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  • About
    • Meet Dr. Ficca
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    • Our Practice
    • When to See a Periodontist?
    • What is a Periodontist?
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    • Periodontal Disease
      • Periodontal Disease Overview
      • Periodontal Disease
      • Mouth – Body Connection
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      • Gum Grafting
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      • Simple Tooth Extractions
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      • Oral Cancer Exam
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      • Pocket Irrigation
      • Pocket Reduction Surgery
      • Prophylaxis (Teeth Cleaning)
      • Regenerative Procedures
      • Ridge Modification
      • Root Amputation
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      • Soft Tissue Grafting
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  • About
    • Meet Dr. Ficca
    • Meet Our Team
    • Our Practice
    • When to See a Periodontist?
    • What is a Periodontist?
    • Blog
  • Dental Implants
    • Dental Implants
    • Implants & Teeth-in-a-Day
    • Dentures vs. Dental Implants
    • Peri Implantitis
    • FAQs
      • Guide to Eating After Dental Implants
      • Questions to Ask About Dental Implants
      • How Dental Implants Work: The Benefits
  • Procedures
    • Cleanings & Prevention
      • Overview
      • Dental Exams & Cleanings
      • Digital X-Rays
      • Fluoride Treatment
      • Home Dental Care
      • How to Properly Brush & Floss
      • i-CAT® 3D Imaging
      • Oral Hygiene Aids
      • Panoramic X-Rays
    • Periodontal Disease
      • Periodontal Disease Overview
      • Periodontal Disease
      • Mouth – Body Connection
      • Periodontal Disease and Diabetes
      • Periodontal Disease, Heart Disease, and Stroke
      • Periodontal Disease and Pregnancy
      • Periodontal Disease and Osteoporosis
      • Periodontal Disease and Respiratory Disease
    • Periodontics
      • Periodontist
      • Bone Grafting
      • Crown Lengthening
      • Gum & Jawbone Corrective Treatments
      • Gum Grafting
      • Gum Recession
      • Oral Pathology
      • Platelet Rich Plasma (PRP)
      • Impacted Canines
      • Simple Tooth Extractions
      • Antibiotic Treatment
      • Bruxism
      • Oral Cancer Exam
      • Periodontal Scaling & Root Planing
      • Pocket Irrigation
      • Pocket Reduction Surgery
      • Prophylaxis (Teeth Cleaning)
      • Regenerative Procedures
      • Ridge Modification
      • Root Amputation
      • Sinus Augmentation
      • Soft Tissue Grafting
    • Gum Disease Treatment
    • Dental Anxiety and Fear
    • Sedation Dentistry
    • All Procedures
  • Gallery
  • Patient Info
    • Patient Resources
    • Patient Reviews
    • Patient Forms
    • Patient FAQ’s
    • COVID-19
    • Helpful Links
  • Referring Doctors
  • Contact
    • Contact Us
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When to See a Periodontist?

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Beginning of Periodontal Disease

Dr. Ficca pointing to a model of teeth

Periodontal disease begins when the toxins found in plaque start to attack the soft or gingival tissue surrounding the teeth. This bacterium embeds itself in the gum and rapidly breeds, causing a bacterial infection. As the infection progresses, it starts to burrow deeper into the tissue causing inflammation or irritation between the teeth and gums. The response of the body is to destroy the infected tissue, which is why the gums appear to recede. The resulting pockets between the teeth deepen, and if no treatment is sought, the tissue which makes up the jawbone also recedes, causing unstable teeth and tooth loss.

Referrals from General Dentists and Self Referral

There are several ways treatment from a periodontist may be sought. In the course of a regular dental check-up, if the general dentist or hygienist finds symptoms of gingivitis or rapidly progressing periodontal disease, a consultation with a periodontist may be recommended. However, a referral is not necessary for a periodontal consultation.

If you experience any of these signs and symptoms, it is important that you schedule an appointment with a periodontist without delay:

  • Bleeding while eating or brushing – Unexplained bleeding while consuming food or during daily cleaning is one of the most common signs of periodontal infection.
  • Bad breath – Continued halitosis (bad breath), which persists even when a rigorous oral hygiene program is in place, can be indicative of periodontitis, gingivitis, or the beginnings of an infection in the gum tissues.
  • Loose teeth and gum recession – Longer looking teeth can signal recession of the gums and bone loss due to periodontal disease. As this disease progresses and attacks the jawbone (the anchor holding the teeth in place), the teeth may become loose or be lost altogether.
  • Gangrene in the tissues – Gangrene is hard to self diagnose, but the general dentist and periodontist will check for its presence in the soft tissues, alveolar bone, and periodontal ligament.
  • Related health conditions – Heart disease, diabetes, osteopenia, and osteoporosis are highly correlated with periodontitis and periodontal infections. The bacteria infection can spread through the bloodstream and affect other parts of the body.

Diagnosis and Treatment

Before initiating any dental treatment, the periodontist must extensively examine the gums, jawbone, and general condition of the teeth. When gingivitis or periodontal disease is officially diagnosed, the periodontist has a number of surgical and non surgical options available to treat the underlying infection, halt the recession of the soft tissue, and restructure or replace teeth which may be missing.

  • Gingivitis/mild periodontal disease – When the gum pockets exceed 4mm in depth, the periodontist or hygienist may perform scaling and root planing to remove debris from the pockets and allow them to heal. Education and advice will be provided on an effective cleaning regime thereafter.
  • Moderate periodontal disease – If the gum pockets reach 4-6mm in length, a more extensive scaling and root planing cleaning might be required. This cleaning is usually performed under local anesthetic.
  • Advanced periodontal disease – Gum pockets in excess of 6-7mm are usually accompanied by bone loss and gum recession. Scaling and root planing will always be performed as the initial nonsurgical treatment. In addition to tose nonsurgical treatments, the periodontist may recommend surgical treatment to reduce pocket depth.
  • Tooth loss – Where one or several teeth are missing due to periodontal disease, dental implants are an effective option. If the bone is strong enough to provide a suitable anchor for the prosthetic tooth, the implant can be placed. However, if the bone is severely eroded, bone grafts may be performed by the periodontist to provide a suitable anchor for the new tooth/teeth.

Ask your periodontist if you have questions about periodontal disease, periodontal treatment, or dental implants.

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Headshot of Dr. Ficca in medical scrubs
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Specializing in Dental Implants and Periodontal Health in Charlotte, NC

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At Metrolina Periodontics & Dental Implants in Charlotte, NC, Dr. Ficca specializes in the placement of dental implants and the prevention and treatment of periodontal disease. He is board-certified by the American Board of Periodontology and provides a standard of excellence in personalized dental care that allows him to provide some of the best quality dental services his patients deserve.

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