Periodontal Care
What is Periodontal Care?
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 turns into calculus. When plaque and calculus are not removed, they begin to destroy the gums and bone. Periodontal disease is characterized by red, swollen, and bleeding gums.
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, research suggests that there may be a link between periodontal disease and other diseases as well. Smoking also increases the risk of periodontal disease.
Good oral hygiene, a balanced diet, and regular dental visits can help reduce your risk of developing periodontal disease.
Signs & Symptoms of Periodontal Disease may include:
Bleeding gums: Gums should never bleed, even when you brush vigorously or use dental floss.
Loose teeth: 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 of infection
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.
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 to indicate the depth.
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
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!
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.
If the disease has progressed to more advanced stages, a special periodontal cleaning called scaling and root planning (deep cleaning) will be recommended. It is usually done one quadrant or one side of the mouth at a time while the area is numb. In this procedure, tartar, plaque, and diseased tissues are removed from above and below the gum line (scaling) and rough spots on root surfaces are made smooth (planning). This procedure helps gum tissue to heal and pockets to shrink. Medications, special medicated mouth rinses, and an electric tooth brush may be recommended to help control infection and healing.
If the pockets do not heal after scaling and root planning, periodontal surgery may be needed 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).
Maintenance
Daily home cleaning helps control plaque and tartar formation, but those hard to reach areas will always need special attention.
Once your periodontal treatment has been completed, 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 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.
Good oral hygiene practices and periodontal cleanings are essential in maintaining dental health and keeping periodontal disease under control.