Frequently Asked Questions 

What is periodontal disease? 

The word periodontal means “around the tooth.” Gums are like a protective layer over the fibers and bone that hold your teeth in your mouth. Periodontal diseases are bacterial infections that destroy those fibers and bone. If you don’t treat these diseases, you could lose your teeth.

Your bone and gum tissue should fit snugly around your teeth. When you have periodontal disease, this supporting tissue and bone is destroyed, forming “pockets” around the teeth where the gum has separated from the tooth. Over time, these pockets become deeper, providing a larger space in which bacteria can live. As bacteria develop around the teeth, they can accumulate and advance under the gum tissue. These deep pockets collect even more bacteria, resulting in further bone and tissue loss. Eventually, if too much bone is lost, the teeth will need to be extracted.

What does a periodontist do?

A periodontist is a dentist who specializes in the prevention, diagnosis and treatment of periodontal disease and in the placement of dental implants to replace missing teeth.

Periodontists go to four years of dental school, then complete two to three years of additional training in periodontics. Dentists often refer their patients to a periodontist when a patient’s periodontal disease is more advanced than the dentist is comfortable treating.

Periodontists also perform cosmetic periodontal procedures to enhance your smile.

Because dental implants are intimately connected with the gum tissues and bone in the mouth, periodontists are the ideal dental professional to place dental implants. Your dentist and periodontist will work together to ensure your dental health and make your smile beautiful.

What will happen if I don’t get periodontal treatment?

If left untreated, periodontal disease leads to bone loss. Excessive bone loss will cause you to lose your teeth.

Your dental health is closely tied to your overall health. In fact, some research shows that the health of your gums can have an effect on the health of your heart. Untreated periodontal disease leads to an increased risk of heart disease.

In pregnant women, untreated periodontal disease can lead to pre-term, low-birth-weight babies.

How do you treat periodontal disease?

Dr. Knox is committed to using the most conservative treatment that will be effective in restoring your dental health. After treatment, he will work with you and your general dentist to maintain your dental health. There are several treatment options depending on your individual needs:

Non surgical treatments

Scaling and Root Planing: Non-surgical treatments include scaling and root planing, a thorough cleaning of the surfaces of the tooth roots to remove plaque and calculus from deep periodontal pockets. This procedure also smoothes the tooth roots and may be followed by other therapies such as placing antibiotics below the gum line.

While many patients only require scaling and root planing, most of those patients will still need ongoing maintenance to protect their dental health.

If scaling and root planing do not resolve the problem, you may need periodontal surgery to restore bone and gum loss caused by periodontal disease and to achieve optimum health.

Surgical Treatments

If Dr. Knox determines that the tissue around your teeth cannot be repaired with non-surgical treatment, he will recommend surgical treatment, which can be done in his office.

Pocket Reduction:  Your bone and gum tissues should fit snugly around your teeth, but periodontal disease destroys tissue and bone, forming pockets around your teeth. Over time the pockets become deeper, allowing bacteria around the teeth and under the gum. Untreated, these pockets continue to deepen, leading to potential tooth loss. If Dr. Knox recommends a pocket reduction procedure, it is because your periodontal pockets have become too deep to clean at home or in the dental office. The procedure involves lifting back the gum tissues around the affected teeth and removing the disease-causing bacteria. If necessary, irregular surfaces of bone will be smoothed. The gum tissue will then be secured back into place.

Regenerative Procedures: As periodontal disease progresses, tissues and bone that support the teeth are lost, resulting in loose teeth or teeth that have to be extracted. Regeneration can reverse some of the damage. During this procedure, Dr. Knox will lift the gum tissue and remove the disease-causing bacteria. He will place bone grafts, membranes and/or tissue-stimulating proteins that encourage your body to regenerate bone and tissue.

Crown Lengthening: Periodontists, since they specialize in treatment of gums, also do cosmetic procedures in preparation for restorative dentistry or to improve the esthetics of your gum line.

To improve a “gummy” smile, a periodontist can perform a crown lengthening. Your teeth may be the proper length, but they may be covered by too much gum tissue. During a crown lengthening, excess gum and bone tissue are reshaped to expose more of your teeth. This can be done to one or more teeth.

