PERIODONTICS

Gum Disease

Above is a diagram of gum disease that shows a deep space between the gums and teeth.  The deep space is corrected through surgical techniques.

ARE YOUR GUMS HEALTHY?

Healthy gums should not bleed easily, be painful or tender to touch or appear red and swollen. If these symptoms do exist, it may be a sign of early gum disease called gingivitis. Other symptoms may include mouth odor, loose or shifting teeth, pus formation, or changes in the shape of the gums (receding or enlarged gums).

The best way to diagnose early gum disease is by a periodontal exam. Periodontics is the study of the structures which surround and support the teeth, for example, bone, gums, blood vessels and nerves.

WHAT IS A PERIODONTAL EXAM?

In a periodontal exam the dentist is looking for signs of early gum disease. If left untreated, gum disease progresses and can result in bone loss. Advanced gum disease, called periodontitis (or pyorrhea), is often diagnosed by x-rays and probing which show the amount of bone loss already suffered.

Bone loss can be measured because there are spaces (pockets) which occur naturally between the teeth and gums. Normally these spaces are only one to three millimeters deep. Pockets which are greater than five millimeters deep usually indicate advanced periodontal disease and probable bone loss.

WHAT CAUSES PERIODONTAL DISEASE?

Periodontal disease is caused by a combination of plaque and bacteria. Plaque is a sticky colorless film which can form on teeth within hours of eating from food left on the teeth.

Bacteria in the mouth forms colonies within plaque and creates infection. As an infection progresses, it can cause normal gums to reshape themselves causing abnormal pockets or other problems. Serious infection leads to bone loss.

WHAT IS THE TREATMENT?

The goal of periodontal treatment is to stop bone loss by eliminating infection and preventing its return. Initial treatment involves deep and thorough cleaning of the teeth beyond that which is done during a normal cleaning. Through a process called root planning and curettage, the dentist will remove all plaque, tartar and infected tissue.

If the initial treatment does not sufficiently reduce pocket depths, the dentist will eliminate deep pockets using various surgical procedures. Surgical techniques reshape the gums by removing tissue or repositioning the gums. When deep pockets are eliminated food is less likely to be trapped, it can be easily removed, and plaque is less likely to form.

HOW SUCCESSFUL IS THE TREATMENT?

Overall, periodontal treatment is very successful but this success depends greatly on prevention and maintenance. The patient must continue to brush and floss on a daily basis and must have regular professional cleanings.

The dentist will also measure the continued success of periodontal treatment by periodic evaluations of the patient. During these evaluations the dentist will measure pocket depths and look for other symptoms. On occasion, it may be necessary to perform follow-up procedures.

CAN PERIODONTAL DISEASE BE PREVENTED?

Yes. Complete removal of plaque can prevent bacteria from creating the infectious process which causes periodontal disease. Proper brushing and flossing is the best way to remove plaque.

no plaque = no bacteria = no infection

If plaque is left on the teeth for long periods of time, it will harden to form calculus (or tartar). Calculus attaches so firmly to teeth it can not be removed by brushing or flossing alone. It can only be removed by the dentist or hygienist at your scheduled cleaning appointment. It is important to brush as soon after eating as possible to prevent the formation of calculus.

WHAT ARE THE SIGNS AND SYMPTOMS OF GUM DISEASE?

To discover if you have gum disease look for:

	red bleeding gums;
	tender, painful gums;
	loose shifting teeth;
	pus formation; mouth odor; and,
	change in the shape of the gums.

Bone loss is painless. The only way to be sure these signs indicate gum disease is through dental examination and diagnosis with x-rays.