Bleeding when you brush your teeth, sore or swollen gums, gum recession (you can see more tooth than you used to see), bad breath, tooth sensitivity, spaces between teeth change or get wider, loose or shifting teeth.  Any of these or a combination of these can indicate signs of periodontal disease.

Periodontal disease is often silent without any pain until the disease reaches advanced stages.  Oftentimes, when the disease is very advanced, there is little that can be done. There are some subtle clues you can look for:

• Loose or wiggling teeth or larger spaces between teeth
• Tender, swollen, red or bleeding gums
• Receding gums that are pulling away from teeth causing teeth to look longer than before
• Sores or “hot spots” in your mouth
• Pain in your mouth that does not go away
• Bleeding while flossing or brushing, or eating certain foods
• A change in your bite or the way your teeth fit together
• Sores or pus between gums and teeth
• Bad breath that does not go away with proper hygiene
• A change in the fit of partials or dentures

Periodontitis is often referred to as a silent disease.  Periodontal infection grows underneath your gums and can cause bleeding when brushing or flossing.  This can also cause inflammation of the gums, but there is no discomfort. Pain starts when the infection becomes severe.

No.  Bleeding gums are not normal.  This is one of the major signs of gum disease.  Think of your gums as the skin elsewhere on your body.  If your skin bled every time you washed, you would become very alarmed.

Untreated periodontal disease can cause tooth loss.  There are several studies relating periodontal disease and systematic diseases including but not limited to diabetes and cardiovascular disease.

Periodontal Disease and Cardiovascular Disease

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3100856/

Periodontitis and Diabetes – A Two-Way Relationship

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3228943/

Plaque is a sticky, colorless film that naturally builds up on tooth surfaces but, if not removed consistently or thoroughly, can irritate the gums causing gum inflammation (gingivitis), the early stage of periodontal disease.  When plaque is not removed thoroughly, it builds up into a hard deposit called calculus or tartar. This continual process can irritate the gums, and a pocket may develop between the teeth and gums. Plaque build-up can eventually destroy the gums and even bone that support the teeth.

Gum (periodontal) disease is an infection of the gums and can affect the bone structure that supports your teeth.  In severe cases, it can make your teeth fall out. Smoking is an important factor that causes gum disease and periodontal disease to be much more severe.

Smoking weakens your body’s infection fighters (your immune system).  This makes it harder to fight off a gum infection. Once you have gum disease, smoking also makes it harder for your gums to heal.

https://www.cdc.gov/tobacco/campaign/tips/diseases/periodontal-gum-disease.html

Bacterial plaque is the primary cause of periodontal disease.  Gum inflammation and periodontal disease can be reduced or prevented by consistently removing plaque both at home and having regular professional cleaning of teeth by a dental hygienist.

Diabetes and periodontal disease go hand in hand.  If your oral health is not stabilized, it can be more difficult to stabilize your diabetes.  There are scientific studies linking periodontal disease and cardiovascular disease. When you visit the medical physician that helps you manage your diabetes and heart health, it is important to inform him or her that you also have periodontal disease.  Dr. Heaton is happy to work with you and your other doctors to coordinate your oral wellness treatments. If you do have diabetes, please coordinate with our staff on when to eat prior to your procedures to prevent drops in blood sugar.

No.  While many patients are referred to us by their general dentist, we also have many patients who find us online or are referred by other satisfied patients.  Dr. Heaton has been in practice since 1985 and is a Board-Certified periodontist and dental implant surgeon. Dr. Heaton has placed well over 6,000 dental implants and was the first periodontist to place dental implants in Houston.  Dr. Heaton’s 5-star reputation is well known throughout the Houston metropolitan area. Your care and comfort are of utmost importance to us and your confidence in our care for you is why we do what we do. Your referrals to colleagues, friends and family members are greatly valued.

Paperwork is required by law and provides Dr. Heaton with details of your medical history and current medications and or supplements.  Please be thorough when filling out forms to provide the most current and accurate information.

Bitewings are used by your general dentist to evaluate teeth for cavities.  In periodontics and dental implants, we evaluate bone and sinus cavities as well as teeth and the jaw.  Dr. Heaton uses 3-D scans and panoramic x-rays to get the best views to assist in successful placement of implants with very precise surgical techniques.

Maintenance visits are critical and the best insurance you can get to prevent future periodontal problems and maintaining dental health.  These visits save time, money and even discomfort in the long run. If your dental insurance pays for just one maintenance visit every six months, that doesn’t mean that is all you need.  Because of your susceptibility to periodontal disease, you need to be seen more often. This goes a long way toward preventing new areas of periodontal disease.

Please do not drink any hot beverages for at least 48 hours after oral surgery.  Cold or room temperature beverages are preferred.

Wait until you no longer feel numbness from surgery to avoid biting your tongue or the side of your cheek when eating.  Avoid hard or crunchy foods for at least three days.