Sometimes crown lengthening is necessary to make a restorative or cosmetic dental procedure possible. If your tooth is decayed, broken below the gum line or doesn’t have enough structure for a crown or bridge, a crown lengthening will adjust the gum and bone level so the tooth can be restored by your regular dentist.

Soft Tissue Grafts: Gums recede for a number of reasons including aggressive tooth brushing or periodontal disease. Gum recession exposes the roots of teeth. Some people don’t like the look of teeth that appear too long because of the receeding gums, and some people are sensitive to hot and cold foods in the area of recession. A periodontist can help identify what caused the recession, help control it, and repair the defect with a soft tissue graft. During a soft tissue graft, Dr. Knox will take gum tissue from the roof of your mouth or another donor source and cover the exposed roots. This can be done to one tooth, several teth or the entire gum line. Tissue grafts repair the defect and help prevent additional recession and bone loss.

What is going to happen at my first appointment?

At your first appointment, Dr. Knox will review your complete medical and dental history, including any medications you’re taking and conditions you’re being treated for. He will conduct a thorough examination that might include a series of x-rays and other diagnostic information. Dr. Knox will examine your gums and your teeth, and use a small measuring instrument to determine the depth of spaces between your teeth and gums. Radiographs (x-rays) will show any bone loss between your teeth.

The exam could take up to an hour. If your treatment is something Dr. Knox can do that day, you’ll have the option of being treated immediately. Most often, we will schedule a second appointment for a treatment conference. Dr. Knox will use information from your referring dentist and information from your exam to write up a treatment plan designed to help you achieve maximum dental health. He will explain his recommended treatment at your treatment conference, and you’ll have time to discuss treatment alternatives, ask questions, set up an appointment schedule, and make financial arrangements.

Do you work with my general dentist regarding my periodontal care?

Dr. Knox will coordinate your periodontal treatment with your general dentist. After Dr. Knox assesses your periodontal needs, he will recommend a treatment plan to you, consulting with your general dentist as necessary.  After Dr. Knox takes care of your periodontal problems, he will talk with your general dentist about your future dental needs.

What are cosmetic procedures?

Periodontists, since they specialize in treatment of gums, also do cosmetic procedures in preparation for restorative dentistry or to improve the esthetics of your gum line.

To improve a “gummy” smile, a periodontist can perform a crown lengthening. Your teeth may be the proper length, but they may be covered by too much gum tissue. During a crown lengthening, excess gum and bone tissue are reshaped to expose more of your teeth. This can be done to one or more teeth.

Sometimes crown lengthening is necessary to make a restorative or cosmetic dental procedure possible. If your tooth is decayed, broken below the gum line or doesn’t have enough structure for a crown or bridge, a crown lengthening will adjust the gum and bone level so the tooth can be restored by your regular dentist.

What are implants?

Dental implants are basically artificial roots that a periodontist places in your jaw bone. A tooth is attached to the artificial root. Implants look and feel like your own teeth. Dental implants do not rely on adjacent teeth for support, so they do not contribute to bone loss and recession. Implants can be used to replace anywhere from one tooth to every tooth. Implant success rates are very predictable based on your dental and medical health.

Do you use the latest equipment and techniques?

As a board-certified periodontist, continuing education is important to Dr. Knox, so he completes hours of continuing education every year. Our practice has state-of-the-art digital x-rays and sterilization equipment and a Periolase digital laser.

Will my insurance cover the cost?

Dental insurance policies often cover periodontal treatment.  We will do everything we can to help you get the most from your insurance coverage. Please bring one of your insurance forms with the patient information filled out and the authorization signed.

Specialty exams and consults may not be covered; therefore, you are responsible for this fee at your first visit.

We have found that most insurance plans pay 50-80 percent of a preset schedule of fees established by the insurance company. Benefits are determined by the type of plan chosen by your employer. We will be happy to file a predetermination prior to treatment. This simply tells the insurance carrier what we plan to do and what it will cost. The insurance carrier will then advise you and our office, in writing, exactly what they will pay towards your treatment. We can accept insurance assignment of benefits as payment or partial payment only after we have this information. Keep in mind that most policies have a $25 to $100 deductible and a yearly maximum.