Gum disease (periodontal disease) is an infection in the gums that surround your teeth. Gum disease needs to be taken very seriously because it is one of the primary causes of tooth loss in adults. Many people do not realize they have the disease as it can be pain free. To ensure early detection, we will check for signs and symptoms at your regular exams.
Periodontal disease is first diagnosed during your exam. We will look for signs and symptoms of the disease at your initial visit and continue to monitor at your regular dental check-ups. If you show signs or symptoms of the disease, we will recommend a more extensive exam for a full tooth by tooth diagnosis.
During your periodontal exam, we will gently measure the space between your teeth and gums. A healthy gum will measure no more than three millimeters and will not bleed. As periodontal disease progresses, the pockets will become deeper. Based on pocket depths, bleeding, inflammation, mobility of the tooth, etc., your hygienist and doctor will make a diagnosis.
Stages of the disease:
The first stage of periodontal disease is gingivitis. Plaque on the teeth irritates the gums, making them tender, inflamed, and likely to bleed.
When plaque hardens it turns into calculus (tartar). As calculus and plaque builds up, the gums will start receding from the teeth. Pockets form between the teeth and the gums and become filled with bacteria and pus. The gums at this point are very red, swollen and will bleed easily. Some bone loss may occur.
As the gums, bone and ligaments become more and more destroyed, the teeth lose their support system. At this point, the teeth may become very loose and may even fall out. Bone loss (possibly severe) will be present.
Based on the stage of your disease, the dentist and hygienist will recommend an appropriate treatment plan for you.
If the disease is caught early on (Gingivitis) and no long term damage has been done, one to two cleanings will be recommended. The extra cleaning will help “catch you up” for cleanings you may have missed in the past. To prevent future issues, regular 6 month cleanings and improvement to your daily hygiene will be needed.
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.
If the disease has become more advanced, scaling and root planing (a deep cleaning) will be recommended. It is usually done one side at a time and the area will be numbed. Scaling involves removing any tartar or plaque that has formed above and below the gum line. Root planing is the process of smoothing the root surfaces. Scaling and Root planing help shrink pockets and allows gum tissue to heal.
If the gums still do not heal after scaling and root planing, periodontal surgery may be needed. Dr. Kirschbaum is skilled in the treatment of more advanced periodontitis and will perform gum surgery to reduce the gum pocket.
After treatment, regular maintenance is needed. Perio Maintenance (a more advanced cleaning) needs to be performed, in place of a regular cleaning, 2 to 4 times a year (depending on your condition). It can take only one day for plaque that is not removed from the teeth to turn into calculus. When you brush your teeth you are removing the majority of the plaque but those harder to reach areas will always need special attention.
At your perio maintenance cleanings, your pockets will be checked. Calculus and plaque will be removed from both above and below the gum line as needed. In addition, your appointment will also include what is done during a conventional cleaning (x-rays as needed, examination of existing restorations, examination of tooth decay, oral cancer screening, a review of good hygiene practices and teeth polishing).
Good oral hygiene and regular periodontal cleanings are essential to keep periodontal disease under control and maintain good health!