1. Do you ever have pain in your mouth?

2. Do your gums ever bleed when you brush your teeth or when you eat hard food?

3. Have you noticed any spaces developing between your teeth?

4. Do your gums ever feel swollen or tender?

5. Have you noticed that your gums are receding (pulling back from your teeth) or your teeth appear longer than before?

6. Do you have persistent bad breath?

7. Have you noticed pus between your teeth and gums?

8. Have you noticed any change in the way your teeth fit together when you bite?

9. Do you ever develop sores in your mouth?

The word periodontal literally means "around the tooth." Periodontal diseases are serious bacterial infections that destroy the attachment fibers and supporting bone that hold your teeth in your mouth. Left untreated, these diseases can lead to tooth loss. There are many forms of periodontal disease:

• Gingivitis
• Aggressive periodontitis
• Chronic periodontitis
• Periodontitis as a manifestation of systemic diseases
• Necrotizing periodontal diseases

Studies have shown that tobacco use may be one of the most significant risk factors in the development and progression of periodontal disease. Smokers are much more likely than non-smokers to have calculus form on their teeth, have deeper pockets between the teeth and gums and lose more of the bone and tissue that support the teeth.

• More about tobacco use and periodontal disease

Research proves that up to 30% of the population may be genetically susceptible to gum disease. Despite aggressive oral care habits, these people may be six times more likely to develop periodontal disease. Identifying these people with a genetic test before they even show signs of the disease and getting them into early interventive treatment may help them keep their teeth for a lifetime.

If you value your oral as well as overall health, anytime is a good time to see a periodontist for a periodontal evaluation.

Sometimes the only way to detect periodontal disease is through a periodontal evaluation. A periodontal evaluation may be especially important in the following situations:

• gums that bleed easily, such as during brushing or flossing
• red, swollen or tender gums
• gums that have pulled away from the teeth
• persistent bad breath
• pus between the teeth and gums loose or separating teeth
• a change in the way your teeth fit together when you bite

If you are thinking of becoming pregnant. Pregnant women who have periodontal disease may be seven times more likely to have a baby born too early and too small. In addition, about half of women experience "pregnancy gingivitis." However, women who have good oral hygiene and have no gingivitis before pregnancy are very unlikely to experience this condition.

If you have a family member with periodontal disease. Research suggests that the bacteria that cause periodontal disease can pass through saliva. This means the common contact of saliva in families puts children and couples at risk for contracting the periodontal disease of another family member.

If you have heart disease, diabetes, respiratory disease or osteoporosis. Ongoing research is showing that periodontal disease may be linked to these conditions. The bacteria associated with periodontal disease can travel into the blood stream and pose a threat to other parts of the body. Healthy gums may lead to a healthier body.

If you feel that your teeth are too short or that your smile is too "gummy." Or, if you are missing one or more of your teeth and are interested in a long-lasting replacement option.

If you are not satisfied with your current tooth replacement option, such as a bridge or dentures, and may be interested in dental implants.

If you have a sore or irritation in your mouth that does not get better within two weeks.

Here are some guidelines for choosing dental care products – what works for most patients most of the time. To find out what is best for your particular needs, talk to your periodontist.

• Begin with the right equipment – a soft bristled toothbrush that allows you to reach every surface of each tooth. If the bristles on your toothbrush are bent or frayed, buy a new one. A worn-out brush will not clean your teeth properly.
• In addition to manual toothbrushes, your choices include automatic toothbrushes and "high tech" electronic toothbrushes. These are safe and effective for the majority of patients.
• Oral irrigators (water spraying devices) will not remove plaque from your teeth unless used in conjunction with brushing and flossing.
• Another aid is the rubber tip, often found on the handle end of a toothbrush used to massage the gums after brushing and flossing.
• Other options include interproximal toothbrushes (tiny brushes that clean plaque between teeth) and interdental cleaners (small sticks or picks that remove plaque between teeth). If used improperly, these dental aids can injure the gums, so it is important to discuss proper use with your periodontist.