The word “periodontal” means “around the teeth”. Periodontal Disease is a chronic infection that attacks the bone and gums that support the teeth. If plaque (a sticky film of food debris, bacteria & saliva) is not removed from the tooth surface it turns into calculus (tartar). If a patient does not remove both plaque and calculus either by home care or dental hygiene visits his bone & gums will deteriorate over time. Most likely, the first sign to a patient that he or she has periodontal disease is the presence of red, swollen and bleeding gums.
Because periodontal disease is usually painless in the early stages, most people are not even aware that they may have it.
Periodontal Disease is the number one reason for tooth loss among adult. Moreover, researchers suggest there may be possible links between periodontal disease and other maladies such as stroke, bacterial pneumonia, diabetes and cardiovascular disease.
The risk of developing periodontal disease can be greatly reduced by maintaining good oral hygiene and planning regular dental visits.
Diagnosis of Periodontal Disease
Your dentist and hygienist are trained to diagnose Periodontal Disease. Early gingivitis of periodontal disease can usually be treated by a hygienist. Once Periodontal Disease progresses, it will necessitate the skills of a Periodontist who is a specialized dentist trained to deal with disease of the bone & gums surrounding your teeth.
During a periodontal exam, a perio probe (small dental instrument with “ruler” like markings on it) is gently used to measure the pocket or space between the tooth and gums. A healthy sulcus measures 3 millimeters or less and does not bleed. During the progress of periodontal disease (if gone untreated) these pockets will get deeper.
During a periodontal exam the clinician will use pocket depths, amount of bleeding, inflammation and tooth mobility to fabricate a periodontal diagnosis that will fall into one of the categories listed below.
Gingivitis: This is the first stage of periodontal disease. Plaque and calculus irritate the gums and make them inflamed and tender and likely to bleed. Gingivitis can be treated successfully with dental hygiene by a hygienist or general dentist.
Periodontitis: Dental plaque will eventually harden into calculus. As plaque and calculus buildup the gums biological connection to teeth recedes and loosens. Deeper pockets form between the gums and teeth and these pockets fill with bacteria and pus. Clinically, gums appear very irritated and bleed easily. Bone loss would appear as moderate.
Advanced Periodontitis: As gums, bone and periodontal ligament continue to be destroyed, the teeth lose progressively more support. Moderate to severe bone loss is present. The affected teeth will become very loose and may be lost.
Treatment for Periodontal Disease:
The treatment of periodontal disease and methods used will be dictated by the severity of the disease. If the disease is caught in the early stages of gingivitis and no “real” damage has been done, the appropriate treatment would be one or two regular dental cleanings. Also, appropriate instructions on improving daily oral hygiene will be given.
If the disease has progressed to more advanced stages then Scaling & Root Planning (deep cleaning) would be recommended. This is usually done on ¼ of the mouth at a time and this is done with local anesthetics.
During this procedure, tartar & plaque (& associated toxins) are removed from above and below gum line. This procedure help gum tissues heal and pockets to shrink.
If pockets do not heal adequately after Scaling & Root Planning, periodontal surgery may be needed to reduce pocket depths, making teeth easier to clean. At this point the services of a Periodontist would be necessary.
Maintenance: Once Periodontal treatment has been completed, your periodontist, general dentist or hygienist will recommend that you have regular maintenance\ (periodontal cleanings) usually every three months. At these appointments, pocket depths will be checked and accumulated calculus & plaque will be removed.
Good oral hygiene practices and periodontal cleanings are essential in or to maintain dental health and keep periodontal disease under control.