Perdiodontal Disease

Perdiodontal Disease

What Is Gum Disease?

Gum disease is an infection of the gums which is caused by poor oral hygiene. If you do not brush and floss properly, bacteria will begin to build up between your teeth and gums in the form of plaque and tartar. Over time, this bacteria will begin to attack the gums and the roots of your teeth. Eventually, this results in permanent damage to the gums, as well as the underlying jaw bone, and the roots of your teeth. Gum disease is one of the leading causes of tooth loss in Americans of all ages.

Gum disease is caused by poor oral hygiene. If you do not brush and floss properly, you may develop gum disease. Your risk of gum disease can be increased by some other lifestyle choices and behaviors, such as excessive alcohol consumption, an unhealthy diet, and tobacco use.

Diagnosis

Periodontal disease is diagnosed by your dentist or 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 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.  As periodontal disease progresses, the pockets usually get deeper.

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

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.

Periodontitis

The second stage of gum disease, often called “periodontitis”, cannot be completely reversed or eliminated, and it will cause permanent damage to your gums and jaw tissue. If you get periodontal care in time, though, you can usually save most or all of your teeth, and halt the progression of the disease.

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 final stage of gum disease is called advanced periodontitis and occurs when gum disease has done significant damage to most or all of your teeth. In many cases, the teeth may become loose, or they may even fall out. Most patients with advanced periodontitis must have their remaining teeth extracted and replaced with dentures. Generalized moderate to severe bone loss may be present.

Treatment

Periodontal treatment methods depend upon the type and severity of the disease. Your 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 planing, periodontal surgery may be needed to reduce pocket depths, making teeth easier to clean.  Your dentist may also recommend that you see a periodontist (specialist of the gums and supporting bone).

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