WHAT IS PERIODONTAL (GUM) DISEASE?

The term “periodontal” means “around the tooth.”  Periodontal disease (also known as periodontitis and gum disease) is a common inflammatory condition that affects the supporting and surrounding soft tissues of the tooth; also the jawbone itself when in its most advanced stages.

Periodontal disease is most often preceded by gingivitis which is a bacterial infection of the gum tissue.  Gingivitis is characterized by inflamed bleeding gums. With proper oral hygiene, it is generally reversible. However,  once this bacterial infection colonizes in the gum pockets between the teeth, it becomes much more difficult to remove and treat.
Periodontal disease is a progressive condition that eventually leads to the destruction of the connective tissue and jawbone.  If left untreated, it can lead to shifting teeth, loose teeth, and eventually tooth loss. Periodontal disease is the leading cause of tooth loss among adults in the developed world and should always be promptly treated.

DIAGNOSIS
Periodontal disease is diagnosed by your dentist during a periodontal examination.  A periodontal probe (small dental instrument) is gently used to measure the pocket or space between the tooth and the gums.  A healthy pocket measures three millimeters or less and does not bleed.   As periodontal disease progresses, the pockets usually get deeper.
Your dentist will use pocket depths, amount of bleeding, inflammation, tooth mobility, and information from your x-rays to make a diagnosis that will fall into the 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. With proper home care and regular dental cleanings, this can usually be reversed.

• Periodontitis

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. 

• Advanced Periodontitis

The teeth lose more support as the gums and underlying bone continues to be destroyed. Unless treated, the affected teeth will become very loose and may be lost. 

TREATMENT
Periodontal treatment methods depend upon the type and severity of the disease.  Your dentist will evaluate for periodontal disease and recommend the appropriate treatment. If the disease is caught in the early stages of gingivitis, 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.  This procedure helps gum tissue to heal and pockets to shrink. Local or low-dose antibiotics may also be used in conjunction with deep cleanings to maximize results. 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.  

MAINTENANCE
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 will recommend that you have regular maintenance cleanings (periodontal cleanings). 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:
Good oral hygiene practices and periodontal cleanings are essential in maintaining dental health and keeping periodontal disease under control!