What is Periodontal Disease?
Meaning "around the tooth," periodontal disease affects the gums that surround the teeth and the bones that support them. Plaque that is left to build up on teeth eventually changes from a sticky film into tartar (calculus). Together, plaque and tartar start to break down the gums and bone in the mouth. One common symptom of this disease is red, swollen and bleeding gums.
It is estimated that four out of every five people have some stage of periodontal disease but are unaware of it. Typically, this is because the first stages of the disease are often painless.
Periodontal disease is the number one cause of tooth loss, and it has also been associated with other serious diseases, such as bacterial pneumonia, diabetes, stroke, increased risk during pregnancy and cardiovascular disease. Researchers are currently trying to find out if the bacteria associated with periodontal disease affects the conditions of other systemic diseases, such as those listed. The risk of periodontal disease increases with people who smoke.
You can reduce your risk of periodontal disease through good oral hygiene, a balanced diet and routine trips to your dentist.
Signs and symptoms of periodontal disease:
- Bleeding gums
- Loose teeth
- New spacing between teeth
- Persistent bad breath
- Pus around the teeth and gums
- Receding gums
- Red and puffy gums
- Tenderness or Discomfort
Your dentist or hygienist can diagnose this disease during a periodontal examination, which is included in your regular dental check up.
A small dental instrument called a periodontal probe is used to measure the space (sulcus) between the teeth and the gums. A healthy sulcus should measure three millimeters or less and it should not bleed. The probe will indicate if the spaces are deeper than three millimeters. Deeper pockets typically indicate a more advanced stage of the disease.
In addition to measuring the sulcus, your dentist will check for inflammation, tooth mobility and other signs that will help in making a diagnosis according to one of the below categories:
The first stage of periodontal disease, gingivitis is characterized by tender, inflamed gums that are also likely to bleed during flossing or brushing.
Plaque build up will eventually harden into calculus, commonly called tartar. This build up will cause the gums to recede away from the teeth, creating deep pockets where bacteria and pus can grow. At this stage, the gums are very irritated and bleed very easily. Beginning stages of bone loss may also be seen with periodontitis.
As the gums, bone and other supporting ligaments are destroyed by periodontal disease, the teeth lose their strong anchoring. As a result, the affected teeth will start to become loose and may even fall out. Bone loss at this stage can be anywhere from moderate to severe.
Treatment for periodontal disease is determined by the type and severity of the disease. Your dentist and hygienist will be able to make the best treatment recommendations for your situation.
One or two regular cleanings are typically all that is necessary to clear up the early stages of gingivitis, when there has still been no bone damage. We will also provide you with tips on how to maintain healthy dental habits at home, so the disease does not return.
More advanced stages of the disease require scaling and root planning (deep cleaning). Normally, this type of cleaning is done on one quadrant of the mouth at a time, and the area being treated is made numb. This procedure removes tartar, plaque and other toxins from above and below the gum line and on root surfaces. Cleaning out these toxins helps the gums to heal, shrinking the pockets back to a normal size. Depending on the patient, we may also recommend medication, mouth rinses and an electric tooth brush to help clear up the infection.
If scaling and root planning does not clear up the problem, periodontal surgery may be necessary to get the pockets back to a normal size. Reducing the pocket size makes keeping your teeth clean much easier, and your dentist may recommend that you see a specialist in this field.
If plaque is not removed within 24 hours after it forms on your teeth, it turns into tartar. Regular home dental care helps prevent the formation of plaque and tartar, but hard-to-reach places need to be cleaned regularly by your dentist to ensure all plaque build up is removed.
After receiving treatment for periodontal disease, it's very important to receive regular maintenance cleanings from a dentist or hygienist. These cleanings will provide your dentist the perfect opportunity to check the sulcus and ensure that your teeth and gums are healthy. Plaque and tartar that haven't been removed by your daily cleaning efforts will be taken care of during this cleaning. You should schedule these check ups about four times a year.
Your periodontal cleaning and examination will also include:
- Examination of diagnostic x-rays
- Examination of existing restorations
- Examination of tooth decay
- Oral cancer screening
- Oral hygiene recommendations
- Teeth polishing
Regular periodontal cleanings combined with good oral hygiene habits will help you to maintain good dental health, and they are effective preventive measures against the return of periodontal disease.