Periodontal diseases are ongoing infections that can destroy the support of your natural teeth. Bacteria form colonies within a sticky layer called plaque or biofilm. Bacterial biofilms are generally resistant to antibiotics and other chemical agents. A large variety of bacteria form an ecosystem that is very adherent and very resistant to removal from tooth surfaces, especially those on teeth within the gap between our teeth and our gums. Their presence and metabolic processes cause our defensive mechanisms to react, which for some proves protective. For those persons susceptible to periodontal disease the immune/inflammatory cascade is excessive, particularly when the biofilm is left undisturbed for a number of hours. The integrity of the skin, which ideally is protecting the gum tissues on the inside of the gap or crevice between the gum and the tooth, is disrupted so that is no longer an effective barrier and may bleed with little disturbance. The tiny blood vessels are affected by the mediators of inflammation and become fragile and are no longer selective with what passes out of them and into them.

Periodontitis is basically an inflammatory disease that damages bone, not the somewhat innocent sounding 'gum problems, often used to describe it.The nearly constant presence of the bacterial biofilm confronts the host, the patient susceptible to periodontitis, whose inflammatory response leads to damage to their own bone. Essentially the bone recedes from the neck of the tooth. As the bone is lost a deeper gap may develop between the tooth and the adjacent gum tissue. When the deepened gap persists it is often called a pocket, which actually protects the biofilm and reduces the patient 's access for removing it. Gum recession is another way the bone loss is experienced. Gum tissue is only securely attached to bone, so if the bone recedes the gum adapts to the new level of the bone. When a person 's genetics allows the bone to be thin enough to readily recede when challenged, bone anatomy is a predisposing factor to gum recession. If the gum over the thin bone is too weak to form an effective seal, the bone is poorly protected. The character and strength of the seal or barrier the gum ideally provides is also a function of genetics, so fragile gum tissue may only provide a weak seal, which additionally may be undermined by inflammation.

Though genetics is the major determinant of susceptibility to bone loss from periodontitis, there are other factors which can predispose or amplify the bone loss a patient experiences. Certain medical conditions, like diabetes, and specific medications may negatively influence the course of one's disease. Stress alters our immune/inflammatory responses such that they might not be as protective. Smoking seems to work through multiple mechanisms to magnify the bone loss experienced and compromising any healing potential, while often further masking the relatively subtle symptoms of infection. Our bites can be in harmony with the supporting bone for our teeth, but they can also be the source of physical stress on the bone, amplifying ongoing bone loss in specific sites. Each of us is most often so accustomed to our bite, our occlusion, that we are unaware of any disharmony. Physical trauma to the gum from harsh personal care measures may damage the gum tissues and create inflammation incompatible with bone health.

These are some of the major modifying determinants that may affect or may have already affected your experience. One of our major responsibilities is to be a source of understanding for you. The list of factors that may negatively influence the health and stability of the supporting bone for our teeth is growing constantly as new science emerges. Drs. McDevitt, Jacquot, and Izarra find that their constant reading of professional journals and their frequent attendance at continuing education courses is an essential part of your successful therapy. The complexity of comprehensive diagnosis requires a thorough analysis of all the identifiable factors that may affect your meeting your health goals.

Dr. John H. Jacquot is a Diplomate of the American Board of Periodontology. He grew up in Jacksonville, FL and attended high school at The Bolles School before receiving his B.A. from the University of North Carolina. He went on to attend the University of North Carolina School of Dentistry and graduated with honors in 2002. After being exposed to the field of periodontics, he decided to complete his formal residency in periodontics and received his master's degree in oral biology, as well as his certificate in periodontics in 2005.

Dr. Jacquot enjoys the continued learning and application of the ever-changing field of periodontics. He especially enjoys the knowledge within the field that can empower and involve a person in their own treatment and solutions. A successful therapeutic outcome with minimal intervention is his objective for every patient.

Besides working full-time in private practice, Dr. Jacquot is an assistant professor at the Georgia Health Sciences University and College of Dental Medicine and the University of North Carolina School of Dentistry. At these schools his focus is training dentists in surgical procedures during their periodontal residency programs. Also, he volunteers one day per month at the Ben Massell Dental Clinic in Atlanta, which serves the city's underprivileged.

Dr. Michael J. McDevitt is a Diplomate of the American Board of Periodontology. After graduating with honors from Emory University School of Dentistry in 1971 he served in the United States Air Force, where he received advanced training in periodontics. This experience confirmed his desire to help patients keep their teeth with a healthy periodontium, so he completed his formal residency in periodontics at Emory in 1975.

Dr. McDevitt continues to pursue the latest and most effective diagnostic and therapeutic opportunities for his patients through numerous continuing education experiences every year. The value of that ongoing education has becomes especially relevant in light of recent, dramatic revelations in the field of periodontics. New concepts of disease processes and the role of a person's genetics and new strategies to afford each patient more opportunity to be engaged in their own treatment and solutions have evolved.

Over the last 20 of his nearly 40 years of clinical practice treating periodontal compromises, Dr. McDevitt has become a sought after teacher. He has spoken at a number of state, regional and national dental meetings, he teaches graduate dentists several times a year as a member of the visiting faculty at the L. D. Pankey Institute, and recently has begun teaching in workshops for dental teams. His focus is on the compassionate, gentle and precise diagnosis that every patient can understand, leading to each individual patient finding they are able to make healthy decisions, consistent with what is in their own best interest.

Mike has been blessed by his 43 year marriage to his precious wife, Marty, by his children, their spouses and his four grandsons. He and Marty have been active members of the Church of the Apostles since soon after its founding.

Dr. Izarra completed both her Dental Medicine Degree and Postdoctoral Certificate in Periodontics and Implant Dentistry at Nova Southeastern University in Fort Lauderdale, Florida. Since graduating in 2012, she has enjoyed building relationships with patients and referrals in a private practice setting and sharing her knowledge with the next generation of dentists as a Clinical Assistant Professor at the University of New England College of Dental Medicine.

Dr. Izarra strives to connect with every patient through a warm and compassionate demeanor and provide care in a comfortable and caring environment. She believes in minimally invasive and evidence-based treatment strategies for long lasting esthetics, health, and function.

Dr. Izarra's passion for dentistry and commitment to clinical excellence has led her to pursue significant achievements beyond the mandatory educational requirements. She has earned Diplomate status from the American Board of Periodontology and the International Congress of Oral Implantologists through a rigorous certification process. Dr. Izarra has extensive experience in traditional periodontics as well as cutting-edge regenerative treatment, dental implant surgery with ridge and sinus augmentation, and cosmetic periodontal plastic surgery procedures. In addition, she is certified in Wilckodontics (Accelerated Osteogenic Orthodontics).

Dr. Izarra is involved with multiple local and national dental organizations, which allows her to stay current in the evolving field of dentistry and refine her clinical skills. She has professional affiliations with the Georgia Dental Association, American Dental Association, American Academy of Periodontology, International Congress of Oral Implantologists, and Academy of Osseointegration.

Dr. Izarra is originally from Caracas, Venezuela and is fluent in both English and Spanish. In her free time she enjoys traveling to new places, taking barre class, being in the sun, salsa dancing, exploring Atlanta restaurants with her husband, Richard, and visiting family in Miami.