Preventative Dentistry

Periodontal Disease

Diagnosis

Periodontal Disease can be diagnosed by a dentist during your periodontal dental examination.

A periodontal probe (a small dental instrument) is gently used to measure the succus, pocket or space between the tooth and the gum. The depth of a healthy gum sulcus measures 3mm or less and does not bleed. If the gums bleed this indicates the presence of periodontal disease.

The periodontal probe indicates if the pocket is deeper than 3mm. As periodontal disease progresses due to poor oral hygiene, the pockets get much deeper.

Your dentist will use pocket depth, the amount of bleeding, inflammation, tooth mobility and other guides to make a diagnosis that will fall in to a 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. 

Periodontitis

Plaque hardens into calculus (tartar). As calculus and plaque continue to build up, the gums begin to recede from the teeth; as a result, the roots are quite often visible, which may result in increased sensitivity.

Deeper pockets form between the gums and teeth and become filled with bacteria and pus. The gums become very irritated, inflamed, and bleed easily. There may also be a presence of tooth mobility and also a bad odour or halitosis.

Advanced Periodontitis

The teeth begin to lose more support as the gums, bone, and periodontal ligaments continue to be destroyed. During this later stage of gum disease the chances of periodontitis are increased, the infected teeth become loose and very mobile, and it may be uncomfortable to bite due to pain.

General to moderate bone loss may be present.

Treatment of Periodontal Disease

The treatment methods for periodontal disease depend on the type, severity and stage of the disease. Your doctor will evaluate the periodontal disease and recommend the appropriate treatment for you.

Periodontal disease progresses as the succus (or pockets between the teeth and gums) fill with bacteria, plaque, and tartar. These cause irritation to the surrounding tissue and result in the gums becoming red, inflamed and prone to bleeding. When these irritants remain, 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, one to two regular cleans will be recommended. You will be given instructions on improving your daily oral hygiene habits and having regular dental cleanings.

If the disease has progressed to a more advanced stage, a root planning (deep cleaning) proceedure is recommended.
This is usually performed on one part of the mouth at a time while the area is numb. In this procedure the tartar, plaque and toxins are removed from the infected gum area and root surfaces are made smooth by cleansing.

This procedure helps gum tissue to heal better and reduces the size and depth of the pockets. Medication, special medicated mouth washes, and an electric toothbrush may be recommended to help control the infection and to promote healing.

If the pockets do not heal after scaling and root cleansing, periodontal surgery may be needed to reduce pocket depths, making it easier for you to clean your teeth.

You may be recommend to see a periodontitis if it is necessary.

Maintenance

It only takes 24 hours for plaque that has not been removed from your teeth to turn into tartar! Therefore it is essential for your daily home regimen to control this plaque and tartar formation; it is important that you reach those hard-to-get-to areas.

Once your periodontal treatment has been completed, your dentist will recommend that you have regular maintenance cleanings (Periodontal cleanings) usually two to four times a year. At these cleaning appointments, the pocket depth will be carefully checked to ensure that your gums are healthy.

Plaque and calculus that is difficult for you to remove at home will be removed by an ultrasonic scaler. Sometimes plaque and calculus form below the gum line, and is is invisible to the eye.

In addition to your periodontal cleaning and evaluation, your appointment will usually include:

• Examination of diagnostic X-rays. This serves to detect decay, tumours, cysts, and bone loss.
• X-rays also help to determine tooth and root positions.
• The examination of existing restorations.
• Checking current fillings and crowns.
• Examination of tooth decay; checking all tooth surfaces for decay.
• Oral cancer screening: checking the face, neck, lips, tongue, cheek, throat and gum tissue for any signs of oral cancer.
• Hygiene recommendations: reviewing and recommending oral hygiene agents that may be needed, such as an electric toothbrush, special periodontal brush, fluorides, rinses, and mouth washes.
• Teeth polishing to remove stains and plaque that is not otherwise removed during tooth brushing and scaling.

Finally, good oral hygiene practices and periodontal cleaning are essential in maintaining dental health and keeping periodontal diseases under control.