What is Periodontal Disease?
The word periodontal means “around the tooth”. Periodontal disease attacks the gums and the bone that support the teeth. Plaque is a sticky film of food debris, bacteria, and saliva. If plaque is not removed, it will then turn into calculus (tartar). When plaque and calculus are present, they begin to destroy the gums and bone. Periodontal disease is characterized by red, swollen, and bleeding gums.
Four out of five people have periodontal disease and don’t know it! Most people are not aware of it because the disease is usually painless in the early stages.
Not only is it the number one reason for tooth loss, but research also suggests that there may be a link between periodontal disease and other diseases such as stroke, bacterial pneumonia, diabetes, cardiovascular disease, and increased risk during pregnancy. Researchers are determining if inflammation and bacteria associated with periodontal disease affect these systemic diseases and conditions. Smoking also increases the risk of periodontal disease.
Periodontal Disease Symptoms
- Bleeding gums – Gums should never bleed, even when you brush vigorously or use dental floss.
- Loose teeth – Also caused by bone loss or weakened periodontal fibers (fibers that support the tooth to the bone).
- New spacing between teeth – Caused by bone loss.
- Persistent bad breath – Caused by bacteria in the mouth.
- Pus around the teeth and gums – Sign that there is an infection present.
- Receding gums – Loss of gum around a tooth.
- Red and puffy gums – Gums should never be red or swollen.
- Tenderness or Discomfort – Plaque, calculus, and bacteria irritate the gums and teeth.
What are the 4 Stages of Periodontal Disease?
Periodontal disease is diagnosed by your dentist or dental hygienist during a periodontal examination. This type of exam should always be part of your regular dental check-up.
A periodontal probe (small dental instrument) is gently used to measure the sulcus (pocket or space) between the tooth and the gums. The depth of a healthy sulcus measures three millimeters or less and does not bleed. The periodontal probe helps indicate if pockets are deeper than three millimeters. As periodontal disease progresses, the pockets usually get deeper.
Dr. Holbrook will use pocket depths, the amount of bleeding, inflammation, tooth mobility, etc., to make a diagnosis that will fall into a category below:
Gingivitis is the first stage of periodontal disease. Plaque and its toxic by-products irritate the gums, making them tender, inflamed, and likely to bleed.
Plaque hardens into calculus (tartar). Once calculus and plaque begin 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 then become very irritated, inflamed, and bleed easily. Slight to moderate bone loss may be present.
The teeth lose more support as the gums, bone, and periodontal ligament continues to be destroyed. Unless treated, the affected teeth will become very loose and may be lost. Generalized moderate to severe bone loss may be present.
Periodontal Disease Treatment
Periodontal treatment methods depend upon the type and severity of the disease. Your dentist and dental hygienist will evaluate for periodontal disease and recommend the appropriate treatment.
Periodontal disease progresses as the sulcus (pocket or space) between the tooth and gums gets filled with bacteria, plaque, and tartar, causing irritation to the surrounding tissues. When these irritants remain in the pocket space, they can cause damage to the gums and eventually, the bone that supports the teeth!
How Is Gingivitis Treated?
If the disease is caught in the early stages of gingivitis, and no damage has been done, 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.
How is Advanced Periodontal Disease Treated?
If the disease has progressed to more advanced stages, a special periodontal cleaning called scaling and root planing (deep cleaning) will be necessary. It is usually done one quadrant of the mouth at a time while the area is numb. In this procedure, tartar, plaque, and toxins are removed from above and below the gum line (scaling) and rough spots on root surfaces are made smooth (planing). This procedure helps gum tissue to heal and pockets to shrink. Medications, special medicated mouth rinses, and an electric toothbrush may be recommended to help control infection and healing.
If the pockets do not heal after scaling and root planing, periodontal surgery may then be necessary to reduce pocket depths, making teeth easier to clean. Your dentist may also recommend that you see a Periodontist (specialist of the gums and supporting bone).
What Our Patients Have to Say
“Thank you for giving me a beautiful smile. Words cannot express my gratitude. You really have changed my life, and for that I will be eternally grateful.” –Stephanie
“Thank you for the superb job you have done restoring my upper teeth. Not only am I no longer embarrassed to smile, I now feel confident smiling broadly and showing my new dental work. While you were generous in crediting the dental lab with the outcome, I know very well that the lab staff would not have been able to do their job without your having done yours so expertly. Furthermore, it has been a pleasure being around you and your staff. It is obvious that you all enjoy your work and take a great deal of pride in it.
