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Diagnosis & Treatment

Periodontal disease (also known as periodontitis and gum disease) is a progressive condition and the leading cause of tooth loss among adults in the developed world.


What causes gum disease?

Periodontal disease occurs when the toxins found in plaque begin to irritate or inflame the gingiva (gum tissue).  The resulting bacterial infection often known as gingivitis, can eventually lead to the destruction of the gum tissue and underlying bone. If periodontal disease is not treated, it can also lead to loose teeth or tooth loss.

Common Causes:

  • Poor dental hygiene
  • Tobacco use
  • Genetic predisposition
  • Pregnancy and menopause
  • Chronic stress and poor diet
  • Diabetes and underlying medical issues
  • Grinding teeth
  • Medication

Common Signs & Symptoms

  • Unexplained bleeding
  • Pain, redness or swelling
  • Longer-looking teeth
  • Bad breath/halitosis
  • Loose teeth/change in bite pattern
  • Pus

Diagnosis

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.

Your dentist or hygienist will use pocket depths, amount of bleeding, inflammation, tooth mobility, etc., to make a diagnosis that will fall into 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. Deeper pockets form between the gums and teeth and become filled with bacteria and pus. The gums become very irritated, inflamed, and bleed easily. Slight to moderate bone loss may be present.

Advanced Periodontitis

The teeth lose more support as the gums, bone, and periodontal ligament continue 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.


Treatment of Periodontal Disease

It is of paramount importance to halt the progression of periodontal disease before it causes further damage to the gum tissues and jawbone. 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.

In the case of moderate periodontal disease, the pockets (under the gumline) of the teeth will be completely cleared of debris using a procedure called scaling and root planing. The pockets may be filled with antibiotics to promote good healing and kill any bacteria that remain.

Severe periodontitis can be treated in several different ways, including:

  • Laser treatment – This can be used to reduce the size of the pockets between the teeth and the gums.
  • Tissue & bone grafting – Where a considerable amount of bone or gum tissue has been destroyed, the dentist may elect to graft new tissue by inserting a membrane to stimulate tissue growth.
  • Pocket elimination surgery – The dentist may choose to perform “flap surgery” to directly reduce the size of the gum pockets.

Preventing periodontal disease is critical in preserving the natural dentition. Addressing the causes of gum disease and discussing them with your dentist will help prevent the onset, progression, and recurrence of periodontal disease.


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