In most cases, bad breath can be eliminated.  Oral hygiene is important and should be done properly and daily.  Dr. Heaton carefully evaluates and suggests alterations or improvements to your flossing, brushing, and tongue health regimens.  There are also products and rinses that can help address oral odor. Stomach problems, sinus problems, poor oral hygiene, certain foods and medications and other factors can also contribute to bad breath.  The presence of undiagnosed or untreated periodontal disease can result in significant oral malodor. If it turns out that the bad breath problem is not an oral problem, a physician appointment is advised.

Yes.  Your general dentist will work with you to create the crown or dentures needed for your dental restoration.   Dr. Heaton and your general dentist will discuss the best approach for your treatment.

Typically, we find most can drive themselves home unless they choose to take a mild sedative prior to their surgical appointment.  With a sedative, it is necessary to designate a driver prior to your appointment and have them take you home after your oral surgery appointment is completed.

If you are having a procedure that requires IV sedation, it is advised not to eat after dinner the night before.  If your procedure requires localized numbing agents, you may eat a light meal up to one hour before your procedure.  Please check with the staff of Dr. Heaton on the specifics of your procedure.

Please call 713-339-2800 and you will be contacted by one of our team members.

There have been comparisons made between electric toothbrushes and manual toothbrushes to look at the ability of each to remove plaque.  Research has shown the power toothbrushes remove twice the plaque as a manual toothbrush.

Dr. Heaton recommends Oral B electric toothbrushes or similar models.  These can be purchased online or in the office.

According to a 2005 independent study, “Brushes that worked with a rotation oscillation action removed more plaque and reduced gingivitis more effectively than manual brushes in the short and long term.”

https://oralb.com/en-us/oral-health/why-oral-b/electric-toothbrushes/benefits-of-electric-toothbrush

Yes.  Electric toothbrushes are preferred by Dr. Heaton for better bacterial plaque removal and are fine to use with dental implants.

Dr. Heaton will recommend to you good choices for daily brushing depending on your individual case and oral health needs.  A fluoride toothpaste is essential for optimal oral health.

People with periodontal disease must be extra careful with their oral hygiene.  The American Dental Association advocates brushing twice each day for those with normal dental health.  Dr. Heaton will advise the best regimen for you after a careful examination and depending on your current oral health needs.

Yes, we do have nitrous oxide (N20), also known as nitrous or laughing gas, in our office to assist with relaxation at no charge.  We use state of the art sedation dentistry to make your experience as comfortable as possible.

Not usually.  At the end of the surgical appointment, we replace the nitrous oxide (N20) with 100% oxygen.  Once this is done, you will feel the same as you did when you first came to your appointment.

Take medications with food to minimize nausea.  Please contact us immediately with your concerns or should you experience more pain.  If need be, we can call in a different or additional prescription.

Numbness wears off very quickly.  Your mouth could be numb up to two hours after surgery depending on your individual metabolism.

Because of skeletal growth and growth spurts, most female patients need to wait until after their 18th birthday.  New research has shown boys need to wait until they are 21 years of age before their skeletal growth is complete.

Once the active phase of therapy for periodontal disease is complete and your disease is under control, maintaining dental health is important.  The goal of maintenance therapy is to reduce or eliminate as many of the risk factors that contributed to the manifestation of your disease. Dr. Heaton will put you on a maintenance program at the end of active therapy.

Frequent Professional Cleaning and Examination:

For many periodontal patients these visits are scheduled once every quarter, ideally alternating these with your general dentist.  This way, you receive expertise from both your general dentist and Dr. Heaton. Bacterial plaque in your mouth takes three months to mature and produce toxins.  These bacteria are part of the oral microbiome. Professional cleaning disrupts these bacteria, forcing it to start the growth process all over again. At each maintenance visit, we also perform a thorough periodontal evaluation.  Remember periodontal disease often occurs with little or no symptoms. It is, therefore, important to have our team assess your oral health regularly so we can address anything that arises in a proactive manner.

Effective brushing and flossing are foundational to proper oral hygiene and is done in specific ways when periodontal disease is found.  Dr. Heaton and his team will guide you with best techniques suited to your unique oral healthcare challenges.

A liquid diet is not necessary.  We recommend soft food. For example:  fish, well cooked chicken, or healthy smoothies with a clean source of protein.  Whey protein or non-GMO pea protein are good options.

You will want to wait until you are no longer numb from surgery to avoid biting the side of your cheek and/or tongue.

Crown lengthening is removal of gum tissue and/or bone to expose more of the actual tooth structure.  This allows your dentist to make a well-fitting crown.

Receding gums are caused by several factors:  grinding and/or clenching, abnormally thin gums, incorrect and excessive brushing, and periodontal disease.

An implant is a screw-like post made of titanium that is implanted into the jaw.  It is a root replacement.

The replacement tooth that is placed on the implant abutment.  The crown is handled by your general dentist.

A titanium post that is locked into the implant.