Diagnosis of Periodontal Disease
A periodontal examination completed by your dentist or dental hygienist is used to diagnose periodontal disease and should always be part of your regular dental check-up.
A periodontal probe (small dental instrument) 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.
Your dentist or hygienist will use pocket depths, amount of bleeding, inflammation, tooth mobility, etc., to make a diagnosis that will fall into a category below:
Gingivitis
The first stage of periodontal disease is gingivitis. The toxin by-product of plaque irritate the gums, making them inflamed, tender and likely to bleed.
Periodontitis
The hardened form of plaque is tartar (calculus). As tartar and plaque build up, the gums begin to recede from the teeth. Deep pockets form between the gums and teeth and become filled with bacteria. Periodontis causes the gums to become irritated, inflamed and bleed easily. Slight to moderate bone loss may also occur.
Advanced Periodontitis
During advanced periodontis the teeth lose more support as the bone, gums and periodontal ligament deteriorate. Without treatment, affected teeth will loosen and may even be lost.
Signs and symptoms of periodontal disease:
Bleeding gums – Gums should never bleed, even when you brush vigorously or use dental floss.
Loose teeth – Also caused by bone loss or weakened periodontal fibers.
New spacing between teeth – Caused by bone loss.
Persistent bad breath – Caused by bacteria in the mouth.
Pus around the teeth and gums – Sign that there is an infection present.
Receding gums – Loss of gum around a tooth.
Red and puffy gums – Gums should never be red or swollen.
Tenderness or Discomfort – Plaque, calculus and bacteria irritate the gums and teeth.
Treatment of Periodontal Disease
The treatment of periodontal disease depends on the severity and type. After evaluating your periodontal disease your dentist and dental hygienist will recommend the appropriate treatment.
As periodontal disease progresses the pocket or space between the tooth and gums becomes filled with bacteria, plaque and tartar, causing irritation to the surrounding tissues. Irritants that remain in the pocket space can cause damage to the gums and bone that supports the teeth!
If periodontal disease is caught in the early stages of gingivitis, before any damage has been done, one to two regular cleanings will be recommended. Your dentist will also give you instructions on improving your daily oral hygiene habits and encourage you to have regular dental cleanings.
Periodontal disease that progresses to advanced stages requires a deep cleaning called scaling and root planning. This deep cleaning is usually done while the area is numb, one quadrant of the mouth at a time. Tartar, plaque and toxins are removed from above and below the gum line and rough spots on root surfaces are made smooth (planning) during this procedure. This procedure works to heal gum tissue and shrink pockets. An electric tooth brush, medications and special medicated mouth rinses may be prescribed to help control infection and encourage healing.
Pockets that do not heal after scaling and root planning may require periodontal surgery to reduce pocket depths, making teeth easier to clean. A Periodontist (gums and supporting bone specialist) may also be recommended by your dentist.
Maintenance for Periodontal Disease
Plaque that is removed from teeth turns into tartar (calculus) in twenty-four hours! At home daily cleaning helps keep plaque and tartar from forming, but hard to reach areas will always need special attention.
Your dentist and dental hygienist will recommend regular maintenance cleanings (periodontal cleanings), usually four times a year once your periodontal treatment has been completed. The pocket depths will be carefully checked to ensure they are healthy. Plaque and tartar that is difficult for you to remove on a daily basis will be removed from above and below the gum line.
Maintaining dental health and keeping periodontal disease under control means using oral hygiene practices and maintaining regulary scheduled cleanings!