Periodontal Disease is a chronic bacterial infection that affects the gums and the bone supporting the teeth. It is an inflammatory and infectious disease. Anyone can get it, but certain people are at greater risk than others.

2. Have You Got it Yet?

The American Academy of Periodontology suggests the following questions in order to find out if you might have periodontal disease:

• Do you ever have pain in your mouth?
• Do your gums ever bleed when you brush or floss your teeth or when you eat hard food?
• Have you noticed and spaces developing between your teeth?
• Do your gums ever feel swollen or tender?
• Have you noticed that your gums are receding (pulling back form your teeth) or that your teeth appear longer than before?
• Do you have persistent bad breath?
• Have you noticed pus between your teeth and gums?
• Have you noticed any change in the way your teeth fit together when you bite?
• Do you ever develop sores in your mouth?

If you answered “yes” to any of these questions, please consult a dentist right away.

3. What are the Risk Factors for Periodontal Disease?

The American Academy of Periodontology cites the following causes and risk factors of periodontal disease:

-Tobacco use may be responsible for more than half the cases of periodontal disease among adults in the U.S. Smokers have a four fold increase in advanced cases of periodontal disease. The Centers for Disease Control and Prevention reveal that 41.3% of daily smokers over the age of 65 are toothless.

-If you have a family member with periodontal disease, please seek evaluation for every member of the family. The bacteria that cause periodontal disease can travel through the saliva and contaminate those in close contact with one another.

-Genetics plays a significant role in periodontal disease, with up to 30% of the population genetically susceptible to gum disease. Those with the genetic marker, may be up to 60% more susceptible.

-Between ages 55-90, 47% of whites have the more serious form of gum disease called periodontitis. 59% of Mexican Americans and 70 % of African Americans in the same age group have periodontitis. People of Chinese heritage also have a high susceptibility. It is estimated that during their lifetime, at least 75% of the population will have periodontal disease.

-Pregnancy and other times of hormonal change in a woman increase susceptibility to gum disease.

- Emotional stress increases the chances of periodontal disease as it depresses the immune system’s ability to fight infection.

-Medications, especially oral contraceptives, anti-depressives, and certain seizure and heart medications.

-Diabetes increases the risk for any infection, including periodontal disease.

-Poor nutrition is especially risky for the periodontal tissues as they typically require a level of support beyond that of the rest of the body.

-Individuals with rheumatoid arthritis are twice are likely to have periodontal disease with moderate to severe jawbone loss.

-Other systemic conditions that interfere with the body’s immune system may worsen the condition of the gums.

4. If I Have Periodontal Disease, Can it be Treated?

The good news is that we can combat the onset of periodontal disease through diligent brushing and flossing, using toothpaste and mouthwash that specifically combat anaerobic bacteria and sulfur compounds, and improved nutrition along with beneficial nutritional supplements. Regular visits to your dentist for preventative care will support your dental health and allow you to know if you are at additional risk.

5. Is there any truth to discussions that I have been hearing that old mercury amalgam fillings are dangerous to our health?

This is an excellent question, and one that dentists, scientists and patients have been asking for decades. Certainly tomes have been written with regards to the concerns of mercury (a known toxin), in dental amalgam. First, let me say that to date, the extensive research performed by the American Dental Association, the US Public Health Service and a multitude of other organizations has "proven" that silver fillings are indeed safe. The theory is that once the mercury binds with the other elements in silver amalgam, it becomes basically an inert substance, notable to cause levels of vaporization that would be harmful to human beings. However, there are those whose research does not support such findings. In fact, there are countries who banned the use of silver fillings several years ago, namely the Scandinavian countries and Germany, to name a few. Additionally, throughout the United States, there are dentists and dental researchers who are convinced of the toxicity of mercury in dental amalgam. Disturbance of the body’s electrical energy by the metal is also a concern expressed by some. So, controversy is widespread.

Up until a few years ago, the issue of whose research we should put our faith and trust in remained a huge dilemma for dentists like myself, who are holistically centered and tend to think seriously, cautiously, and very openly about such issues. Fortunately, something has changed in dentistry in recent years. What has changed is this: now we have incredibly strong materials in dentistry that can be used in place of amalgam restorations. They are tremendously beautiful, as well, offering luminescent qualities and shades almost identical to tooth enamel. Composite resin, porcelain and ceramic restorations are now available for most any situation.

There is a great learning curve and a sophisticated level of skill involved in using these materials effectively, as they are very technique-sensitive. It is important for a patient to know that their dental practitioner is highly comfortable in implementing the newer, more contemporary restorative options. In addition, they must be aware that these materials are not only more costly, some may not last as long as the "older" silver fillings. (No doubt, in the short term, silver fillings are the most economical of dental restorations and have served patients remarkably well for many decades.) Regardless, with the emphasis on improved health and esthetics that has surged in the past twenty years, we find ourselves responding to the call for tooth-colored restorations on a daily basis.

Now that many of us have been using esthetic restorations in our practices for some time, we have become aware of more technical reasons to stay away from amalgam fillings. When amalgam is used, more tooth structure often has to be removed in order to create mechanical undercuts in the tooth for retention, and to have sufficient depth and breadth of the restoration for adequate strength. With tooth-colored fillings, only areas of the tooth that are decayed or cracked must be removed. Therefore, it allows us to practice more conservatively, preserving valuable and healthy tooth structure. There are many other distinct advantages of not using amalgam to restore a tooth, now that we are able to use bonded adhesive restorations. Other than poor esthetics, (and health considerations that may be inherent, yet unsubstantiated or even undiscovered, in using amalgam), we now know that amalgam fillings actually contribute to microfractures within tooth structure. This occurs because their rate ofexpansion and contraction (as it relates to temperature changes within the mouth), is different than that of natural tooth structure. These fractures, or cracks, may contribute to the increased need for root canal therapy and crowns on teeth. In fact, several years ago, when select dental practices progressed to the advanced level of "microdentistry", we began to have the opportunity to diagnose such concerns on a daily basis. This alone, may be enough of a reason to prompt dental practices to become completely amalgam free.