The word periodontal means around the tooth. Periodontal disease affects gums and tooth-supporting bone, caused by plaque turning into tartar if not removed. Periodontal disease is characterized by red, swollen, and bleeding gums. Many people have periodontal disease unknowingly because early stages are typically painless. It's a leading cause of tooth loss and may correlate with other conditions like stroke, diabetes, and cardiovascular disease due to inflammation and bacteria. Quitting smoking, maintaining oral hygiene, a balanced diet, and regular dental check-ups can lower the risk of developing 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
Diagnosis
Periodontal disease is diagnosed through a periodontal examination during regular dental check-ups. A periodontal probe measures pocket depths between teeth and gums, with depths over three millimeters indicating potential gingivitis or periodontal disease progression. 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 marks the initial phase of periodontal disease, characterized by tender, inflamed gums prone to bleeding due to bacterial plaque buildup. It can be reversed through professional dental scaling and diligent home care, including twice-daily brushing and daily flossing.
Periodontitis
When plaque isn't removed through proper home care and regular scalings, it hardens into tartar. This buildup causes gums to recede, forming deeper pockets filled with bacteria and toxins, leading to inflammation, easy bleeding, and potential bone loss.
Advanced Periodontitis
The teeth lose more support as the gums, bone, and periodontal ligament continue to be destroyed by the bacteria and toxins present in the plaque and calculus. Unless treated, the affected teeth will become very loose due to bone loss around the teeth and may be lost. Generalized moderate to severe bone loss may be present.
Periodontal treatment depends on the disease's type and severity. Dentists and hygienists evaluate and recommend suitable treatments. Periodontal disease advances as pockets between teeth and gums fill with bacteria, plaque, and tartar, irritating surrounding tissues and damaging gums and bone. Without bone damage, early-stage gingivitis may be treated with one to two regular cleanings and improved oral hygiene instructions.
Advanced stages require scaling and root planing (deep cleaning), done one mouth quadrant at a time under local anesthesia. This procedure removes tartar, plaque, and toxins from above and below the gum line, smoothing root surfaces to promote gum healing and pocket reduction. Regular three-month cleanings are recommended for periodontal disease patients, along with medications, medicated rinses, and electric toothbrushes to control infection and aid healing. If pockets don't heal post-procedure, periodontal surgery may be necessary. A periodontist may also be consulted for specialized care.
Plaque can turn into tartar within 24 hours if not removed, making daily cleaning crucial. After periodontal treatment, dentists recommend maintenance cleanings four times a year to check pocket depths and remove difficult plaque and calculus. Regular cleanings ensure gum health by addressing hard-to-reach areas.
In addition to your periodontal cleaning and evaluation, your appointment will usually include:
- Examination of diagnostic X-rays: Essential for detection of decay, tumors, cysts, and bone loss. X-rays also help determine tooth and root positions
- Examination of existing restorations: Check current fillings, crowns, etc.
- Examination of tooth decay: Check all tooth surfaces for decay
- Oral hygiene recommendations: Review and recommend oral hygiene aids as needed. (Electric toothbrushes, special periodontal brushes, fluorides, rinses, etc.)
- Teeth polishing: Remove stain and plaque that is not otherwise removed during tooth brushing and scaling
Good oral hygiene practices and periodontal cleanings are essential in maintaining dental health and keeping periodontal disease under control!
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