone to support the dental implants.

Related Subjects

Excess Gingiva

People are often defined by their smile. When their smile is not quite right because of too much visible gum tissue, crown lengthening can often be performed to improve a “gummy smile”. Crown lengthening procedures are designed to reshape the gum tissue to allow teeth that appear short to look longer. This can enhance a natural smile, or improve esthetics for patients who are having veneers or other cosmetic dentistry completed.

Reasons for Excess Gingiva

Occasionally the gingiva can become swollen or overgrown due to local irritants such as braces, natural hormonal changes, or long term use of medications for blood pressure, to control seizures, or to suppress their immune system. These drugs include calcium channel blockers, beta-blockers, phenytoins, and cyclosporins.

The excess or enlarged gum tissue can be trimmed and sculpted using a periodontal blade or laser.

Treatment

Dr. Dow specializes in a wide range of soft and hard tissue treatments and services. Please visit Crown Lengthening.

Restorative/Orthodontic Related Problems

Periodontal treatment is designed to do more than treat gum disease. Cosmetic periodontal procedures help to restore a more natural appearance and enhance the beauty of a smile. The goal of these procedures is to improve the self-confidence and image of the patient while correcting any dental defects. They can improve a “gummy” smile, or help to improve the appearance of teeth that have lost gum tissue due to recession.

Can dental implants have problems?

Dental implants are a fantastic solution to replace missing teeth. If properly planned and maintained, implants can last a lifetime. In certain situations, and if implants are not maintained regularly, peri-implant disease can develop. Mild peri-implant disease, known as peri-implant mucositis, is a reversible condition in which the soft tissue is inflamed around a dental implant. Your dentist and Dr. Dow screen for this when he/she measures your gums during an exam. If left untreated, this condition may worsen and result in bone loss which is known as peri-implantitis.

Unfortunately peri-implantitis is far more prevalent around dental implants than one would think. In fact, because dental implants are presented as the ‘ultimate lifelong solution’, many people think that when they replace their teeth with implants that they no longer have to clean or maintain them. The truth is that the tissues surrounding implants are more susceptible to inflammation than a normal tooth.

What is Peri-implant disease?

Peri-implant disease is an inflammatory disease affecting soft and hard tissues surrounding dental implants. It is characterized by bleeding, the formation of deep periodontal pockets and bone loss which, if left untreated, can lead to implant loss. As the global number of individuals that undergo restorative therapy through dental implants increases, peri-implant disease is considered as a major and growing problem in dentistry.

Peri-implant mucositis: The first signs

Peri-implantitis should be taken seriously

Risk Factors for Developing Implant Disease

  • Patient Related Factors: Every person is different and certain factors related to their systemic health (e.g. diabetes, osteoporosis), history of periodontal disease, social factors (e.g. inadequate oral hygiene, smoking, drug abuse), and occlusal problems (e.g. grinding and clenching) contribute to their risk of developing peri-implant disease.
  • Microbiology: Patients with active periodontal disease are at risk that the bacteria causing that periodontal infection will infect the tissues surrounding the implant.
  • Bone support: An appropriate thickness of adequate bone must cover the entire implant surface. In order for bone to survive and remain healthy it must be at least 1.5mm thick. If bone is lost and the roughened implant surface may become exposed to bacteria, which colonize the surface.
  • Protective Soft Tissue: Gingiva, the thick protective bound down tissue that in health surrounds teeth and is resistant to bacterial intrusion, is more necessary around dental implants than around natural teeth.
  • Debris: After the final restoration is placed, it is very difficult to access and clean around the top of the dental implant. If the crown is glued in using dental cement, the cement that squirts out around the edges must be meticulously removed. Similarly plaque and calculus must be removed in order to prevent peri-implant infection.

Preventing Peri-implant Disease

Dr. Dow specializes in the placement, maintenance and repair of dental implants. Proper planning is the number 1 way to avoid peri-implant problems.

  • Evaluation and early treatment is critical. Dr. Dow likes to check the implant 1 month following placement of your final restoration. If there are any signs of a problem they can be treated early.
  • Regular home care and professional cleanings are recommended for all patients, especially for patients with dental implants. If plaque accumulates on a dental implant and is left undisturbed, it hardens into calculus which can be extremely difficult to remove and which may eventually lead to the failure of that implant.

Implants fuse to the bone and, although they feel like normal teeth, they are not suspended by a ligament like a tooth. Implants do not absorb clenching and grinding well and can therefore become damaged or the tissue may become irritated if they are not protected. Because of this an occlusal guard is usually recommended. Talk with your dentist about your options.

Treatment of Peri-implant Disease

Dental implants should be gently probed regularly to screen for problems. Implants with signs of inflammation, bleeding or pus on probing, periodontal probing depths greater than 4mm, but no bone loss can be treated with a special cleaning regimen including removing any irritants and detoxifying the implant surface. This treatment can reverse the disease process.

In addition to cleaning and detoxifying antibiotics may be used to combat bacteria which are irritating the tissues and leading to destruction of bone.

If peri-implant disease has progressed to the point where bone loss has occurred, then surgery may be required to access the infected tissue and remove it. Your periodontist can share your options with you about what treatments would be most beneficial to you and your implants. These options include the options listed above as well as surgical cleaning, and bone grafting.

Related Subjects

Periodontists are uniquely qualified to place implants, evaluate and maintain dental implants, and to treat implant problems. Please visit our services page if you are curious about process of delivering Dental Implants. If you already have an implant and have been diagnosed with a problem please visit our services page related to Maintaining Dental Implants.