Periodontal Diseases

Periodontal disease (also known as gum disease) are infections of the gum and bone that hold teeth in place.

Gingivitis is the initial stage of periodontal disease. Affected gum areas become increasingly red. They may appear swollen and may bleed easily, especially when you brush or floss your teeth. This condition is reversible at this stage with regular brushing, flossing and visits to the dentist. If it is not treated, however, gingivitis may lead to a more serious condition call periodontitis.

Periodontitis can irreversibly damage the gums, bones and other structures that support the teeth and it can lead to tooth loss. However, treatment can help. At more advanced stages, the disease may require more complex treatment to prevent tooth loss. In the worst case, teeth can become loose and need to be removed by the dentist. How periodontitis is treated often depends on how far the condition has progressed and how well your body responds to therapy over time.

Warning Signs

  • Gums that bleed easily
  • Red, swollen or tender gums
  • Gums that have pulled away from the teeth
  • Pus between the teeth and gums when the gums are pressed
  • Persistent bad breath or bad taste
  • Permanent teeth that are loose, separating or changing position
  • Any change in the way your teeth fit together when you bite
  • Any changes in the fit of partial dentures
  • Exposed tooth roots

How are periodontal diseases diagnosed?

If you schedule regular dental checkups, your dentist can detect developing periodontal diseases before the gums and the bone supporting your teeth are irreversibly damaged. Periodontal diseases are most often progressive - left untreated, the condition often becomes worse. During a checkup, our dentist examines your gums for periodontal problems. An instrument called a periodontal probe is used to gently measure the depth of the spaces between your teeth and gums. At the very edge of the gum line, healthy gums tissue forms a very shallow, v-shape groove (also known as a sulcus) between the tooth and gums. The normal depth of the sulcus should be 3 millimeters or less. When periodontal disease is present, this normally shallow sulcus develops into a deeper pocket that bleeds, collects more plaque bacteria and is difficult to keep clean. Dental X-rays also may be taken to evaluate the condition of bone and supporting the teeth and to detect other problems not visible during the clinical examination. If gum disease is diagnosed, our dentist may provide treatment, or you may be referred to a periodontist, a dentist who specializes in the diagnosis, prevention and treatment of periodontal diseases.

How are periodontal diseases treated?

The first non-surgical step usually involves a special cleaning, called scaling and root planing. This is sometimes referred to as "periodontal" or "deep" cleaning. Scaling and root planing is a method of treating periodontal disease when pockets are greater than 3mm. Scaling is used to remove plaque and tarter beneath the gum line. A local anesthetic may be given to reduce any discomfort. Using an instrument called a small scale or an ultrasonic cleaner, plaque and tartar are carefully removed down to the bottom of each periodontal pocket. The tooth's root surfaces are then smoothed or planed. This procedure helps gum tissue to heal and periodontal pockets to shrink. The procedure also makes it more difficult for plaque to accumulate along the root surfaces.

Depending on the extent of the disease, your dentist may recommend that one or more sections (quadrants) of the mouth be treated with scaling and root planing. Treatment requires one or more visits. You'll be given instructions on how to care for your healing teeth and gums.

Your dentist also may recommend medications to help control infection and pain, or to aid healing. These medications could include a pill, a mouth rinse, or a substance that the dentist places directly in the periodontal pocket after scaling and root planing. If you smoke or chew tobacco products, it is important to quit. Your dentist may also advise you to talk to your physician about any other health problems that may be affecting your oral health.

Once the scaling and root planing treatment is complete, another appointment will be made within a few weeks. At this appointment, the dentist will examine your gums to see how they have healed and how the periodontal pockets have decreased. Many patients do not require any further active treatment, only preventive care.

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