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 is gently used to measure the sulcus, which is a 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. Pockets measuring four millimetres are usually an indication gingivitis, or an inflammation of the gums. As periodontal disease progresses, the pockets get deeper. Pocket of five millimetres and higher indicated periodontal disease. 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 is the first stage of periodontal disease. Plaque which contains bacteria and its toxin by-products irritate the gums, making them tender, inflamed, and likely to bleed. Gingivitis is reversible by having a thorough dental scaling followed by excellent home care which includes brushing twice per day and daily flossing.
As plaque is left on the teeth, due to improper home care and lack of regular dental scalings, it 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 other toxins. The gums become very irritated, inflamed, and bleed easily. Slight to moderate bone loss may also be present.
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 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, the pocket, 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 to the bone, 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 as the gums reattach to the tooth surface. Regular three months are recommended for clients with periodontal disease. 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 who specializes in periodontal disease.
It only takes twenty four hours for plaque that is not removed from your teeth to turn into calculus (tartar)! Daily home cleaning helps control plaque and tartar formation, but those hard to reach areas will always need special attention.
Once your periodontal treatment has been completed, your dentist and dental hygienist will recommend that you have regular maintenance cleanings (periodontal cleanings), usually four times a year. At these cleaning appointments, the pocket depths will be carefully checked to ensure that they are healthy. Plaque and calculus that is difficult for you to remove on a daily basis will be removed from above and below the gum line.
In addition to your periodontal cleaning and evaluation, your appointment will usually include:
- Examination of diagnostic x-rays (radiographs): 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!
Tooth whitening (or bleaching) is a simple, non-invasive dental treatment used to change the color of natural tooth enamel and is an ideal way to enhance the beauty of your smile.
Because having whiter teeth has now become the number one aesthetic concern of most patients, there are a number of ways to whiten teeth. The most popular method is using a home tooth whitening system that will whiten teeth dramatically over the course of approximately 2 weeks. In-office bleaching is also a great alternative for those looking for a one-time bleaching session. Bleaching works by removing accumulated stains from within the teeth, hence returning the teeth to their original colour. Since tooth whitening only works on natural tooth enamel, it is important to evaluate replacement of any old fillings, crowns, etc. Replacement of any restorations will be done after bleaching so they will match the newly bleached teeth.
Tooth whitening is not permanent. A touch-up maybe needed every several years, and more often if you smoke, drink coffee, tea, or wine.
Reasons for tooth whitening:
- Fluorosis (excessive fluoridation during tooth development)
- Normal wear of outer tooth layer
- Stained teeth due to medications (tetracycline, etc.)
- Yellow, brown stained teeth
What does tooth whitening involve?
This type of tooth whitening usually requires two visits. At the first appointment, impressions (molds) will be made of your teeth to fabricate custom, clear plastic, trays.
At your second appointment, you will try on the trays for proper fit, and adjustments will be made if necessary. The trays are worn with special whitening solution either twice a day for 30 minutes or overnight for a couple of weeks depending on the degree of staining and desired level of whitening. It is normal to experience tooth sensitivity during the time you are whitening your teeth, but it will subside shortly after you have stopped bleaching.
You will receive care instructions for your teeth and trays, and be encouraged to visit your dentist regularly to help maintain a beautiful, healthy, white smile.
In-office bleaching usually requires a 1 hour appointment in which 1-3 sessions (more if required) of bleaching are preformed using an ultraviolet light. This type of bleaching can also be followed by take home bleaching trays to achieve desired results.