Frequently Asked Questions

Periodontal (gum) disease is an infection of the gums and bone surrounding and supporting your teeth. This disease is initiated by bacteria from food remnants that accumulate in a film around your teeth (plaque). Bacterial plaque as well as your body’s immune response to the plaque cause damage to the gums and bone. Periodontal disease is the leading cause of tooth loss for adults in the United States.

Periodontal disease is a silent disease and for most people, can occur with no pain. If you suspect you have gum disease, take the self test or contact Periodontist Dr. Melanie Towe in her Frederick office at 240-651-5478 for a free consultation.

Yes. Periodontal disease in its mildest form is called gingivitis. The signs are swollen, red gums that may bleed when you brush. If untreated, it can develop into more advanced form of periodontal disease, called periodontitis. At this stage, there is bone loss and gum detachment from the tooth. There is also a type of periodontal disease that is more aggressive, where bone loss and tooth loss can occur rapidly.

When a tooth is lost, your remaining teeth may shift positions. Typically the tooth opposing the missing tooth will extrude (come up/down into the position of the missing tooth), and the adjacent teeth can lean into the space of the missing tooth. These changes in your bite will require complex procedures to correct once it happens. Also, when a tooth is lost, the bone begins to shrink (atrophy) and the face can get an aged and “sunken in” look.

Teeth can be replaced using one of three options:

  • Removable teeth (partial or full methods)
  • Fixed bridges (false teeth attached to adjacent teeth)
  • Dental implants (anchors that support teeth)


Dental implants are the only treatment option that prevents bone loss from the jaw when teeth are missing, because it replaces both portions of the missing tooth (the root and the crown). Removable teeth and fixed bridges only replace the crown part of the tooth (the part that you chew with), and not the root (the part that goes into the jaw bone, and anchors the tooth).

If you have questions as to which option is best for you, please contact Periodontist Dr. Melanie Towe in her Frederick office at 240-651-5478 for a free consultation and more information regarding missing teeth.

We have to first determine the amount of bone that you have remaining, using special X-rays that we will order for you. In the case that you have substantial bone loss, Dr. Towe specializes in growing new gums and bone (regenerative procedures), and she will establish a plan that will allow you to have implants even if your have a history of gum disease and bone loss. This is one of Dr. Towe’s specialties.

There are many implant treatment options for a patient with missing teeth. In many cases, the options have costs similar to other forms of tooth replacement, such as removable type dentures or fixed bridges. Some insurance plans provide coverage for implant-tooth replacement. We will be happy to check with your insurance to find out.

Dental implant treatment is a long term solution, and once healed, can last for your lifetime. It is the best option for teeth replacement at this time and great long term investment on your dental health.

The classic rule is to brush as often as you eat each day (after each meal), and floss nightly, right before you brush. However, your home care regimen is unique to your needs, habits and diet. There may be special devices that can enhance your oral health such as an electric tooth brush, special mouth rinse or tooth paste, a water pick or a small brush to get between the teeth. Dr. Towe will customize a home care regimen for you that is effective, practical and that fits into your lifestyle.

In most cases, the answer is no. Normal gum shrinkage can occur due to aging however, in majority of the cases, it is a sign of disease or over brushing. Dr. Towe will diagnose the cause of your problem and suggest a treatment (if necessary) that will effectively stop the recession and may reverse it.

There are several solutions. One is the fabrication of a night guard that will cover your teeth at night, and prevent the upper and lower teeth from touching. This will protect your teeth and prevent the damage of grinding.

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