What is Periodontal Disease?
Periodontal means “around the tooth.” This disease destroys the gum tissue and bone that anchor the teeth in your mouth.
It is a destructive, progressive disease that begins with the daily formation of bacterial plaque. The bacteria will collect below the gumline and produce toxins that attack the surrounding tissues. Eventually the supporting bone is destroyed.
It causes 70% of the tooth loss in American adults. Unfortunately, most adults are not aware of their disease, because its symptoms are so subtle.
Causes of Periodontal Disease
The accumulation of bacterial plaque is always the primary cause of periodontal disease. Plaque is the sticky, colorless film that is constantly forming on your teeth. When it is not effectively removed, it hardens into calculus (commonly called tartar).
- Smoking (the #1 risk!)
- Hormonal Changes (puberty, pregnancy, menopause)
- Certain Medications
- Diabetes and other systemic or immune-suppressive diseases
- Problems with your bite
- Poorly done or overly large or old fillings
Stages of Periodontal Disease
HEALTH: Gum tissue (or gingiva) and bone hold the teeth firmly in place. The tissue has healthy color and firmness. Probe measurements are 3mm or less.
GINGIVITIS: Gums may bleed and are swollen, but the bone is not affected. Probings are typically 3mm to 4mm in depth.
EARLY TO MODERATE PERIODONTITIS: Gingiva becomes more red and swollen and bleeds more easily. Recession may occur. Bad breath and taste are apparent. Bone begins to break down. Pockets deepen to 4-6mm.
ADVANCED PERIODONTITIS: The disease worsens. Teeth may become loose or drift; bad breath may be constant. The roots of the teeth may become exposed and sensistve to heat and cold. Bone loss will be severe and pockets will be in excess of 5mm.
The Hygienist’s Assessment
Evaluating the extent of your diseased state will be important in deciding the right treatment for you and will help us monitor the results of our therapy. Your hygienist and doctor will
- Take complete medical and dental history
- Perform a careful oral exam
- Take a full mouth series of X-rays
- Use a probe to measure and record the gum pocket depth, bone loss, recession levels, bleeding sites, and mobility of your teeth.
- Models of your teeth may be made to study your bite
Treating Active Periodontal Disease
The treatment of your disease will depend upon how severely the gum and bone loss has progressed. Your hygienist will determine the best type of treatment for your needs.
PROPHYLAXIS: This is the “cleaning” or prophy you may have had in the past. It will remove plaque and calculus from above the gumline. This treatment is for those with healthy gums and mild gingivitis. A prophylaxis is NOT effective in treating other forms of periodontal disease.
SCALING and ROOT PLANING: These nonsurgical procedures are used to treat active disease. Our goals WILL be to eliminate bleeding, swelling, and infection, reduce pocket depth, and regain tissue attachment at the base of the pocket.
SCALING: Will remove bacterial plaque, hard deposits and pus from within the deep pockets.
ROOT PLANING: Will smooth the roots and remove toxins that have infected the surrounding tissue. It is usually performed on one section of your mouth at a time and can take up to six visits to complete. We may recommend that we numb the area for your comfort. Most patients have little to no tenderness when the numbness wears off.
Maintenance of Periodontal Health
- The tissue and bone that is destroyed in periodontal disease cannot be regained or “cured”. The goal of treatment is to eliminate the disease that is present and to establish a personal regimen that will prevent its return in your mouth, which would case further destruction.
- After scaling and root planing visits, your hygienist will reevaluate your gum and bone condition and your plaque levels and decide on a recall or “recare” schedule to fit your needs. Most patients that have gotten periodontal disease will require more frequent maintenance visits than the regular, twice-yearly “cleaning”. Studies show that a 3 to 4 month maintenance schedule can help insure a healthy, stable, outcome.
- Just as important will be the steps you will take to remove the daily re-accumulation of plaque deposits. Again, the primary cause of dental disease, plaque, is constantly forming in your mouth and needs to be carefully and diligently removed every 24 hours. We will be happy to customize a home care routine based on your needs and help you select the oral care products that will maintain your health.
- In the event that our therapy and your home efforts are not successful in controlling the disease, a referral to a periodontal specialist may be necessary.