Periodontal Disease

Periodontal disease is considered a “silent” disease because there is usually no pain associated with this bacterial infection of the gums and tissues. Studies show that more than half of people over the age of 18 have gum disease in at least the early stages; and after the age of 35, three out of four people are affected to some degree.  The best way to avoid periodontal disease is to practice good oral hygiene and visit your dentist regularly.

Diagnosis

Periodontal disease is diagnosed by your dentist and dental hygienist during a periodontal examination.  This type of exam should always be part of your regular dental check-up.

A periodontal probe (small dental ruler) is gently used to measure the sulcus (pocket or space) between the tooth and the gums.  The depth of a healthy sulcus measures three millimeters or less and does not bleed.  The periodontal probe helps indicate if pockets are deeper than three millimeters.  As periodontal disease progresses, the pockets usually get deeper (4mm or above).

The dentist and hygienist will use pocket depths, amount of bleeding, inflammation, tooth mobility, along with radiographs, to make a diagnosis that will fall into a category below:

Gingivitis    

Gingivitis is the first stage of periodontal disease.  Plaque and its toxin by-products irritate the gums, making them tender, inflamed, and likely to bleed.    If gingivitis is caught early on and properly treated, it can be reversed.   However, if left untreated it can lead to periodontitis.

Periodontitis

Plaque hardens into calculus (tartar).  As calculus and plaque continue to build up, the gums begin to recede from the teeth.  Deeper pockets form between the gums and teeth and become filled with bacteria and pus.  The gums become very irritated, inflamed, and bleed easily.  Slight to moderate bone loss may be present.

Advanced Periodontitis

The teeth lose more support as the gums, bone, and periodontal ligament continue to be destroyed by bacteria, plaque and calculus embeded in these pockets.  Unless treated, the affected teeth will become very loose and may be lost.  Generalized moderate to severe bone loss may be present.

 

Treatment

Periodontal treatment methods depend upon the type and severity of the disease.  The dentist and dental hygienist will evaluate for periodontal disease and recommend the appropriate treatment.

Periodontal disease progresses as the sulcus (pocket or space) between the tooth and gums gets filled with bacteria, plaque, and tartar, causing irritation to the surrounding tissues.  When these irritants remain in the pocket space, they can cause damage to the gums and eventually, the bone that supports the teeth!

If the disease is caught in the early stages of gingivitis, and no damage has been done, one to two regular cleanings will be recommended.  You will also be given instructions on improving your daily oral hygiene habits and having regular dental cleanings.

If the disease has progressed to more advanced stages, a special periodontal cleaning called scaling and root planing (deep cleaning) will be recommended.  It is usually done one quadrant of the mouth at a time while the area is numb.  In this procedure, tartar, plaque, and toxins are removed from above and below the gum line (scaling) and rough spots on root surfaces are made smooth (planing).  This procedure helps gum tissue to heal and pockets to shrink.  Medications, special medicated mouth rinses, and an electric tooth-brush may be recommended to help control infection and healing.

If the pockets do not heal after scaling and root planning (reattach tightly to the teeth), periodontal surgery may be needed to reduce pocket depths, making teeth easier to clean.  Dr Meyer may also recommend that you see a Periodontist (specialist of the gums and supporting bone).

Maintenance

It only takes twenty-four hours for plaque that is not removed from your teeth to turn into calculus (tartar)!  Daily home cleaning helps control plaque and tartar formation, but those hard to reach areas will always need special attention.

Once your periodontal treatment has been completed, we will recommend you have regular maintenance cleanings (periodontal cleanings), usually four times a year.  At these cleaning appointments, the pocket depths will be carefully checked to ensure that they are healthy.  Plaque and calculus that is difficult for you to remove on a daily basis will be removed from above and below the gum line. 

Good oral hygiene practices and periodontal cleanings are essential in maintaining dental health and keeping periodontal disease under control!