Everything You Need to Know About Oral Health: Insights from a Periodontist

In this video, periodontist Dr. Lena Paloma discusses various aspects of oral health. She explains that a periodontist is a specialized dentist who focuses on the supporting structures of teeth, such as gums and ligaments. Dr. Paloma emphasizes the importance of regular dental care and referrals from dentists or other healthcare providers. She also addresses the impact of pregnancy on oral health, the treatment of canker sores, the prevalence of gum disease, and its connection to diabetes. Additionally, she discusses dry socket, a condition that occurs after tooth extraction, and offers advice on how to prevent and treat it.

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Key Insights:

  • A periodontist is a specialized dentist who focuses on the supporting structures of the teeth, such as the gums, ligaments, and bony socket.
  • A periodontist and a dentist work together in regular oral care, but a periodontist can also be directly referred by other healthcare providers, like endocrinologists or gynecologists.
  • Pregnancy can cause hormonal changes that affect oral health, leading to changes in the gums and ligaments.
  • Canker sores, officially called aphthous ulcers, are common and can be found on various areas in the mouth. They usually take ten days to two weeks to heal, but if they persist longer, it’s important to consult a dentist.
  • Treatment for canker sores is mostly symptomatic, but putting salt directly on the sore is not recommended. It’s best to use salt mixed with water to create a saline solution.
  • Gum disease, specifically periodontitis, affects around half of adults in the US. It can be exacerbated by certain health conditions like diabetes.
  • Diabetes increases the risk of gum disease, and gum disease can lead to poor diabetic outcomes due to reduced blood flow and compromised healing in the oral cavity.
  • Oral health is connected to overall health, and factors like menopause, hormone replacement therapy, or oral contraceptives can influence both. It’s important to communicate with your dentist about any changes or conditions.
  • Dry socket, known as alveolar osteitis, occurs when the blood clot that forms after tooth extraction gets dislodged. It can cause pain and delayed healing. If it happens, it’s essential to seek dental care for treatment.


What’s up everybody, we are talking everything you need to know when it comes to the mouth. This is Periodontist Dr. Lena Paloma, and I’m gonna bet she’s never seen teeth like these. I mean, come on now, right?

Dr. Paloma is a Periodontist based in New York City and is a Professor and Chair of NYU’s Ashman Department of Periodontology. Okay, we got a chair in the house, bam!

So, what’s the difference between a Periodontist and a Dentist? Give us the tea, doctor.

A Periodontist is a special kind of dentist. To become a dentist, you go to school for four years, but it takes an additional three years of school after dental school to specialize in periodontics. A Periodontist looks at not just the teeth, but the supporting structures of the teeth. That means the bony socket that holds the tooth in place, the ligament that connects the tooth to the bony socket, and the gums and soft tissue that house all of those structures.

As a Periodontist, do you work hand in hand with dentists or is that totally separate from regular oral care?

One would see their dentist for regular oral care. If a dentist realizes there is a problem beyond general dental care, they would refer the patient to a Periodontist. Alternatively, another healthcare provider like an endocrinologist for somebody with diabetes, or a gynecologist for someone going through pregnancy changes, might also refer a patient directly to a Periodontist without going through a dentist.

So, how can being pregnant affect your oral health?

When we have an influx of different hormones, you start to see changes in the gums and those changes can also be seen in the ligament. Just like the same hormones that make our uteruses stretch, they make everything else change as well. It’s important to tell your dentist if you’re pregnant or planning to become pregnant.

Okay internet, give us your best shot. This question is about a canker sore.

Officially, it’s called an aphthous ulcer, and an aphthous ulcer is a little area in the mouth. It can be in the lining of the cheek, around or under the tongue, or on your gums. And boy, is it annoying. It feels like it’s your whole galaxy. It’s something that you just have your mind on until it goes away, which usually takes ten days to two weeks. If it doesn’t, it could be something more serious. So, if you have a sore like that persisting longer, any lumps, bumps, bleedy areas, ulcerations more than 10 days to two weeks, call your dentist immediately. Be vigilant.

Now, in terms of treating a canker sore, I’ve seen a lot of videos out there on social media where people put salt directly on the canker sore. Do you recommend doing anything like that?

Treatment for canker sores is mostly symptomatic. Putting salt directly on a wound is not going to make you feel any better. A little salt mixed in with water to reach that physiologic saline can help. Stay away from anything that has a drying effect in the mouth, anything with alcohol, anything that burns, anything too spicy, too hot, or too cold. Over-the-counter numbing gels are available, but I would stress selecting one that doesn’t have sugar in the ingredients because we don’t want to cause unnecessary decay to the adjacent teeth. We also like to stay away from things like peroxide and mouthwash with alcohol when we have an aphthous ulcer. It’s important to look for triggers, the things that bring on these aphthous ulcers. Once you know your triggers, you can avoid certain things. Sometimes it’s tomatoes or orange juice. Everybody has a little different trigger, so prevention is the key.

How prevalent is gum disease and how can life health challenges affect your gum health?

Gum disease is very prevalent. The starting component of gum disease, which is gingivitis, is pretty universal. But if it gets beyond gingivitis and starts to affect the bony socket that holds your teeth in place, it’s called periodontitis. Recent reports have shown that around half of adults in America have periodontitis, so it’s pretty prevalent.

Another thing I heard is that if you have diabetes, that can also affect your oral health.

Diabetes increases your risk of gum disease and gum disease increases your risk of poor diabetic outcomes. The teeth and the jaws, the supporting structures, rely on blood flow from tiny little capillaries. When those get clogged up in a diabetic patient, all those good healing factors from our blood supply don’t reach the target. We tend to think of oral health as disconnected from our overall health, but it’s important to share any hormonal changes, whether it’s menopause, hormone replacement therapy, or oral contraceptives, with your dentist. It’s all connected.

I know that all too well because I’m actually on a blood thinner, and I had to have a procedure, and my dentist was like, „You didn’t tell us.“ She was like, „Yeah, we gotta check with your hematologist-oncologist.“ And I said, „Okay.“ So now I get it, now I understand it’s all connected.

People on TikTok have been posting videos about this dental condition known as dry socket.

Technically, a dry socket is known as alveolar osteitis. When a permanent tooth is removed, normal healing is through that blood supply. All the good healing factors from our blood come into that little socket and form a blood clot. In the case of a dry socket, that clot gets dislodged, and once that happens, there’s nowhere for the blood and its good healing factors to come and lodge in the sight that needs to heal.

What does someone do if that happens?

If a dry socket happens, sometimes without even doing anything to trigger it, you’ll go back to the dentist. They’ll give you something to flush the area so that you don’t get any additional bad bacteria, fungus, or food debris in the site. Symptomatic relief is also provided through over-the-counter NSAIDs and aspirin to keep the pain at bay.

If you have any pressing health questions, comment below, and don’t forget to hit subscribe to get more answers from medical experts on the questions you want to know. Thank you so much, Dr. Paloma, for joining us. And remember to see your periodontist for any medical advice.