Periodontal disease is an infection of the tissues that support your teeth. Your gum tissue is not attached to the teeth as high as it may seem. There is a very shallow v-shaped crevice called a sulcus between the tooth and gums. Periodontal diseases attack just below the gum line in the sulcus, where they cause the attachment of the tooth and its supporting tissues to break down. As the tissues are damaged, the sulcus develops into a pocket: generally, the more severe the disease, the greater the depth of the pocket.
Periodontal diseases are classified according to the severity of the disease. The two major stages are gingivitis and periodontitis. Gingivitis is a milder and reversible form of periodontal disease that only affects the gums. Gingivitis may lead to more serious, destructive forms of periodontal disease called periodontitis.
It is possible to have periodontal disease and have no warning signs. That is one reason why regular dental checkups and periodontal examinations are very important. Treatment methods depend upon the type of disease and how far the condition has progressed. Good oral hygiene at home is essential to help keep periodontal disease from becoming more serious or recurring. You don’t have to lose teeth to periodontal disease. Brush, clean between your teeth, eat a balanced diet, and schedule regular dental visits for a lifetime of healthy smiles.
Some factors increase the risk of developing periodontal disease:
- Tobacco smoking or chewing
- Systemic diseases such as diabetes
- Some types of medication such as steroids, some types of anti-epilepsy drugs, cancer therapy drugs, some calcium channel blockers and oral contraceptives
- Bridges that no longer fit properly
- Crooked teeth
- Fillings that have become defective
- Pregnancy or use of oral contraceptives
Several warning signs that can signal a problem:
- Gums that bleed easily
- Red, swollen, tender gums
- Gums that have pulled away from the teeth
- Persistent bad breath or bad taste
- Permanent teeth that are loose or separating
- Any change in the way your teeth fit together when you bite
- Any change in the fit of partial dentures
Periodontitis is usually a slow process that takes years to become a severe problem. Like a slow leaky pipe though, over time you may find a pool in your basement. As the disease progresses and bone loss becomes more pronounced, it becomes more difficult to clean at home. If periodontitis is allowed to go unchecked, the result is usually teeth that become so loose they either fall out or need to be extracted due to infection. The presence of tartar on the roots of the teeth may make the problem more severe. For this reason it is very important for those patients with periodontitis (and remember many who have it do not know it because they don’t see their dentist) to have their teeth cleaned professionally.
Initial therapy for periodontitis is usually called scaling and root planing. This procedure encompasses a number of steps. First we measure the depth of the pocketing (the amount of bone loss around the root of the tooth) that has taken place. This is a baseline measurement that will allow us to track progress as the gums tighten up after treatment. Next we use specialized instruments to remove tartar and clean the teeth above and below the gum tissue. Depending on the patients tolerance, we may need to anesthetize (get numb) during this part. The gums will normally bleed some during this procedure and probably for a few days after. They will, however, be much healthier after this deep cleaning. Scaling and root planing will take between 1-4 appointments depending on the difficulty of the case. Once completed regular checkups and cleanings (every 3-6 months) is recommended. If regular appropriate checkups are completed after treatment, scaling and root planing should not need to be done again for years.