Please accept my sincere thanks for the outstanding job. It would have been remiss of me not to let you know how thrilled I am with the results of the work you have done. Feel free to use this as an unsolicited endorsement of your practice, and be assured I will not hesitate to recommend you as the occasion arises.” -Don G.
Periodontal Disease Prevention
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.
After your periodontal treatment, your dentist and dental hygienist will recommend that you have regular maintenance cleanings (periodontal cleanings), usually four times a year. At these cleaning appointments, the pocket depths will then 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:
- Examination of diagnostic x-rays (radiographs): Essential for detection of decay, tumors, cysts, and bone loss.X-rays also help determine tooth and root positions.
- Examination of tooth decay: Check all tooth surfaces for decay.
- Oral cancer screening: Check the face, neck, lips, tongue, throat, cheek tissues, and gums for any signs of oral cancer.
- Examination of existing restorations: Check current fillings, crowns, etc.
- Oral hygiene recommendations: Review and recommend oral hygiene aids as needed. (Electric toothbrushes, special periodontal brushes, fluorides, rinses, etc.)
- Teeth polishing: Remove stain and plaque that is is still present after tooth brushing and scaling.
Good home oral hygiene practices and periodontal cleanings are essential in maintaining dental health and keeping periodontal disease under control!
Periodontal Treatment FAQs:
Can I Have Gum Disease Without Bleeding Gums?
Bleeding gums is one of the most talked-about symptoms of gum disease. It's not the only one, though. Yes, you can have gingivitis or gum disease and not experience this symptom. In fact, people who smoke are quite likely to have gum disease, even advanced periodontal disease, without noticing "pink in the sink." This is because of the way that smoking inhibits blood flow to surface tissues, including the gums. There are other reasons bleeding may not occur when gum disease is present. You may simply not stimulate the gums in the affected area enough to cause bleeding or may not be touching the affected area at all. Gum disease is largely a condition that is caused by a lack of hygiene in one or more parts of the mouth. While you may not have bleeding, there are other signs that can alert you to the presence of harmful bacteria. These include chronic bad breath, the appearance of "long teeth", visible gum recession, and tooth sensitivity or pain.
I've Heard Gum Disease and Diabetes are Somehow Related. How are They?
Gum disease and diabetes are two completely different conditions. One is considered a dental problem while the other is considered a chronic health condition. How could the two be linked? According to studies, one inherently affects the other. This may occur in numerous ways. When blood sugar is not regulated, as it isn't in diabetics, there is less efficient circulation in some areas of the body. There is higher inflammation and lowered ability to fight infection. These conditions make it more difficult for the body to respond to conservative treatments, such as routine cleanings that help correct gingivitis. Conversely, according to the American Diabetes Association, chronic inflammation in the body, a state that is influenced by gum disease, can make it more difficult to regulate blood sugar levels, making a person more susceptible to diabetes. While concerning, this data actually provides insight that can help people prevent and manage diabetes through proper oral hygiene.
How is it that Gum Disease Can Affect My Cardiovascular Health?
Multiple studies have linked gum disease and poor cardiovascular health, showing a significant increase in the risk of high blood pressure, heart attack, and stroke when gum disease is present. In this instance, the concern is bacterial overload. Gum disease is a chronic infection that occurs when there are too many harmful bacteria in the mouth. These microorganisms stick to teeth in plaque and tartar. They invade the gums and collect in pockets that form when the gum tissue is weakened. Bacteria are living organisms, which means they may not stay put in one area of the body. From the mouth, bacteria can enter the bloodstream. Here, they can get lodged in the walls of your arteries, where they contribute to atherosclerosis.
Does Gum Disease Run in the Family?
As you've come to deal with your own experience of gingivitis and gum disease, you may have learned that others in your family share this struggle. It's been suggested that gum disease can "run in the family." It can. However, this may not be in the way you'd normally think of a genetic condition. Gum disease is not genetic. There is no shared gene that makes you more susceptible to developing gum disease. It's much more likely that you share family dietary habits and also oral care habits. Who taught you how to take care of your teeth? If that person has or had gum disease, there's a strong potential that they didn't teach you optimal oral care habits. The same people who taught you how to brush, floss, and eat were the same people who took you to the dentist (or not). So, gum disease running in families is more about learned habits than genetics. The good news about this is you can always learn new habits!